400-A:1 Department Continued. 

There is continued the department of state government known as the insurance department, which shall be an independent regulatory agency.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:10 Staff. 

I. The commissioner may, within the limits of available funds, appoint or employ and prescribe the duties of such assistants, actuaries, examiners, clerks, and other employees as may be necessary to discharge the duties placed upon the insurance department by RSA title XXXVII.

II. The commissioner may from time to time contract for and procure on a fee or independently contracting basis, such additional actuarial, examination, rating, and other technical and professional services as he may deem necessary for the discharge of his duties. None of the individuals rendering such services pursuant to this paragraph shall be in the classified service of the state; provided, however, the commissioner may authorize, in his discretion, the payment of group hospitalization, hospital medical care, surgical care and other medical benefits, social security benefits, annual and sick leave benefits and such other benefits as are afforded to classified state employees, except participation in the New Hampshire retirement system, to such individuals who have been employed for 6 months or more as he shall determine.

III. If necessary to ensure the timely review of rates and forms submitted for approval under title XXXVII, the commissioner may retain, without appropriation under RSA 9 and without qualifying as a department expenditure under RSA 4:15, independent actuaries or other professionals or specialists as reviewers, the cost of which shall be borne by the regulated entity whose rates or forms are the subject of the review. The entity shall pay the retained professional or specialists directly for their costs. The commissioner shall conduct oversight of such independent reviewers in a manner that is consistent with standards for the use of independent reviewers established by the National Association of Insurance Commissioners in its Financial Condition Examiners Handbook and Market Regulation Handbook and shall ensure that costs are reasonable for the work performed. The amount paid by the company under this paragraph in any fiscal year shall be applied as a nontransferable credit against and to the extent of the company's administrative fee under RSA 400-A:39 in the subsequent fiscal year and not thereafter.


Source. 1971, 244:1. 1977, 499:4. 1987, 411:6. 1988, 62:4. 2017, 218:3, eff. July 10, 2017. 2022, 143:1, eff. Aug. 6, 2022.

    400-A:11 Advisory Councils and Committees. 

I. The commissioner may create advisory councils and committees to assist him in dealing with regulatory problems, may appoint members and may provide by rule for the regular creation, governance, duties and termination of any council or committee he establishes.

II. Members of advisory councils or committees shall be reimbursed for their necessary expense of travel and subsistence. Said expenses shall be a charge upon available funds and the appropriation of the insurance department.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:12 Prohibited Interests. 

I. The commissioner, deputies, assistants, actuaries, examiners, or employees of the department shall not be connected with the management or be holder of material number of shares of any insurer, insurance holding company, insurance agency or broker, or be pecuniarily interested in any insurance transaction except as authorized under Title XXXVII in their official capacity, or as a policyholder or claimant under a policy; except, that as to matters wherein a conflict of interests does not exist on the part of any such individual, the commissioner may employ and retain from time to time insurance actuaries, examiners, accountants, and other technicians who are independently practicing their professions even though from time to time similarly employed or retained by insurers or others.

II. Nothing contained in this section shall be deemed to prohibit:

(a) Receipt by any such individual of fully vested commissions or fully vested retirement benefits to which entitled by reason of services performed prior to becoming commissioner or prior to employment in the department.

(b) Investment in shares of regulated diversified investment companies.

III. No person who has formerly served as a commissioner, deputy, assistant, actuary, examiner, or otherwise as an employee of the department nor any person that has been retained by the commissioner under Title XXXVII, shall disclose any third party confidential information gained by reason of such public position, nor shall any person otherwise use such information for personal gain or benefit. Nothing in this paragraph shall be construed to limit any protections that an employee or a former employee has under RSA 275-E.


Source. 1971, 244:1. 2017, 6:1, eff. Mar. 31, 2017.

    400-A:13 Delegation of Powers. 

I. The commissioner may delegate to his deputies, assistants, actuaries, examiners, or employees of the department the exercise or discharge in the commissioner's name of any power, duty, or function, whether ministerial, discretionary or of whatever character, vested in or imposed upon the commissioner. However, he shall not delegate his rulemaking powers upon RSA 400-A:15.

II. The official act of any such person acting in the commissioner's name and by his authority shall be deemed an official act of the commissioner.


Source. 1971, 244:1. 1986, 210:2, eff. June 6, 1986.

    400-A:14-a Health Insurance Coverage. 

No resident of this state, regardless of whether he or she has or is eligible for health insurance coverage under any policy or program provided by or through his or her employer, or a plan sponsored by the state or the federal government, shall be required to obtain or maintain a policy of individual insurance coverage except as required by a court or the department of health and human services where an individual is named a party in a judicial or administrative proceeding. No provision of this title shall render a resident of this state liable for any penalty, assessment, fee, or fine as a result of his or her failure to procure or obtain health insurance coverage. This section shall not apply to individuals voluntarily applying for coverage under a state-administered program pursuant to Title XIX or Title XXI of the Social Security Act. This section shall not apply to students being required by an institution of higher education to obtain and maintain health insurance as a condition of enrollment. Nothing in this section shall impair the rights of persons to privately contract for health insurance for family members or former family members.


Source. 2011, 266:1, eff. July 1, 2011.

    400-A:14 Orders, Notices. 

I. The commissioner shall issue upon hearing such prohibitionary and mandatory orders as are reasonably necessary to secure compliance with insurance laws, rules, and regulations. Orders and notices of the commissioner shall be effective only when in writing signed by him or by his authority. Except as otherwise expressly provided by law as to particular orders, every order of the commissioner shall state its effective date and shall concisely state:

(a) its intent or purpose;

(b) the grounds on which it is based; and

(c) the provisions of this title pursuant to which action is taken or proposed to be taken; but failure to so designate a particular provision shall not deprive the commissioner the right to rely thereon. Except as provided as to particular procedures, an order or notice may be given by delivery to the person to be ordered or notified, or by mailing it, prepaid, addressed to such person at his principal place of business or residence as last of record in the department. The order or notice shall be deemed to have been given when deposited in a depository of the United States Postal Service, and of which the affidavit of the individual who so mailed the order or notice shall be prima facie evidence.

II. If any person is entitled to a hearing by any provision of this title before any proposed action is taken, the notice of the proposed action may be in the form of a notice to show cause stating that the proposed action may be taken unless such person shows cause at a hearing to be held as specified in the notice, why the proposed action should not be taken, and stating the basis of the proposed action.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:15-a Standardized Claim Forms for Health Insurance. 

All health insurers, health maintenance organizations, health service corporations, hospital service corporations, medical service corporations, preferred provider programs and third party administrators shall use "HCFA-1500" and "UB-92" forms for all paper and electronic submissions and shall not routinely require additional forms or information. When CMS officially replaces the "HCFA-1500" or the "UB-92" form, the replacements shall be considered the official form under this section.


Source. 1993, 127:1. 1996, 188:1. 2003, 145:5, eff. Aug. 16, 2003.

    400-A:15-b Confidentiality of Provider's Personal Information. 

I. Health insurers and other third party payors shall not display a medical provider's home address, date of birth, or social security number on documents provided to subscribers for the purpose of claim payment unless the provider has provided that information for the purposes of claim payment.

II. The provisions of this section shall apply to group hospital and medical expense policies subject to RSA 415, group health service plan contracts issued pursuant to RSA 420-A, and to health maintenance organization policies and plans issued pursuant to RSA 420-B.


Source. 2003, 284:1, eff. Jan. 1, 2004.

    400-A:15-c Identification of Health Coverage Under the Jurisdiction of the Commissioner. 

All health coverage as defined in RSA 420-G:2, IX and prescription drug and dental benefits offered separately as described in RSA 420-G:2, IX(j) shall be identified as being under the jurisdiction of the commissioner. Such identification shall be clearly printed on a member's identification card and the policy issued to an insured after January 1, 2010. The commissioner shall adopt rules, pursuant to RSA 541-A, designating the form and manner of the identification required under this section.


Source. 2009, 305:1, eff. Sept. 29, 2009.

    400-A:15-d Exemption From Rulemaking Requirement;  Forms. 

In adopting forms under RSA 541-A, the commissioner shall be exempt from the requirements of RSA 541-A:7 and RSA 541-A:8.


Source. 2012, 93:1, eff. July 28, 2012.

    400-A:15-e Consumer Services Program. 

I. The commissioner shall maintain a program to investigate complaints and respond to inquiries received, and, when warranted, refer matters for enforcement, further investigation, or examination against insurers, producers, or any other entity subject to the regulatory authority of the commissioner. The program shall include, but not be limited to, the following:

(a) A toll-free telephone number dedicated to the handling of complaints and inquiries.

(b) A standardized complaint form designed to assure that complaints will be properly registered and tracked.

(c) Maintenance of a comprehensive database of complaints and inquiries adequate to promote efficient case handling and to allow department analysts to discern potential issues with regulated entities and market trends that require follow up and potential regulatory action.

(d) The commissioner shall, if deemed appropriate, notify insurers, producers, or other regulated entities against whom the complaint is made of the nature of the complaint, may request appropriate relief for the complainant, and may meet and confer with the complainant and the regulated entity in order to mediate the complaint. This section shall not be construed to give the commissioner power to adjudicate claims.

(e) Retention of records on complaints and inquiries consistent with the insurance department's general record retention policy.

(f) Sharing of complaint information, pursuant to RSA 21-U, with other state agencies regulating financial services.

(g) Referral of complaints not within the department's jurisdiction to appropriate public and private agencies.

(h) Complaint handling goals that can be tested against consumer satisfaction surveys carried out pursuant to paragraph V.

(i) Inclusion in the department's annual report to the governor and council, required under RSA 400-A:26, detailed information regarding the program required by this section, that shall include, but not be limited to: a description of the operation of the complaint handling process, listing the number of complaints and inquiries received; enforcement actions taken pursuant to complaints received; the amount of staffing resources devoted to the handling and resolution of complaints; and the amount of recoveries made on behalf of consumers.

II. The commissioner may establish a secure, online complaint response system to distribute and receive complaint information from insurers and other regulated entities. Insurers or other regulated entities shall be required to submit and receive complaint information, including, but not limited to, requested claim files, underwriting files, correspondence, and other supporting documents, using any system established by the commissioner pursuant to this paragraph.

III. (a) In receiving complaints and inquiries, investigating complaints, and responding to complaints and inquiries by members of the public concerning the handling of insurance claims by insurers or producers, or alleged misconduct by insurers or producers, the commissioner shall not decline to investigate complaints for any of the following reasons:

(1) The insured is represented by an attorney in a dispute with an insurer, or is in mediation or arbitration.

(2) The insured has a civil action against an insurer.

(3) The complaint is from an attorney, if the complaint is based upon evidence or reasonable beliefs about violations of law known to an attorney because of a civil action.

(b) Consistent with the principles of res judicata and administration and judicial economy, the commissioner may defer any mediation effort or enforcement proceeding related to a complaint until the finality of a dispute, mediation, arbitration, or civil action involving the claim is known.

(c) Nothing in this section shall be construed to waive the confidential and privileged nature of all documents, materials, or other information in possession of the department pursuant to an investigation of a complaint or consumer inquiry, as provided in RSA 400-A:16.

IV. In coordination with the consumer services program, the commissioner shall provide for the education of, and dissemination of information to, members of the general public concerning insurance matters. The commissioner may in person or through employees of the department meet with individuals, organizations, and associations interested in insurance for the purpose of securing cooperation in the enforcement of the insurance laws of this state and may disseminate information concerning the insurance laws of this state for the assistance and information of the public. In addition, the commissioner shall arrange for public service announcements, website information, social media statements, and other outreach efforts reasonably designed to inform consumers of the availability of the department's consumer assistance program and how to register a complaint or make an inquiry to the department.

V. The department shall include, with each notification of final action to a complainant, or, at a minimum, with a number of randomly selected notifications of final action sufficient to assure the validity of results, a complaint handling consumer satisfaction evaluation form. This form shall clearly and concisely seek an evaluation of the department's performance in handling the complainant's grievance. The areas of evaluation shall include, but not be limited to: whether the complaint was handled in a fair and reasonable manner, evaluated thoroughly and without bias; the time required for resolution of the complaint; whether the complaint was referred and, if so, whether it was referred within a satisfactory time; whether the staff involved in handling the complaint demonstrated an adequate knowledge of the issues involved in the complaint; whether the complainant was satisfied with the result of the department's intervention; and whether the complainant would recommend the department's complaint handling services to others.

VI. The commissioner shall ascertain patterns of complaints by insurer, geographic area, insurance line, type of violation, and any other valid basis the commissioner may deem appropriate for further investigation, and periodically evaluate the complaint patterns to determine additional examination, investigative, or enforcement actions which may be taken by the commissioner, and report on all actions taken with respect to those patterns of complaints in his or her annual report to the governor and council pursuant to RSA 400-A:26, and to the public. For the purposes of this paragraph, complaints mean those written complaints received by the commissioner under paragraph I, and written complaints received by the commissioner from any other sources, alleging misconduct or unlawful acts by insurers or production agencies.


Source. 2018, 134:1, eff. May 30, 2018. 2019, 101:3, eff. Aug. 20, 2019.

    400-A:15-f Confidentiality;  Forms and Rates. 

I. Forms and rates that are filed for review in accordance with Title XXXVII shall be confidential pending approval. Forms and rates filed for informational purposes shall be confidential until effective.

II. An approved filing and any supporting information that is not otherwise exempt from disclosure by law or rule, shall be open to public inspection on or after the date the filing is approved or its effective date, whichever is later, provided however, that for health filings for markets in which there is a specific, mandatory open enrollment period established by law, forms and rates shall be available for public review no later than the first day of the mandated open enrollment period.

III. In accordance with RSA 91-A:5, IV, any information submitted as part of the form and rate review process that is required to be held confidential by law, including commercial and proprietary trend assumptions, proprietary predictive models, and any other commercial or proprietary information and supporting documentation, shall not be disclosed.


Source. 2018, 37:1, eff. Aug. 13, 2018. 2021, 50:5, eff. July 24, 2021.

    400-A:15-g General Provisions Regarding Review of Rate and Form Filings. 

Unless otherwise provided in specific provisions of title XXXVII or in rules promulgated thereunder, when reviewing a rate or form filing submitted by an insurer, the commissioner shall:

I. Within 30 days of receipt, examine the rate or form filing and notify the insurer of any apparent errors or omissions that render the filing incomplete or request any additional information that the insurance department is permitted by law to require and that is deemed by the commissioner to be relevant to the review process.

II. Within 60 days after receipt of the filing or after receipt of the additional information or corrections timely requested by the commissioner pursuant to paragraph I, the commissioner shall:

(a) Approve or deny the filing, in whole or in part; or

(b) Commence an adjudicative proceeding in accordance with RSA 541-A.

III. In the event that the commissioner returns one or more preliminary objections to the insurer regarding a rate or form filing, the period in paragraph II shall not include the period during which the insurer is preparing its response.

IV. Upon written agreement of the insurer, the commissioner may extend any of the time periods for review provided for in this section.

V. Wherever the general time limits prescribed by this section differ from specific time limits provided for by other provisions of title XXXVII or in rules promulgated thereunder, the specific time limits provided for by such other provisions shall control.

VI. If the commissioner fails to take action on a rate or form filing governed by this section within the time limits prescribed in this section, the filing shall be deemed approved. If at any time after a rate or form has been deemed approved under this paragraph, the commissioner finds that the rate or form does not meet any of the requirements under title XXXVII, the commissioner may, after notice and hearing, order the discontinuance of the rate or form. The order shall provide a reasonable time after which the filing shall be deemed no longer effective. The order shall not affect any contract or policy made or issued prior to the expiration of the period set forth in the order. However, a policyholder shall have the privilege to cancel the policy containing the nonconforming rate or policy provision without penalty.

VII. RSA 541-A:29 and RSA 541-A:29-a shall not apply to insurer rate and form filings under title XXXVII.


Source. 2018, 279:22, eff. Jan. 1, 2019.

    400-A:15-h General Provisions Regarding Company, Producer, and Adjuster Licensing. 

Unless otherwise provided in specific provisions of title XXXVII or in rules promulgated thereunder, when reviewing a license application submitted by a company, producer, or adjuster, the commissioner shall:

I. Within 30 days of receipt, examine the license application and notify the applicant of any apparent errors or omissions that render the application incomplete or request any additional information that the insurance department is permitted by law to require and that is deemed by the commissioner to be relevant to the review process.

II. Within 60 days after receipt of the application or after receipt of the additional information or corrections timely requested by the commissioner pursuant to paragraph I, the commissioner shall:

(a) Approve or deny the application, in whole or with restrictions; or

(b) Commence an adjudicative proceeding in accordance with RSA 541-A.

III. In the event that the commissioner returns one or more preliminary objections to the company, producer, or adjuster regarding a license application, the period in paragraph II shall not include the period during which the applicant is preparing a response.

IV. In the event that the commissioner is conducting an investigation of an applicant pursuant to RSA 400-A:16 of possible violations of insurance laws, the period in paragraph II shall not include the period during which the investigation is pending.

V. Upon written agreement of the applicant, the commissioner may extend any of the time periods for review provided for in this section.

VI. Wherever the general time limits prescribed by this section differ from specific time limits provided for by other provisions of title XXXVII or in rules promulgated thereunder, the specific time limits provided for by such other provisions shall control.

VII. If the commissioner fails to take action on a license application governed by this section within the time limits prescribed in this section, the application shall be deemed approved. If at any time after a license application has been deemed approved under this paragraph, the commissioner finds that the applicant does not meet standards for licensure, the commissioner may, after notice and hearing, order the revocation, suspension, or restriction of the license.

VIII. RSA 541-A:29 and RSA 541-A:29-a shall not apply to company, producer, or adjuster license applications under title XXXVII.


Source. 2018, 279:22, eff. Jan. 1, 2019.

    400-A:15 Statutes, Rules, and Regulations;  Violation. 

I. The commissioner shall have full power and authority to make, promulgate, amend and rescind reasonable rules and regulations for, or as an aid to, the administration or effectuation of any provision or provisions of this title or of the Gramm-Leach-Bliley Act of 1999 (Public Law 106-102) which relate to insurance and such other rules and regulations as are reasonably necessary to implement such provisions.

II. Prior to the adoption of any rule or regulation, or the amendment or repeal thereof, the commissioner shall publish or otherwise circulate notice of his intended action and afford interested persons opportunity to submit data or views either orally or in writing.

III. Any person who knowingly violates any statute, rule, regulation, or order of the commissioner may, upon hearing, except where other penalty is expressly provided, be subject to such suspension or revocation of certificate of authority or license, or administrative fine not to exceed $2,500 per violation, as may be applicable under this title for violation of the statute or the provision to which the rule, regulation, or order relates.


Source. 1971, 244:1. 2000, 313:12. 2008, 153:1, 2, eff. June 6, 2008.

    400-A:16 Investigations, Enforcement. 

I. The commissioner may conduct such investigations in addition to those specifically provided for as he or she may find necessary in order to promote the efficient administration of the provisions of this title.

II. Any individual or entity who transacts insurance in this state or is otherwise subject to the authority of the commissioner shall, upon request of the commissioner, provide the commissioner with all documents and information relevant to any investigation under this section within 10 working days, or shall request within the 10 working-day period, for good cause shown, additional time to respond.

III. Except as provided in subparagraphs (a)-(d), any documents, materials, or other information in the control or possession of the insurance department that is furnished by an insurer, producer, or an employee or agent thereof acting on behalf of the insurer or producer, or from the National Association of Insurance Commissioners, its affiliates or subsidiaries, or from regulatory and law enforcement officials of other foreign or domestic jurisdictions, or is otherwise obtained by the commissioner in an investigation pursuant to this section shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to this section. No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized herein. The following shall apply:

(a) The commissioner may use documents, materials, or other information obtained through an investigation in furtherance of any regulatory or legal action brought as part of the commissioner's duties.

(b) The commissioner may share documents, materials, or other information, including the confidential and privileged documents, materials, or other information under paragraph III, with other state, federal, and international regulatory agencies including the Bank for International Settlements, with the International Association of Insurance Supervisors or the National Association of Insurance Commissioners, their affiliates or subsidiaries, and with state, federal, and international law enforcement authorities; provided, that the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information.

(c) The commissioner may disclose to an insured or claimant who has filed a complaint against an insurer, a copy of the insurance company's letter to the department in response to the complaint. The commissioner shall adopt rules, pursuant to RSA 541-A, as may be necessary, to identify those documents obtained from the company during the course of the investigation of the insured's or claimant's complaint that may be disclosed upon request to assist the insured or claimant in understanding the basis for the department's actions related to the investigation. The commissioner shall not disclose to an insured or claimant any information that would interfere with any civil, criminal, or administrative enforcement proceeding.

(d) The commissioner may disclose to the public the number and nature of complaints and inquiries filed by consumers with the department; provided, however, no information exempt from disclosure under RSA 91-A shall be disclosed and no disclosure shall abridge the privacy interests of any consumer filing such a complaint or inquiry.

IV. The commissioner may institute suits or other legal proceedings as necessary for the enforcement of any rules, regulations, or provisions of this title.

V. If the commissioner has reason to believe that any person has violated any provision of this title for which criminal prosecution is provided, he or she shall so inform the attorney general. The attorney general shall promptly institute such action or proceedings against such person as in his or her opinion the information may require or justify.

VI. The attorney general, upon request of the commissioner, is authorized to proceed in the courts of any other state or in any federal court or agency to enforce an order or decision of any court, proceeding or in any administrative proceeding before the commissioner.


Source. 1971, 244:1. 1987, 411:5. 1988, 62:5. 2008, 67:1. 2009, 178:1. 2012, 100:4, eff. July 28, 2012. 2022, 142:4, eff. Aug. 6, 2022.

    400-A:17 Hearings. 

I. The commissioner may hold hearings for any purpose within the scope of this title as he may deem advisable.

II. He shall hold a hearing:

(a) if required by any provision of this title,

(b) or upon written application for a hearing by a person aggrieved by any act or impending act, or by any report, rule, regulation, or order of the commissioner (other than an order for the holding of a hearing, or order on a hearing, or pursuant to such order, of which hearing such person had notice).

III. Any such application must be filed with the commissioner within 30 days after such person knew or reasonably should have known of such act, impending act, failure, report, rule, regulation, or order, unless a different period is provided for by other applicable law, and in which case such other law shall govern. The application shall briefly state the respects in which the applicant is so aggrieved, together with the ground to be relied upon for the relief to be demanded at the hearing. The commissioner may require that the application be signed and sworn to by a person competent to be a witness in civil courts.

IV. If the commissioner finds that the application is timely, made in good faith, and that the applicant would be so aggrieved if his grounds are established he shall hold a hearing within 30 days after the filing of the application, or within 30 days after the application has been sworn to, whichever is the later date, unless in either case the hearing is postponed by mutual consent.

V. Failure to hold the hearing upon application therefor of a person entitled thereto as hereinabove provided shall constitute a denial of the relief sought, and shall be the equivalent of a final order of the commissioner on hearing for the purpose of an appeal under RSA 400-A:24.

VI. Pending the hearing and decision thereon, the commissioner may suspend or postpone the effective date of his previous action.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:18 Notice of Hearing. 

I. Except where a longer period is expressly provided in this title, the commissioner shall give written notice of the hearing not less than 10 days in advance. The notice shall state the date, time, and place of the hearing and specify the matters to be considered thereat. If the persons to be given notice are not specified in provision pursuant to which the hearing is held, the commissioner shall give such notice to all persons whose pecuniary interest, to the commissioner's knowledge or belief, are to be directly and immediately affected by the hearing. Notice of the hearing may be waived, and the hearing held at a time mutually fixed by the commissioner and the parties.

II. If any such hearing is to be held for consideration of rules and regulations of the commissioner, or of other matters which, under paragraph I above, would otherwise require separate notices to more than 30 persons, in lieu of other notice, the commissioner may give notice of the hearing by publication thereof in a newspaper of general circulation in this state, at least once each week during the 2 weeks immediately preceding the week in which the hearing is to be held; except, that the commissioner shall mail such notice to all persons who have requested the same in writing in advance and have paid to the commissioner the reasonable amount fixed by him to cover the cost thereof. All such notices, other than published notices, shall be given as provided in RSA 400-A:14.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:19 Conduct of Hearing. 

I. The commissioner may hold a hearing in Concord or any other place of convenience to parties and witnesses, as the commissioner determines. The commissioner or his designee shall preside at the hearing, and shall expedite the hearing and all procedures involved therein.

II. Any party to the hearing shall have the right to appear in person and by counsel, to be present during the giving of all evidence, to have a reasonable opportunity to inspect all documentary and other evidence and to examine and cross-examine witnesses, to present evidence in support of his interest and to have subpoenas issued by the commissioner to compel attendance of witnesses and production of evidence in his behalf. Testimony may be taken orally or by deposition, and any party shall have such right of introducing evidence by interrogatories or deposition as may obtain in the superior court.

III. Upon good cause shown, the commissioner shall permit to become a party to the hearing by intervention, if timely, such persons, not original parties thereto, whose interests are affected by the commissioner's order made upon the hearing.

IV. Formal rules of pleading or of evidence need not be observed at any hearing.

V. The hearing shall be public, unless the commissioner or hearing officer determines that a private hearing would be in the public interest, in which case and only with the consent of all parties to the hearing, the hearing shall be private.

VI. The commissioner or his hearing officer may cause a complete record to be made of the hearing proceedings by a competent reporter or by electronic recording, and if transcribed, such record shall be made a part of the commissioner's record of hearing. In the event of an appeal from any order of the commissioner issued pursuant to Title XXXVII, if a record of the proceedings is available a transcript shall be made, and expenses of transcription shall be paid by the party making the appeal at the rate charged for transcripts of proceedings in the superior court at the time the appeal is made. Nothing in this chapter shall prohibit any party to a hearing held pursuant to Title XXXVII from receiving at any time, upon request and upon payment of expenses, a transcript of the hearing, if a record was made.

VII. The validity of any hearing held in accordance with the notice thereof, or waiver of notice, shall not be affected by the failure of any person to attend or remain in attendance.


Source. 1971, 244:1. 1975, 147:1, eff. July 25, 1975.

    400-A:2 Construction. 

This title shall be liberally construed.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:20 Witnesses and Documentary Evidence. 

I. As to the subject of any examination, investigation or hearing being conducted by him, the commissioner may subpoena witnesses and administer oaths or affirmations and examine any individual under oath, or take depositions; and by subpoena duces tecum may require the production of documentary and other evidence. Any delegation by the commissioner of power of subpoena shall be in writing.

II. Every person subpoenaed to appear at any such hearing, examination, or investigation shall obey the subpoena, testify truthfully, conduct himself with decorum, and in no way obstruct the proceeding or purpose thereof.

III. Witnesses shall be entitled to the same fees and allowances as witnesses in the superior court; except that no insurer, agent, broker, or other person subject to this title who is a subject of such proceeding, and no officer, director, or employee of any of the foregoing, shall be entitled to witness or mileage fees. No person shall be excused from attending and testifying in obedience to a subpoena on the ground that the proper witness fee was not tendered or paid, unless the witness shall have demanded such payment as a condition precedent to attending the hearing, examination, or investigation and unless such demand shall not have been complied with.

IV. Any individual knowingly testifying falsely under oath or making a false affirmation, as to any matter material to any such examination, investigation or hearing, shall upon conviction thereof be guilty of perjury.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:21 Witnesses;  Disciplinary Proceedings. 

I. If any individual without reasonable cause fails to appear when summoned as a witness, or refuses to answer a lawful and pertinent question, or refuses to produce documentary evidence when directed to do so by the commissioner or deports himself in a disrespectful or disorderly manner at the inquiry, or obstructs the proceedings by any means, whether or not in the presence of the commissioner or his designee, he is guilty of contempt and may be dealt with as provided in RSA 400-A:21, II.

II. The commissioner or his designee, as the case may be, may file a complaint in the superior court, setting forth under oath the facts constituting the contempt and requesting an order returnable in not less than 2 nor more than 5 days, directing the alleged contemner to show cause before the court, why he should not be punished for contempt. Upon the return of such order, the court shall examine the alleged contemner under oath, and the alleged contemner shall have an opportunity to be heard. If the court determines that the respondent has committed any alleged contempt, the court shall punish the offender as if the contempt had occurred in an action arising in or pending in such court. Provided however, the contemner shall have a period of 10 days from the determination of the superior court within which to purge himself of contempt and thereby avoid the sanctions imposed.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:22 Witnesses;  Immunity From Prosecution. 

I. If any individual asks to be excused from attending or testifying or from producing any books, papers, records, contracts, correspondence, or other documents in connection with any examination, hearing, or investigation being conducted by the commissioner on the ground that the testimony or evidence required of him may tend to incriminate him or subject him to a penalty or forfeiture, and shall by the insurance commissioner be directed to give such testimony or produce such evidence, he must nonetheless comply with such direction, but he shall not thereafter be prosecuted or subjected to any penalty or forfeiture for or on account of any transaction, matter or thing concerning which he may have so testified or produced evidence, and no testimony so given or evidence produced shall be received against him upon any criminal action, investigation, or proceeding; except, however, that no such individual so testifying shall be exempt from prosecution or punishment for any perjury committed by him in such testimony, and the testimony or evidence so given or produced shall be admissible against him upon any criminal action, investigation, or proceeding concerning perjury; provided further that no witness shall be compelled to testify where such testimony would create a reasonable possibility of penalty or sanction by a court, agency, or other body of competent jurisdiction, which penalty or sanction has not as of the hearing date (or the date of any appeal therefrom) been banned by operation of law or waived as to the witness.

II. Any such individual may execute, acknowledge and file in the office of the commissioner a statement expressly waiving such immunity or privilege in respect to any transaction, matter or thing specified in such statement, and thereupon the testimony of such individual or such evidence in relation to such transaction, matter or thing may be received or produced before any judge or justice, court, tribunal, grand jury, or otherwise, and if so received or produced, such individual shall not be entitled to any immunity or privileges on account of any testimony he may so give or evidence so produced.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:23 Order on Hearing. 

I. In the conduct of hearings under this title and making his order thereon, the commissioner shall act in a quasi-judicial capacity.

II. Within 90 days after termination of a hearing, or of any rehearing thereof or reargument thereon, or within such other period as may be specified in this title as to particular proceedings, the commissioner shall make his order on hearing covering matters involved in such hearing, and give a copy of the order to each party to the hearing in the same manner as notice of the hearing was given to such party; except, that as to hearings held with respect to merger, consolidation, bulk reinsurance, conversion, affiliation, or change of control of a licensed insurer as provided in RSA 401-B and RSA 403-A, where notice of the hearing was given to all who are stockholders or policyholders, or both, of an insurer involved, the commissioner is required to give a copy of the order on hearing to the corporation and insurer parties, to intervening parties, to a reasonable number of such stockholders or policyholders as representative of the class, and to other parties only upon written request of such parties.

(a) The order shall contain:

(1) A concise statement of facts found by the commissioner upon the evidence adduced at the hearing;

(2) A concise statement of the commissioner's conclusions from the facts so found;

(3) His order, and the effective date thereof; and

(4) Citation of the provisions of this title upon which the order is based; but failure to so designate a particular provision shall not deprive the commissioner of the right thereafter to rely thereupon.

(b) The order may affirm, modify, or rescind action theretofore taken or may constitute taking of new action within the scope of the notice of hearing.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:24 Appeal From the Commissioner. 

I. An appeal from the commissioner shall be taken only from an order on hearing, or as to a matter on which the commissioner has refused or failed to hold a hearing after application therefor under RSA 400-A:17, or as to a matter as to which the commissioner has failed to make his order on hearing as required by RSA 400-A:23.

II. Any appeal shall be in accordance with RSA 541.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:25 Records;  Inspection;  Destruction. 

I. Unless otherwise provided by law, all records and documents of the insurance department are subject to public inspection pursuant to the right to know law, RSA 91-A. Notwithstanding the provisions of RSA 91-A, the commissioner may determine by order that it is in the public interest to make public additional records and documents or to hold certain records and documents confidential within the insurance department.

II. Except as otherwise provided by law, all records and documents of the department are subject to subpoena by a court of competent jurisdiction.

III. The commissioner may destroy at the end of 3 years from the date of filing any records determined to be no longer of any value to the state. The commissioner may destroy at an earlier date such records of the department which are readily available to the commissioner in an unaltered form from any other state or federal agency or from any licensed insurance company.


Source. 1971, 244:1. 1983, 473:1. 2008, 67:2, eff. July 20, 2008. 2021, 56:1, eff. July 24, 2021.

    400-A:26 Annual Report. 

On or before November 1 in each year, the commissioner shall make a written report to the governor and council showing with respect to the preceding calendar year the receipts and expenses of the department for the year and such recommendations as he deems advisable.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:27 Publications. 

I. The commissioner may have the annual report, examination reports, directory of authorized insurers, directory of licensed insurance representatives, license examination material, insurance laws, related laws and regulations, and other publications relating to insurance prepared under his administration, published in pamphlet form from time to time and may affix a reasonable price to each copy to cover the price of printing, handling, and postage.

II. The commissioner may furnish free copies of the publications prepared under paragraph I to public officials and libraries in the state and elsewhere. The cost of free distribution shall be charged upon available funds and the appropriation for the insurance department.


Source. 1971, 244:1. 1987, 411:7, eff. May 26, 1987.

    400-A:28 Interstate Cooperation. 

The commissioner and his staff shall maintain close relations with the commissioners of other states and shall actively participate in the activities and affairs of the National Association of Insurance Commissioners and other organizations so far as it will, in his judgment, enhance the purposes of the insurance laws. The actual and necessary travel and related expenses incurred by the commissioner and members of his staff in attending meetings of said associations, their committees, subcommittees, hearings, and other official activities, as well as the general expenses of participation in such associations shall be a charge on available funds and the appropriation of the insurance department.


Source. 1971, 244:1. 1987, 411:8, eff. May 26, 1987.

    400-A:29-a Fees for Continuing Education Course Submissions;  Special Fund Established. 

I. The commissioner may impose and collect reasonable application fees as provided in RSA 400-A:29, XXIII(a) and (b) from sponsoring organizations for submissions of continuing education courses to meet educational requirements established by rule for producers, consultants, and adjusters.

II. The fees collected by the commissioner under paragraph I shall be deposited in the general fund.

III. Members of the respective continuing education advisory councils shall be reimbursed for all actual travel. The commissioner shall pay the expenses of compensating the continuing education advisory council within the limits of appropriations made in the operating budget for this purpose.


Source. 1988, 105:1. 2010, 13:2, eff. July 1, 2010. 2019, 134:22, eff. June 25, 2019.

    400-A:29 Fees. 

I.
 
Certificate of authority
 
 (a)
 
Application
 
$1,000
 (b)
 
Initial certificate
 
$100
 (c)
 
Annual renewal
 
$100
 (d)
 
Reinstatement
 
$50
 (e)
 
Amendment
 
$25
II.
 
Charter documents (other than those filed or transmitted with application for certificate of authority)
 
 (a)
 
For filing or transmitting articles of amendment, domestic companies 
 
$25
 (b)
 
For filing or transmitting a copy of amendment to the articles of incorporation of a foreign or alien company, $35. If the amendment is filed or transmitted more than 60 days after the same has become effective in the home state, the corporation shall pay to the commissioner a penalty of $50.
 
III.
 
Filing or transmitting of annual statement
 
$100
IV.
 
Application for withdrawal and final report of foreign or alien insurance company
 
$25
V.
 
Application to reserve corporation name (90 days)
 
$25
 


VI.
 
Advisory organizations and statistical agents.
 
 (a)
 
Application fee
 
$300
 (b)
 
Initial certificate
 
$150
 (c)
 
Annual renewal
 
$150
 (d)
 
Form filing-each form filing
 
$20
 (e)
 
Rate filing-each rate filing
 
$20
VII.
 
Health service corporations
 
 (a)
 
Corporation's annual certificate of authority
 $200
 (b)
 
Annual statement
 $100
VIII.
 
Road and tourist services
 
 (a)
 
Application fee for certificate of authority
 $300
 (b)
 
Initial certificate
 $100
 (c)
 
Annual renewal
 $100
 


VIII-a.
 
Consumer Guaranty Contract Obligors
 
 (a)
 
Registration fee
 
$300
 (b)
 
Annual renewal fee
 
$150
 


IX.
 
[Repealed.]
 
 
X.
 
Producers; resident and non-resident
 
 (a)
 
Non-refundable application and license fee
 $210
 (b)
 
Non-refundable biennial renewal
 $150
 (c)
 
Amendment to license
 $50
 (d)
 
Additional fee for late renewal
 $150
 (e)
 
Fee for late completion of continuing education
 $50
 (f)
 
Appointment fee
 $25
 (g)
 
Termination fee
 $25
 (h)
 
Address change fee
 $10
 (i)
 
Mail return fee
 $25
XI.
 
Surplus lines; Company annual application for inclusion in approved list
 $250
XII.
 
Insurance vending machines
 
 (a)
 
Application fee, each machine
 
$50
 (b)
 
Initial license, each machine
 
$50
 (c)
 
Annual renewal, each machine
 
$50
XIII.
 
Other licensing documents; producer, consultant, adjuster, public adjuster; copies (all documents)
 
$1 per page.
 


XIV.
 
Variable life and annuity
 
 


 (a)
 
Certificates
 $5
 (b)
 
Company registration
 $100
 (c)
 
Annual renewal
 $100
XV.
 
Adjuster's licenses; resident and non-resident
 
 (a)
 
Non-refundable application and license fee
 $75
 (b)
 
Non-refundable biennial renewal
 $75
 (c)
 
Amendment to license
 $50
 (d)
 
Additional fee for late renewal
 $75
 (e)
 
Fee for late completion of continuing education
 $25
 (f)
 
Address change fee
 $10
 (g)
 
Mail return fee
 $25
XVI.
 
Service of process on commissioner
 
$25
XVII.
 
The commissioner shall also collect in advance, reasonable fees, as determined by the commissioner for such other official acts and services as may be necessary or required by Title XXXVII or XXXVIII.
 
XVIII.
 
Public adjusters; resident and non-resident
 
 (a)
 
Non-refundable application and license fee
 $100
 (b)
 
Non-refundable biennial renewal
 $100
 (c)
 
Additional fee for late renewal
 $100
 (d)
 
Fee for late completion of continuing education
 $25
 (e)
 
Address change fee
 $10
 (f)
 
Mail return fee
 $25
XIX.
 
Insurance consultants; resident and non-resident
 
 (a)
 
Non-refundable application and license fee
 $210
 (b)
 
Non-refundable biennial renewal
 $150
 (c)
 
Amendment to license
 $50
 (d)
 
Additional fee for late renewal
 $150
 (e)
 
Fee for late completion of continuing education
 $50
 (f)
 
Address change fee
 $10
 (g)
 
Mail return fee
 $25
XX.
 
Managing general agents
 
 (a)
 
Application fee
 
$50
 (b)
 
Original license
 
$350
 (c)
 
Renewal license
 
$250
XXI.
 
Reinsurance intermediaries
 
 (a)
 
Application fee
 
$50
 (b)
 
Original license
 
$350
 (c)
 
Renewal license
 
$250
 


XXII.
 
Discount Medical Plan Organizations
 
 
 (a)
 
Original Application
 
$300
 (b)
 
Renewal
 
$150
 


XXIII.
 
Continuing education course submission fee
 
 
 (a)
 
Initial
 
$25
 (b)
 
Renewal
 
$25
 

Source. 1971, 244:1. 1975, 416:1. 1983, 473:2. 1986, 58:2. 1997, 284:16. 1998, 85:3. 2000, 315:2-8. 2001, 95:2, 10-12. 2003, 150:4; 293:8. 2004, 224:2. 2006, 196:1. 2008, 18:1, I, 2-7; 206:2. 2010, 13:1; 212:2. 2016, 109:1. 2017, 133:1, eff. Aug. 15, 2017. 2019, 134:21, eff. June 25, 2019. 2022, 223:2-5, eff. Aug. 16, 2022.

    400-A:3 Insurance Commissioner;  Appointment;  Term. 

The head of the department shall be the insurance commissioner who is charged with the rights, powers, and duties pertaining to the enforcement and execution of the insurance laws of this state. The commissioner shall have all powers specifically granted to him or her or reasonably implied in order to enable him or her to perform the duties imposed by this title. The commissioner shall have such additional rights, powers, and duties as may be provided by other laws. The commissioner shall be appointed by the governor with advice and consent of the council. The commissioner shall hold office for 5 years. Vacancies in the office of the insurance commissioner shall be filled for the unexpired term of such office. The commissioner may be removed only as provided by RSA 4:1.


Source. 1971, 244:1. 2007, 156:14, eff. Aug. 17, 2007.

    400-A:30 Accounts. 

The commissioner shall keep a correct account of all fees and moneys received by him by virtue of his office, and shall pay the same over to the treasurer of the state forthwith.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:31 General Premium Tax:  Report. 

I. Every authorized insurer and each formerly authorized insurer shall, on or before March 15 of each year, or within any reasonable extension of time therefor which the commissioner may for good cause have granted on or before such date, file with the commissioner a report in such form as prescribed by the commissioner showing all gross direct premiums, including policy, membership and other fees and assessment, policy dividends applied in payment for insurance and all other considerations for insurance received by it during the next preceding calendar year on account of policies covering property, subjects, or risks located, resident or to be performed in this state after deducting from such total return premiums or dividends actually returned or credited to policyholders.

(a) As to title insurers, that portion of the premium chargeable to title search and examination services as reasonably determined by the commissioner may be deducted from such total.

(b) In determining the amount of such gross direct premiums taxable in this state, all such premiums or other considerations written, procured or received in this state shall be deemed written on property, subjects or risks located, resident or to be performed in this state except such premiums or other considerations as are properly allocated or apportioned and reported as taxable premiums of any other state or states, and except such premiums or other considerations written on property, subjects or risks located, resident or to be performed anywhere outside the United States of America.

II. The report shall be signed by the insurer's president, vice-president, secretary, treasurer, or manager. Any person that submits false information in a report shall be subject to prosecution for unsworn falsification, pursuant to RSA 641:3.

III. The commissioner may require at any time verified supplemental statements with reference to any matter pertinent to the proper assessment of the tax.

IV. [Repealed.]


Source. 1971, 244:1. 1977, 600:42. 1979, 360:12. 1981, 111:1. 2002, 207:1. 2010, 13:7, I, eff. July 1, 2010. 2022, 42:1, eff. July 2, 2022.

    400-A:32-a Timely Mailing. 

I. Any report, claim, tax return, statement and other document, relative to tax matters, required or authorized to be filed with or any payment made to the state which is:

(a) Transmitted through the United States mail, shall be deemed filed and received by the state on the date shown by the post office cancellation mark stamped upon the envelope or other appropriate wrapper containing it.

(b) Mailed but not received by the state or where received and the cancellation mark is illegible, erroneous or omitted, shall be deemed filed and received on the date it was mailed if the sender establishes by competent evidence that the report, claim, tax return, statement, remittance, or other document was deposited in the United States mail on or before the date due for filing; and in cases of such non-receipt of a report, tax return, statement, remittance, or other document required by law to be filed, the sender files with the state or political subdivision a duplicate within 30 days after written notification is given to the sender by the state of its non-receipt of such report, tax return, statement, remittance, or other document.

II. If any report, claim, tax return, statement, remittance, or other document is sent by United States registered mail, certified mail or certificate of mailing, a record authenticated by the United States post office of such registration, certification or certificate shall be considered competent evidence that the report, claim, tax return, statement, remittance or other document was mailed, and the date of registration, certification or certificate shall be deemed the postmarked date.

III. If the date for filing any report, claim, tax return, statement, remittance, or other document falls upon a Saturday, Sunday or legal holiday, the filing shall be considered timely if performed on the next business day.

IV. The provisions of this section shall not apply to payment or remittance for tax sales, the advertisement of tax sales, tax sale redemptions or payment of subsequent taxes thereon.


Source. 2003, 144:1, eff. Jan. 1, 2004.

    400-A:32-b Electronic Funds Transfer. 

 Insurers shall remit taxes by electronic funds transfer according to the following schedule:

I. When the insurer had a tax liability in the prior tax year of $40,000 or more, effective January 1, 2006.

II. When the insurer had a tax liability in the prior tax year of $30,000 or more, effective January 1, 2007.

III. When the insurer had a tax liability in the prior tax year of $20,000 or more, effective January 1, 2008.


Source. 2003, 144:1. 2005, 248:2. 2008, 154:1, eff. June 6, 2008.

    400-A:32 Premium Tax;  Collection, Minimum, Penalty, and Prepayments. 

I. (a) Every insurer shall pay to the insurance commissioner a tax upon such net premiums, for lines of business written, as set forth in the report filed pursuant to RSA 400-A:31, I, less estimated payments made in accordance with RSA 400-A:32, II, as follows:

(1) Effective July 1, 2007, a tax of 1.75 percent for all lines of business written pursuant to RSA 401:1, I-III and V-VIII, RSA 416-A:2, and RSA 401:1-a, I and II;

(2) Effective January 1, 2009, a tax of 1.50 percent for all lines of business written pursuant to RSA 401:1, I-III and V-VIII, RSA 416-A:2, and RSA 401:1-a, I and II;

(3) Effective January 1, 2010, a tax of 1.25 percent for all lines of business written pursuant to RSA 401:1, I-III and V-VIII, RSA 416-A:2, and RSA 401:1-a, I and II; and

(4) A tax of 2 percent for all lines of business written pursuant to RSA 401:1, IV, including, but not limited to, insurers licensed pursuant to RSA 420-A, RSA 420-B, and RSA 420-F.

(b) Provided, however, that every authorized insurer shall pay to the insurance commissioner a minimum annual premium tax of no less than $200.

II. (a) For the calendar year ending December 31, 2006, on or before March 15, June 15, September 15, and December 15, every authorized insurer required to pay a tax in accordance with RSA 400-A:32, I shall pay to the insurance commissioner an amount equal to 
1/4 of the previous calendar year's tax paid pursuant to said paragraph; provided, however, any authorized insurer having an estimated liability of $100 or less for each quarter shall make payment in full on March 15. These payments shall be considered as a partial payment of the tax upon the business done in the state during the calendar year in which the payment was received.

(b) For the calendar year ending December 31, 2007, and for every year thereafter, on or before March 15 of each year every authorized insurer required to pay a tax in accordance with RSA 400-A:32, I shall make payment in full to the insurance commissioner of an amount equal to 100 percent of the previous calendar year's taxes paid pursuant to said paragraph. The payments shall be considered as a partial payment of the tax upon the business done in the state during the calendar year in which the payment was received.

III. (a) Except as provided in subparagraphs (b) and (c), the taxes imposed in paragraphs I and II of this section shall be promptly forwarded by the commissioner to the state treasurer for deposit to the general fund.

(b) Taxes imposed attributable to premiums written for medical and other medical related services for the newly eligible Medicaid population as provided for under RSA 126-AA shall be deposited into the New Hampshire granite advantage health care trust fund established in RSA 126-AA:3. The commissioner shall notify the state treasurer of sums for deposit into the New Hampshire granite advantage health care trust fund no later than 30 days after receipt of said taxes. The moneys in the trust fund may be used for the administration of the New Hampshire granite advantage health care program, established in RSA 126-AA.

(c) Taxes imposed on premiums written by duly authorized insurance companies for family and medical leave insurance written in connection with the administration of RSA 21-I:99 through RSA 21-I:111 or RSA 282-B shall be deposited into the FMLI premium stabilization trust fund established in RSA 282-B:5. The commissioner shall notify the state treasurer of sums for deposit into the FMLI premium stabilization trust fund no later than 30 days after receipt of said taxes.

IV. Any insurer failing to file the report required by RSA 400-A:31 or failing to remit the proper tax within the time for filing shall pay a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of the tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due. If the tax or the estimated tax is not paid when due, the commissioner may suspend or revoke the insurer's certificate of authority.

V. If the insurer liable for the taxes imposed in paragraphs I and II of this section is a member of a unitary business within the meaning of RSA 77-A:1, XIV, then the entire amount of the taxes due under this chapter by the individual member of such unitary business shall be allowed as a credit pursuant to RSA 77-A:5, III, against such individual member's portion of the total tax liability of the unitary business under RSA 77-A. In the event that the individual member's credit exceeds such member's portion of the total tax liability of the unitary business, the excess of such credit shall be allowed as a credit against any other individual member's tax liability under RSA 77-A, provided such other member is also subject to the tax imposed by this chapter. The commissioner of revenue administration shall adopt rules, in accordance with RSA 541-A, to determine an individual member's portion of the total tax liability based upon each member's activity within New Hampshire.


Source. 1971, 244:1. 1985, 343:3. 1991, 354:17. 1999, 271:1. 2002, 207:2. 2006, 277:2, 3. 2010, Sp. Sess., 1:109; Sp. Sess., 1:121. 2016, 13:2, eff. July 1, 2017. 2018, 342:10, eff. Dec. 31, 2018. 2019, 179:1, eff. Jan. 1, 2020. 2021, 91:465, eff. July 1, 2021.

    400-A:33 Repealed by 2010,13:7, II, eff. July 1, 2010. 

    400-A:34-a Credit for Business Enterprise Tax. 

The tax imposed under RSA 77-E shall be allowed as a credit against the taxes due under this chapter and shall be deemed to be taxes paid pursuant to this chapter for the purposes of RSA 77-A:5, III. Any insurer subject to taxation under this chapter shall first apply such credits as provided in this section, and then pursuant to RSA 77-A:5, X. The taxes paid pursuant to RSA 77-E by an individual member of a unitary business within the meaning of RSA 77-A:1, XIV shall be allowed as a credit against any other individual member's liability under this chapter, provided that such other member is also subject to the tax imposed by this chapter. To the extent the credit for taxes paid pursuant to RSA 77-E exceeds the taxes imposed under this chapter, such excess shall be deemed to be taxes imposed under RSA 77-E and shall be allowed as a credit against the taxes due under RSA 77-A as provided by RSA 77-A:5, X.


Source. 1993, 350:31. 2007, 255:9, eff. Jan. 1, 2008.

    400-A:34 Exemption;  Abatement. 

I. The provisions of RSA 400-A:31 and 32 shall not apply to mutual insurance companies that operate on an assessment plan and require as a condition for granting insurance the signing of a premium deposit note by the insured, which note is given for the purpose of establishing a limit of liability to assessment, while their total receipts from policyholders is less than $10,000 per year.

II. Any insurer authorized to do business in this state, having complied with the provisions of this chapter, which shall deem itself aggrieved by reason of any tax imposed upon it by the insurance commissioner, may apply within one year after the due date of any tax imposed upon it, and not afterwards, by petition to the Merrimack county superior court for an abatement of so much thereof as it may claim to have been unlawfully imposed upon it.

III. Such petition shall be entitled against the insurance commissioner, and all summonses therein shall be served upon the insurance commissioner. In any such action, the superior court, after hearing, shall make such order as justice may require and may order the insurance commissioner to credit the petitioner in any tax assessment thereafter made against the petitioner with any amount found to have been illegally assessed against and paid by the petitioner, with interest thereon at such rate as the court may deem just.

IV. Notwithstanding paragraphs II and III, if an insurer or other person engaged in the business of insurance in this state has paid taxes, fees or other charges pursuant to title XXXVII in excess of the amount legally chargeable against such insurer or other person, application may be made for a refund of the overpayment. If the commissioner is satisfied that, because of some mistake of fact, error in calculation, or erroneous interpretation of a law of this state or any other state, an overpayment was made by the insurer or other person, the commissioner shall apply the amount of the overpayment toward the payment of taxes, fees or other charges already due or which may become due or make a cash refund to the insurer or other person. Application for a refund shall be made within 3 years after the date of the excess payment of taxes, fees or other charges.


Source. 1971, 244:1. 1983, 473:3. 1989, 76:1. 2010, 13:6. 2014, 204:26, eff. July 11, 2014.

    400-A:35 Retaliatory Provisions. 

When, by the laws of any other state or country, any taxes, fines, penalties, licenses, fees, deposits, or other obligations or prohibitions, additional to or in excess of those imposed by this state upon companies not organized under the laws of this state and their agents doing business in this state, are imposed upon insurance companies of this state and their agents doing business in such state or country, the same taxes, fines, penalties, licenses, fees, deposits, or other obligations or prohibitions shall be imposed upon all insurance companies of such state or country and their agents doing business in the state, so long as such laws remain in force. In the absence of proof satisfactory to the commissioner, the laws of a foreign country shall be presumed to be the same as those of that state in which an insurance company of that foreign country has its principal place of business in the United States.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:36-a Filing Requirements. 

I. Each domestic, foreign, and alien insurer who transacts insurance in this state shall annually on or before March 1 of each year, file with the National Association of Insurance Commissioners a portable document format (pdf) copy of its annual statement convention blank, along with such additional filings as prescribed by the commissioner for the preceding year, and a pdf copy of all subsequent quarterly statements. The information filed with or transmitted to the National Association of Insurance Commissioners shall be in the same format and scope as that required by the commissioner and following those accounting procedures and practices prescribed by the National Association of Insurance Commissioners Accounting Practices and Procedure Manual, and shall include the signed jurat page and, if required by any state in which the insurer transacts business, the actuarial certification. Any amendments and addenda to the annual statement filing subsequently filed with or transmitted to the commissioner shall also be filed with or transmitted to the National Association of Insurance Commissioners.

II. Foreign insurers that are domiciled in a state which has a law substantially similar to RSA 400-A:36-a, I shall be deemed in compliance with this section.


Source. 1988, 133:4. 1990, 92:2. 1995, 165:1. 2006, 196:3, eff. July 30, 2006. 2019, 183:2, eff. Sept. 8, 2019.

    400-A:36-b Immunity. 

I. In the absence of actual malice, members of the National Association of Insurance Commissioners, their duly authorized committees, subcommittees, and task forces, their delegates, employees, and all others charged with the responsibility of collecting, reviewing, analyzing, and disseminating the information developed from the filing of the annual statement convention blanks shall be acting as agents of the commissioner under the authority of RSA 400-A:36-a and shall not be subject to civil liability for libel, slander, or any other cause of action by virtue of their collection, review, and analysis or dissemination of the data and information collected from the filings required under such section.

II. In the absence of actual malice, no person shall be subject to civil liability for libel, slander or any other cause of action arising from filing reports or furnishing information concerning any activity that may constitute insurance fraud as defined in RSA 638:20, if such reports or information is provided to or received from the commissioner, law enforcement officials, the National Association of Insurance Commissioners, any state or federal agency established to detect, prevent or prosecute insurance fraud, or an insurance company authorized to do business in the state. The immunity conferred by this section applies unless the person seeking to impose civil liability proves actual malice. Any person against whom a civil action is brought, and who is found to be entitled to immunity from liability under this section, shall be entitled to recover reasonable attorney's fees and costs from the person who brought the civil action.


Source. 1988, 133:4. 1993, 239:3, eff. Jan. 1, 1994.

    400-A:36-c Confidentiality. 

All financial analysis ratios and examination synopses concerning insurance companies that are submitted to the department by the National Association of Insurance Commissioners' Insurance Regulatory Information System are confidential and shall not be disclosed by the department. Nothing contained in this title shall prevent or be construed as prohibiting the commissioner from disclosing any other material or information obtained by the commissioner in line with the duties of the commissioner's office so long as the governmental or regulatory agency or office receiving the information agrees in writing to keep it confidential and in a manner consistent with this title.


Source. 1988, 133:4. 1995, 165:2, eff. July 31, 1995.

    400-A:36-d Revocation of Certificate of Authority. 

The commissioner may suspend, revoke, or refuse to renew the certificate of authority of any insurer failing to file its annual statement when due or within any extension of time which the commissioner, for good cause, may have granted.


Source. 1995, 227:1, eff. Aug. 13, 1995.

    400-A:36 Annual Financial Statement. 

I. Every insurance company doing business in this state shall, on or before March 1 each year, make and file or transmit to the commissioner a statement under oath of its president and secretary, in accordance with the National Association of Insurance Commissioners Annual Statement Blank following the National Association of Insurance Commissioners Annual Statement Instructions and those accounting procedures and practices prescribed by the National Association of Insurance Commissioners Accounting Practices and Procedure Manual or allowed as a permitted accounting practice as provided in the manual, showing the amount of its capital stock, assets, liabilities, outstanding risks, premium notes, receipts, expenditures, losses, assessments, salaries and emoluments, and any other information calculated to fully disclose the condition and method of management of the company for the year ending the preceding December 31, which statement shall include the whole amount of premiums written during the preceding year for insurance on property, or risks located or persons resident in this state.

II. The commissioner may extend the time for filing or transmitting such statement for cause shown for a period of not more than 60 days. Life insurance companies shall not be required to file or transmit that part of their annual statement known as the gain and loss exhibit until the succeeding May 1. An insurer intentionally failing to file or transmit its annual statement as required by paragraph I shall forfeit to the department $25 for each day of delinquency. The commissioner may refuse to continue, or may suspend or revoke, the certificate of authority of any insurer intentionally failing to file or transmit its annual statement when due. The insurer shall pay the fee for filing or transmitting its annual statement as prescribed by RSA 400-A:29 at the time of filing or transmitting or with the premium tax return, but no later than March 15th.

III. In addition to the above, the commissioner may require from any person or company subject to this title:

(a) Statements, reports, including reports audited by independent public accountants, answers to questionnaires and other information, and evidence thereof, in whatever reasonable form he designates, and at such reasonable intervals as he may choose, or from time to time;

(b) Full explanation of the programming of any data storage or communications systems in use; and

(c) That information from any books, records, electronic data processing systems, computers or any other information storage system be made available to him at any reasonable time and in any reasonable manner.

IV. The commissioner may prescribe forms for the reports under RSA 400-A:36, III. The forms shall be consistent, as far as practicable, with those prescribed by other states.

V. Any officer, manager or general agent of any insurer authorized to do or doing an insurance business in this state, and any person controlling or having a contract under which he has a right to control such an insurer, whether exclusively or otherwise, and any person with executive authority over or in charge of any segment of such an insurer's affairs, and any insurance agent or other person licensed under the insurance code shall reply promptly in writing or in other designated form, to any written inquiry from the commissioner requesting a reply.

VI. The commissioner may require that any communication made to him under this section be verified.

VII. 
Immunity. In the absence of actual malice, no communication required by the commissioner under this section shall subject the person making it to an action for damages for defamation.

VIII. The information obtained pursuant to RSA 400-A:36, III shall be privileged.

IX. Any director, officer, agent or employee of any insurer who subscribes to, makes or concurs in making or publishing, any annual or other statement required by law, having actual knowledge that the same contains any material statement which is false shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person.

X. The commissioner may retain, without appropriation under RSA 9 and without qualifying as a department expenditure under RSA 4:15, attorneys, independent actuaries, independent certified public accountants, or other professionals or specialists to review financial statements, the cost of which shall be borne by the company which is the subject of the financial analysis. The company shall pay the retained professional or specialists directly for their costs. The commissioner shall conduct oversight of such independent reviewers in a manner that is consistent with standards for the use of independent reviewers established by the National Association of Insurance Commissioners in its Financial Condition Examiners Handbook and Market Regulation Handbook and shall ensure that costs are reasonable for the work performed. The amount paid by the company under this paragraph in any fiscal year shall be applied as a nontransferable credit against and to the extent of the company's administrative fee under RSA 400-A:39 in the subsequent fiscal year and not thereafter.


Source. 1971, 244:1. 1973, 528:273. 1975, 414:1. 1990, 92:1. 1992, 288:2, 3. 2003, 144:2. 2006, 196:2. 2017, 218:4, eff. July 10, 2017. 2019, 183:1, eff. Sept. 8, 2019. 2022, 143:2, eff. Aug. 6, 2022.

    400-A:37 Examinations. 

I. (a) 
Authority, Scope, and Scheduling of Examinations. The commissioner or any of his or her examiners may conduct an examination of any company as often as the commissioner deems appropriate. In scheduling and determining the nature, scope and frequency of the examinations, the commissioner shall consider the results of financial statement analyses and ratios, changes in management or ownership, actuarial opinions, reports of independent Certified Public Accountants and other criteria as set forth in the Financial Condition Examiners' Handbook or the Market Regulation Handbook in effect and adopted by the National Association of Insurance Commissioners. Except as otherwise expressly provided, the commissioner shall examine each domestic insurer at least once every 5 years, and he or she shall annually examine, value, or cause to be valued the reserve liabilities, including loss adjustment expense reserves, of each domestic insurer. For the purpose of making the annual valuation of the reserve liabilities for all outstanding life insurance policies and annuity and pure endowment contracts of domestic insurance companies, the commissioner may employ a competent actuary who shall make such valuation of a company's contractual obligations and the company's compliance with the law.

(b) For purposes of completing an examination of any company under this title, the commissioner may examine or investigate any person, or the business of any person, in so far as such examination or investigation is, in the sole discretion of the commissioner, necessary or material to the examination of the company.

(c) In lieu of an examination of any foreign or alien insurer licensed in this state, the commissioner may accept an examination report on the company as prepared by the insurance department for the company's state of domicile or port-of-entry state until January 1, 1994. Thereafter, such reports may only be accepted if:

(1) The insurance department was at the time of the examination accredited under the National Association of Insurance Commissioners' Financial Regulation Standards and Accreditation Program; or

(2) The examination is performed under the supervision of an accredited insurance department or with the participation of one or more examiners who are employed by such an accredited state insurance department and who, after a review of the examination work papers and report, state under oath that the examination was performed in a manner consistent with the standards and procedures required by their insurance department.

II. 
Examination of Non-Insurance Company Licenses. For the purpose of ascertaining compliance with law or relationships and transactions between any person and any insurer or proposed insurer, and in circumstances where the commissioner has reasonable grounds to believe there is noncompliance with or violation of law, regulation, or order, he or she may, as often and to the extent he or she deems advisable, examine the accounts, records, documents, and transactions pertaining to or affecting the insurance affairs or proposed insurance affairs and transactions of:

(a) Any insurance producer, adjuster, insurer representative, or any person holding himself or herself out as any of the foregoing. (Provided, however, that if upon examination of any person specified in this paragraph the commissioner shall determine that such person is not in violation of the provisions of Title XXXVII or applicable regulations, the expense of the examination shall be borne by the insurance department.)

(b) Any person having a contract under which he enjoys by terms or in fact the exclusive or dominant right to manage or control the insurer.

(c) Any person in this state engaged in, or proposing to be engaged in this state in, or holding himself out in this state as so engaging or proposing, or in this state assisting in, the promotion, formation, or financing of an insurer or insurance holding corporation, or corporation or other group to finance an insurer or the production of its business.

(d) Any rating bureau or organization.

(e) Any licensee or other person subject to this title.

(f) Or if adequate information cannot be obtained, any insurance holding company; or person holding the shares of voting stock or policyholder proxies of an insurer as voting trustee or otherwise, for the purpose of controlling the management thereof.

III. 
Conduct of Examinations.

(a) Upon determining that an examination should be conducted, the commissioner or the commissioner's designee shall issue an examination warrant appointing one or more examiners to perform the examination and instructing them as to the scope of the examination. In conducting the examination, the examiner shall observe those guidelines and procedures set forth in the Financial Condition Examiners' Handbook or the Market Regulation Handbook adopted by the National Association of Insurance Commissioners. The commissioner may also employ such other guidelines or procedures as the commissioner may deem appropriate.

(b)(1) Every company or person from whom information is sought, its officers, directors and agents must provide to the examiners timely, convenient and free access at all reasonable hours at its offices to all books, records, accounts, papers, documents and any or all computer or other recordings relating to the property, assets, business and affairs of the company being examined. The officers, directors, employees and agents of the company or person must facilitate the examination and aid in the examination so far as it is in their power to do so. The refusal of any company, by its officers, directors, employees or agents, to submit to examination or to comply with any reasonable written request of the examiners shall be grounds for suspension or refusal of, or nonrenewal of any license or authority held by the company to engage in an insurance or other business subject to the commissioner's jurisdiction. Any such proceedings for suspension, revocation, or refusal of a license or authority shall be conducted pursuant to RSA 400-A:15, III.

(2) Neither the commissioner nor any examiner shall remove any record, account, document, file, or other property of the person being examined from the office or place of such person except with the written consent of such person in advance of such removal or pursuant to an order of court duly obtained. This subparagraph shall not be deemed to affect the making and removal of copies or abstracts of any such record, account, document, or file.

(c) The commissioner or any of his examiners shall have the power to issue subpoenas, to administer oaths and to examine under oath any person as to any matter pertinent to the examination. Upon the failure or refusal of any person to obey a subpoena, the commissioner may petition a court of competent jurisdiction, and upon proper showing, the court may enter an order compelling the witness to appear and testify or produce documentary evidence. Failure to obey the court order shall be punishable as contempt of court.

(d) When making an examination under this title, the commissioner may retain, without appropriation under RSA 9 and without qualifying as a department expenditure under RSA 4:15, attorneys, appraisers, independent actuaries, independent certified public accountants or other professionals and specialists as examiners, the cost of which shall be borne by the company which is the subject of the examination. The company shall pay the retained professional or specialist directly for these costs.

(e) Nothing contained in this title shall be construed to limit the commissioner's authority to terminate or suspend any examination in order to pursue other legal or regulatory action pursuant to the insurance laws of this state. Findings of fact and conclusions made pursuant to any examination shall be prima facie evidence in any legal or regulatory action.

(f) Nothing contained in this title shall be construed to limit the commissioner's authority to use and, if appropriate, to make public any final or preliminary examination report, any examiner or company workpapers or other documents, or any other information discovered or developed during the course of any examination in the furtherance of any legal or regulatory action which the commissioner may, in his discretion, deem appropriate.

(g) For the purposes of this section "person" means an individual, a corporation, a partnership, an association, a joint stock company, a trust, an unincorporated organization, and any similar entity or any combination of such entities acting in concert.

IV. 
Exam Report, Distribution, Procedure.

(a) No later than 60 days following completion of the examination, the examiner in charge shall file with the department a verified written report of examination under oath. Upon receipt of the verified report, the department shall transmit the report to the company examined, together with a notice which shall afford the company examined 30 days to make a written submission or rebuttal with respect to any matters contained in the examination report. The company examined may request, within the 30 day period and for good cause shown, additional time to make the written submission or rebuttal.

(b) Within 30 days of the period allowed for the receipt of written submissions or rebuttals, the commissioner shall fully consider and review the report, together with any written submissions or rebuttals, and any relevant portions of the examiner's workpapers and enter an order:

(1) Adopting the examination report as filed or with modification or corrections. If the examination report reveals that the company is operating in violation of any law, regulation or prior order of the commissioner, the commissioner may order the company to take any action the commissioner considers necessary and appropriate to cure such violation;

(2) Rejecting the examination report with directions to the examiners to reopen the examination for purposes of obtaining additional data, documentation or information, and refiling as provided in subparagraph (a); or

(3) Calling for an investigatory hearing with no less than 20 days notice to the company for purposes of obtaining additional documentation, data, information, and testimony.

(c)(1) Upon the adoption of the examination report, the commissioner shall continue to hold the content of the examination report as private and confidential information for a period of 20 days, except as otherwise provided in this chapter.

(2) If requested by the person examined within 20 days after receipt of the order adopting the examination report, or if deemed advisable by the commissioner, the commissioner shall hold a closed meeting relative to the report. The closed meeting shall be conducted within 20 days after a request for closed meeting. Any order of the commissioner issued pursuant to RSA 400-A:37, IV(b)(1) shall be suspended pending a final decision of the commissioner after the closed meeting and the commissioner shall not file the report until after such closed meeting and his or her final order on the report; except that the commissioner may furnish a copy of the examination report:

(A) To the governor, attorney general, or treasurer pending the closed meeting and final decision thereon; and

(B) As otherwise provided in this chapter.

(3) After the closed meeting, the commissioner shall issue a final order on the report and shall file the final report. The commissioner may order the company to take any action the commissioner considers necessary and appropriate to cure any violation. Twenty days after the report is filed as a final report, the commissioner may open the report for public inspection if no court of competent jurisdiction has stayed its publication.

(4) If no request for a closed meeting is filed, the commissioner shall issue a final order on the report, shall file the final report, and may take all other appropriate action as set forth in subparagraph (3).

(5) A final report shall be filed, and any order shall be issued within 6 months after the adoption of the examination report.

(6) If the report is an examination of a domestic insurer, a copy of the report, or a summary approved by the commissioner, when filed in the department, together with the recommendations or statements of the commissioner or his or her examiner, shall be presented by the insurer's chief executive officer to the insurer's board of directors or similar governing body at a meeting which shall be held within 90 days following receipt of the report in final form by the insurer. A copy of the report shall also be furnished by the secretary of the insurer, if incorporated, or by the attorney-in-fact if a reciprocal insurer, to each member of the insurer's board of directors or board of governors, if a reciprocal insurer. The certificate of the secretary or attorney-in-fact that a copy of the examination report has been furnished to such persons shall constitute knowledge of the contents of the report by each such member.

(7) The final report after filing shall be admissible in evidence in accordance with rules of the superior court, in any action or proceeding brought by the commissioner against the person examined, or against its officers, employees, or agents. In any such action or proceeding, the commissioner or the commissioner's examiners may, however, at any time testify and offer proper evidence as to information secured or matters discovered during the course of an examination, whether or not a final written report of the examination has been made, furnished, or filed in the department.

(d) Nothing contained in this title shall prevent or be construed as prohibiting the commissioner from disclosing the content of an examination report, preliminary examination report or results, or any matter relating thereto, to the insurance department of this or any other state or country, or to law enforcement officials of this or any other state agency of the federal government at any time, so long as such agency or office receiving the report or matters relating thereto agrees in writing to hold it confidential and in a manner consistent with this title.

(e) In the event the commissioner determines that regulatory action is appropriate as a result of any examination, he or she may initiate any proceedings or actions as provided by law.

IV-a. 
Privilege for and Confidentiality of Reports and Ancillary Information.

(a) Except as provided in subparagraph IV(d) and in this subparagraph, all documents, materials, or other information, including, but not limited to, models or products provided by an entity separate from and not under direct or indirect corporate control of the company using the model or product, working papers, complaint logs, and copies thereof created, produced or obtained by or disclosed to the commissioner or any other person in the course of an examination made under this title, or in the course of analysis by the commissioner of the financial condition or market conduct of a company shall not be made public by the commissioner or any other person and shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. The commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.

(b) Documents, materials, or other information, including, but not limited to, all working papers, and copies thereof, in the possession or control of the National Association of Insurance Commissioners and its affiliates and subsidiaries shall be confidential by law and privileged, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action, if they are:

(1) Created, produced, or obtained by or disclosed to the National Association of Insurance Commissioners and its affiliates and subsidiaries in the course of the National Association of Insurance Commissioners and its affiliates and subsidiaries assisting an examination made under this chapter, or assisting a commissioner in the analysis of the financial condition or market conduct of a company; or

(2) Disclosed to the National Association of Insurance Commissioners and its affiliates and subsidiaries under subparagraph (b)(1) by a commissioner.

(c) For the purposes of subparagraph (b), this chapter includes the law of another state or jurisdiction that is substantially similar to this chapter.

(d) Neither the commissioner nor any person who received the documents, material, or other information while acting under the authority of the commissioner, including the National Association of Insurance Commissioners and its affiliates and subsidiaries, shall be permitted to testify in any private civil action concerning any confidential documents, materials, or other information subject to subparagraphs (a) and (b).

(e) In order to assist in the performance of the commissioner's duties, the commissioner:

(1) May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to subparagraphs (a) and (b), with other state, federal, and international regulatory agencies including the Bank for International Settlements, with the International Association of Insurance Supervisors or the National Association of Insurance Commissioners and their affiliates and subsidiaries, and with state, federal, and international law enforcement authorities; provided, that the recipient agrees to maintain the confidentiality and privileged status of the document, material, communication, or other information.

(2) May receive documents, materials, communications, or information, including otherwise confidential and privileged documents, materials, or information, from the National Association of Insurance Commissioners and its affiliates and subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information; and

(3) May enter into agreements governing sharing and use of information consistent with this subparagraph.

(4) May disclose the content of an examination report, preliminary examination report or results, or any matter relating thereto relative to workers' compensation audits, to the department of labor, and all such information or matter relating thereto in the possession or control of the department of labor shall be confidential by law and privileged, shall not be subject to disclosure under RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.

(f) No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the commissioner under this paragraph or as a result of sharing as authorized in subparagraph (e).

(g) A privilege established under the law of any state or jurisdiction that is substantially similar to the privilege established under this paragraph shall be available and enforced in any proceeding in, and in any court of, this state.

(h) In this paragraph "department," "insurance department," "law enforcement agency," "regulatory agency," and the "National Association of Insurance Commissioners" include, but are not limited to, their employees, agents, consultants, and contractors.

V. [Repealed.]

VI. [Repealed.]

VII. 
Examination Expense. The insurer or other person examined pursuant to this section shall bear the expense of the examination. Such expense shall be limited to expenses charged pursuant to RSA 400-A:37, III(d) and a reasonable per diem allowance for compensation and expenses for state employee examiners as determined by the commissioner. As to the per diem expense allowance and compensation allowance involved in any such examination, the commissioner may give due consideration to scales and limitations recommended by the National Association of Insurance Commissioners and outlined in the examination manual sponsored by that association. Provided, however, that if upon examination of any person specified in RSA 400-A:37, II(a) the commissioner shall determine that such person is not in violation of the provisions of Title XXXVII or applicable regulations, the expense of the examination shall be borne by the department.

VIII. 
State Employee Examiners. Notwithstanding any other provision of law, the insurer or other person liable for the travel expense of an examination pursuant to RSA 400-A:37, VII shall make such payment either directly to the state employee examiner conducting the examination, whether or not such individual is in the classified system, or to the state of New Hampshire, as may be directed by the commissioner. The commissioner may direct that the travel expense allowance be paid directly to the individual conducting the examination. The compensation allowance charged for work by state employee examiners shall be paid directly to the state. The amounts paid directly to individuals conducting the examination pursuant to this paragraph may be in excess of any amounts that may be appropriated for such purposes.

IX. 
Immunity From Liability.

(a) No cause of action shall arise nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives, or an examiner appointed by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of this chapter.

(b) No cause of action shall arise, nor shall any liability be imposed against any person for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative, or examiner pursuant to an examination made under this chapter, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive.

(c) This paragraph shall not abrogate or modify in any way common law or statutory privilege or immunity heretofore enjoyed by any person identified in subparagraph (a).

(d) A person identified in subparagraph (a) shall be entitled to an award of attorney's fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander or any other relevant tort arising out of activities in carrying out the provisions of this chapter and the party bringing the action was not substantially justified in doing so. For the purposes of this paragraph, a proceeding is "substantially justified" if it had a reasonable basis in law or fact at the time that it was initiated.


Source. 1971, 244:1. 1979, 40:1. 1983, 371:1. 1992, 288:4 to 6. 1993, 254:1. 2000, 166:2. 2004, 155:1-4. 2007, 255:6, 7. 2009, 186:1-7, I, II. 2012, 100:5. 2017, 170:1, eff. Aug. 27, 2017. 2019, 102:1, eff. Aug. 20, 2019. 2022, 42:2, eff. July 2, 2022.

    400-A:38 Repealed by 1975, 500:4, eff. Sept. 22, 1975. 

    400-A:39-a Repealed by 2004, 161:7, eff. Jan. 1, 2010. 

    400-A:39-b Review and Evaluation of Proposed Insurance Mandated Benefit Proposals Under RSA 281-A, RSA 415, RSA 420-A, and RSA 420-B. 

I. The commissioner is authorized to contract for an external review and evaluation of any mandated benefit.

II. Whenever a legislative measure containing a mandated benefit is proposed, the standing committee of either the house or the senate having jurisdiction over the proposal may refer the proposal to the insurance department for review and evaluation.

III. Upon a referral of a mandated benefit proposal from the standing committee of the house or the senate having jurisdiction over the proposal, or at the discretion of the commissioner, the insurance department shall conduct a review and evaluation of the mandated benefit proposal and shall report any results to the standing committee that has oversight of the mandated benefit. In the instance of a mandated benefit proposal affecting RSA 281-A, the review and evaluation by the insurance department shall be conducted in conjunction with input from the labor department.

IV. The report shall include, at a minimum and to the extent that information is available, the following:

(a) The social impact of mandating the benefit.

(b) The financial impact of mandating the benefit.

(c) The medical efficacy of mandating the benefit.

(d) The effects of balancing the social, economic, and medical efficacy considerations.

V. For the purposes of this section, a mandated benefit proposal is one that mandates insurance coverage for certain conditions, specific health services, specific diseases, or certain providers of health care services.


Source. 2010, 61:2, eff. May 18, 2010.

    400-A:39 Administration Fund. 

I. There is hereby established in the state treasury an administration fund for the sole purpose of paying all costs of the office of the commissioner. The fund shall be administered by the commissioner. The state treasurer shall be the custodian of the fund and all moneys and securities in the fund shall be held in trust by the state treasurer and shall not constitute money or property of the state.

II. For the purposes of this section, "
affiliate
" shall be as defined in RSA 401-B:1, I.

III. The state treasurer is authorized to disburse moneys from the fund upon written order of both the insurance commissioner and commissioner of administrative services in accordance with a budget approved by the general court. The state treasurer shall be required to give bond in an amount to be fixed and with securities approved by the insurance commissioner conditioned upon the faithful performance of his or her duty as custodian of the fund.

IV. Each insurer licensed to do business in this state, including nonprofit health services corporations organized pursuant to RSA 420-A, health maintenance organizations organized pursuant to RSA 420-B, Delta Dental Plan of New Hampshire regulated pursuant to RSA 420-F, and multiple-employer welfare arrangements licensed pursuant to RSA 415-E, shall make payments to the fund each year of its pro rata share of the fiscal year's costs of the office of the commissioner to be appropriated out of the fund. Such share is to be computed in accordance with paragraphs V and VI of this section.

V. For each year, the total amount of such payments made to the fund by all such insurers shall be an amount that, when combined with any available fund balance, is not less than the amount appropriated by the general court for the expenses of the office of the commissioner for the fiscal year commencing on the July 1 in which the payments are due.

VI. The amount payable each year by each such insurer shall be computed by the commissioner as follows:

(a) Based on the annual statement filed in such year by each insurer under RSA 400-A:31, RSA 420-A:20, RSA 420-B:9, RSA 420-F:9, or other financial statement filed under RSA 415-E:11, the commissioner shall ascertain each insurer's amount of gross direct premiums written, including policy, membership and other fees, service charges, policy dividends applied in payment for insurance, and all other considerations for insurance originating from policies covering property, subjects, or risks located, resident or to be performed in New Hampshire after deducting return premiums and dividends actually returned or credited to policyholders. The premium for Medicaid managed care coverage provided by a health carrier contracting with the department of health and human services under RSA 126-A:5, XIX shall not be included in an insurer's assessable premium, except where that coverage is provided through the purchase of insurance coverage pursuant to the New Hampshire granite advantage health care program under RSA 126-AA. If any such insurer does not otherwise timely provide the commissioner with the information necessary for such ascertainment, it shall do so on or before May 1 of each year.

(b) The commissioner shall total the amounts ascertained for all such insurers under subparagraph (a) so that the commissioner has a total for each nonaffiliated individual insurer and for each group of affiliated insurers.

(c) If the total, determined in subparagraph (b), for any nonaffiliated individual insurer or for any group of affiliated insurers exceeds the maximum allowable assessable premium amount, the commissioner shall effect an adjustment.

(1) The maximum allowable assessable premium amount shall be $200,000,000 for assessments based on premiums reported in the calendar 2000 annual statements or other financial statement submitted in compliance with RSA 415-E:11. The maximum allowable assessable premium amount shall increase each year based on the change in the Consumer Price Index, all items, as published by the United States Department of Labor Statistics or any successor or substitute index generally used to determine the purchasing power of the United States dollar and adopted by the commissioner through regulation. For calendar years after 2000, the ratio of:

(A) the index for the period 2 years prior to the calendar year in question to

(B) the index for 1998 shall be multiplied by $200,000,000 and rounded to the nearest million to obtain the maximum allowable assessable premium amount.

The commissioner shall never implement an adjustment to the maximum allowable assessable premium amount that would cause it to decrease from the prior year.

(2) The commissioner shall adjust each insurer's assessable premium from that calculated in subparagraph (a) by multiplying the amount ascertained in subparagraph (a) by the ratio of the maximum allowable assessable premium amount ascertained in subparagraph (c)(1) to the greater of the premium amount ascertained in subparagraph (b), or the maximum allowable assessable premium amount ascertained in subparagraph (c)(1).

(d) The commissioner shall total the adjusted amounts ascertained for all such insurers under subparagraph (c).

(e) For each such insurer, the commissioner shall determine the percent that the amount ascertained for it under subparagraph (c) is of the total amount ascertained for all such insurers under subparagraph (d).

(f) For each such insurer, the commissioner shall multiply the percent ascertained for it under subparagraph (e) by the sum of the amount indicated by paragraph V plus all credits applied pursuant to RSA 400-A:10, III, RSA 400-A:36, X, or RSA 401-C:7, II. The amount resulting, less any credits for which the insurer is eligible under RSA 400-A:10, III, RSA 400-A:36, X, or RSA 401-C:7, II, shall be the administrative fee for such insurer, provided that the minimum administrative fee payable by any such insurer shall be $100.

VII. At the close of each fiscal year, the commissioner shall review the department's actual expenditures against funds collected. Total assessments shall not exceed the amount appropriated to the fund. The commissioner shall not be required to return previously collected assessments. The balance in the fund at the beginning of the new fiscal year shall proportionately be used to reduce future assessments under this section.

VIII. The commissioner shall perform the calculations required by this section and notify each insurer of the insurer's assessment payable under this section as soon as practicable after July 1 of each year.

IX. The commissioner shall be charged with the conservation of the assets of the fund. In furtherance of this purpose, the attorney general shall appoint a member of his or her staff to represent the fund in all proceedings brought to enforce payment of assessments as provided in paragraph VI.

X. This section shall not apply to fraternal benefit societies or town mutual insurance companies.

XI. Any insurer that does not pay amounts due under this section within 45 days of the billing date shall incur a late payment penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

XII. The commissioner shall restrict the authority of any insurer, who does not pay amounts due under this section within 90 days of the billing date, to servicing existing in-force business only.

XIII. For any insurer, who does not pay amounts due under this section within 180 days of the billing date, the commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state.

XIV. The commissioner may adopt rules that provide for the administration of this section in accordance with state agency accounting principles and practices.


Source. 1981, 111:2. 1985, 225:2; 316:1, 2; 399:3, I. 1989, 186:1. 1991, 246:2. 2001, 52:1. 2015, 276:257. 2017, 218:5, eff. July 10, 2017. 2018, 342:18, eff. Dec. 31, 2018. 2019, 179:2, eff. Jan. 1, 2020. 2022, 141:1, eff. Aug. 6, 2022.

    400-A:4 Seal. 

The office shall have a seal which shall be like the seal of state, except the words, "Insurance Department, New Hampshire," shall be substituted for the words "Seal of the State of New Hampshire, 1776". The commissioner shall attach the seal of the office to all certificates and other similar official papers issued by him, and no further proof shall be required to authenticate the same when they are offered in evidence.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:40 to 400-A:66 Repealed by 1991, 355:93, I, eff. July 1, 1991. 

    400-A:5 Office. 

The commissioner shall be provided with an office in some suitable place in Concord.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-A:6 Deputy Commissioner;  Other Department Positions. 

I. The commissioner, subject to the approval of the governor, shall appoint a deputy commissioner of insurance who shall hold office for 5 years and until a successor has been appointed and qualified.

II. The deputy commissioner of insurance shall perform such duties and exercise such powers of the commissioner pursuant to RSA Title XXXVII as the commissioner from time to time may authorize.

III. When the office of the commissioner is vacant, or when the commissioner is unable to perform his duties because of mental or physical disability, the deputy commissioner of insurance shall be acting commissioner.

III-a. There shall be an assistant commissioner who shall be appointed by the commissioner of insurance. He or she shall serve at the pleasure of the commissioner. When the offices of the commissioner and deputy commissioner are vacant, or when the commissioner or deputy commissioner is unable to perform his or her duties because of mental or physical disability, the assistant commissioner shall be acting commissioner. The assistant commissioner shall perform such duties and exercise such powers of the commissioner pursuant to RSA Title XXXVII as the commissioner from time to time may authorize.

III-b. [Repealed.]

III-c. [Repealed.]

III-d. [Repealed.]

IV, V. [Repealed.]

VI. [Repealed.]

VII. The commissioner shall appoint, as the commissioner's assistants, a director of financial regulation, a director of life and health, a director of health economics, a director of health care analytics, a general counsel, an insurance fraud director, a senior insurance fraud investigator, a director of property and casualty, a property and casualty actuary, a chief property and casualty actuary, a workers' compensation analyst, a chief life, accident and health actuary, a compliance and enforcement counsel, a chief financial examiner, a communications director, and a health reform coordinator, each of whom shall serve at the pleasure of the commissioner. The director of financial regulation, director of life and health, director of health economics, director of health care analytics, general counsel, insurance fraud director, senior insurance fraud investigator, director of property and casualty, property and casualty actuary, chief property and casualty actuary, workers' compensation analyst, chief life, accident and health actuary, compliance and enforcement counsel, chief financial examiner, communications director, and health reform coordinator, shall perform such duties and exercise such powers as the commissioner may authorize.


Source. 1971, 244:1. 1977, 499:2. 1987, 411:11. 1990, 246:5, 6; 254:37. 1992, 221:3. 1997, 351:21. 2003, 150:3. 2004, 187:6. 2005, 177:102. 2008, 387:4. 2010, 212:1; 243:14. 2015, 276:174, 176. 2017, 154:1, 2, 9, eff. Aug. 15, 2017. 2018, 140:2, eff. May 30, 2018. 2021, 91:374, eff. July 1, 2021.

    400-A:67 Repealed by 2015, 227:2, eff. Nov. 1, 2016. 

    400-A:7 Repealed by 1977, 499:6, eff. Sept. 12, 1977. 

    400-A:8 Compensation;  Expenses;  Bonds. 

I. 
Compensation. The salary of the commissioner, deputy commissioner, assistant commissioner, and all assistants to the commissioner shall be as prescribed in RSA 94:1-a.

II. 
Expenses. The commissioner, deputy commissioner, assistant commissioner, and all assistants to the commissioner shall be allowed their traveling expenses while engaged in the performance of their duties.

III. 
Bonds. The commissioner shall procure an official blanket bond conforming to New Hampshire law and covering the commissioner and each employee of his office in the penal sum of $100,000. The bond shall be underwritten by an insurer authorized to transact business in the state and shall be filed in the office of the secretary of state. Premium for the bond shall be a charge upon available funds and the appropriation for the insurance department.


Source. 1971, 244:1. 1977, 499:3. 1990, 246:7. 1992, 221:4. 2004, 187:7. 2015, 276:175. 2017, 154:3, eff. Aug. 15, 2017.

    400-A:9 Departmental Organization. 

Within the department there shall be such divisions, not expressly provided for or prohibited by law, as the commissioner deems advisable for the discharge of his duties.


Source. 1971, 244:1, eff. Aug. 17, 1971.

    400-B:1 Purpose. 

The intent of this chapter is to provide clear record retention and production instruction to entities licensed by the department.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    400-B:10 Time Limits to Provide Records and to Respond to Examiners. 

I. Initial data requests shall be submitted to a company at least 30 days prior to the commencement of the on-site examination, desk audit, or other form of review to provide ample time for the company to prepare the materials requested by the examining state. Paragraphs II and III shall apply to requests for supplemental data and information not anticipated at the time of the initial request as specified herein.

II. As a means to facilitate the examination and to aid in the examination in accordance with RSA 400-A:37, an insurer shall provide any requested document or written response to an inquiry submitted by an examiner within 10 working days, or such other time period as mutually agreed upon by the examiner and the insurer. When the requested document or response is not produced by the insurer within the specified time period, a violation shall be deemed to have occurred unless the insurer can demonstrate to the satisfaction of the commissioner that the requested record cannot reasonably be provided within the specified time period of the request.

III. Additional records requested by the commissioner shall be made available for the examination upon the date specified by the examiner-in-charge.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    400-B:11 Confidential Materials. 

Original records required to be provided during a market conduct examination shall be returned to the insurer following the examination. If the records relate to an inquiry made by an examiner, copies of the records shall become a part of the work papers of the examination. Examination work papers obtained as part of a market conduct examination are privileged and confidential and not subject to the provisions of RSA 91-A.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    400-B:12 Penalties. 

 Any insurer or related entity who knowingly violates any provision of this chapter may, upon hearing, except where other penalty is expressly provided, be subject to suspension or revocation of its certificate of authority or license, and an administrative fine not to exceed $2,500 per violation.


Source. 2008, 153:3, eff. June 6, 2008.

    400-B:13 Rulemaking. 

The commissioner may adopt rules, pursuant to RSA 541-A, as necessary for the purposes of this chapter.


Source. 2015, 91:1, eff. Aug. 4, 2015.

    400-B:2 Definitions. 

All definitions contained in RSA 417 are hereby incorporated by reference. In addition, for the purposes of this chapter:

I. "
Application and accompanying records
" means any written or electronic application form, any enrollment form, any document or record thereof, used to add coverage under any existing policy, questionnaire, telephone interview form, paramedical interview form, or any other document used to question or underwrite an applicant for any policy issued by an insurer or for any declination of coverage by an insurer.

II. "
Claim file and accompanying records
" means the file maintained to show clearly the inception, handling, and disposition of each claim. The claim file shall be sufficiently clear and specific so that pertinent events and dates of these events can be reconstructed.

III. "
Complaint
" means any written or electronically transmitted communication primarily expressing a grievance.

IV. "
Declination
" or "
declined underwriting file
" means all written or electronic records concerning coverage for which an application has been submitted to the insurer or its producer but the insurer has made a determination not to issue a policy or not to add additional coverage when requested.

V. "
Department
" means the insurance department.

VI. "
Examiner
" means a market conduct examiner or any other examiner authorized or designated by the commissioner to conduct an examination pursuant to this chapter.

VII. "
Grievance
" for health insurance purposes, means a written complaint submitted by or on behalf of a covered person regarding the:

(a) Availability, delivery, or quality of health services, including a complaint regarding an adverse determination made pursuant to utilization review;

(b) Claims payment, handling, or reimbursement for health care services; or

(c) Matters pertaining to the contractual relationship between a covered person and a health carrier.

VIII. "
Inquiry
" means a specific question, criticism, or request made in writing to an insurer by an examiner.

IX. "
Related entity
" includes a person authorized to act on behalf of the insurer in connection with the business of insurance.


Source. 2005, 221:1. 2006, 196:14. 2009, 178:2, eff. Sept. 11, 2009.

    400-B:3 Records Required for Market Conduct Purposes. 

I. An insurer or related entity licensed to do business in this state shall maintain its books, records, and documents in a manner so that the commissioner can readily ascertain during an examination the insurer's compliance with state insurance laws and rules and with the standards outlined in the NAIC Market Regulation Handbook, including, but not limited to, company operations and management, policyholder service, marketing, producer licensing, underwriting, rating, complaint/grievance handling, and claims practices.

II. For a health insurer, the insurer or related entity shall maintain its books, records, and documents in a manner so that the practices of the insurer regarding network adequacy, utilization review, quality assessment and improvement, and provider credentialing may be ascertained during a market conduct examination.

III. These records shall be retained for the current year plus 5 years.

IV. The producer of record, if the insurer does not maintain such information, shall maintain a file for each policy sold, and the file shall contain all work papers and written communications in his or her possession pertaining to the policy documented therein. These records shall be retained for the current year plus 5 years.

V. During an examination of the insurer, the insurer shall provide a copy of the written contract entered into with each third party vendor or service provider as requested by an examiner within the time frames set forth in RSA 400-B:10.


Source. 2005, 221:1. 2009, 178:3, eff. Sept. 11, 2009.

    400-B:4 Policy Record File. 

I. A policy record file shall be maintained for each policy issued, and shall be maintained for the duration of the current policy term plus 5 years, or for life insurance policies and annuity contracts, for the time the policy or contract is in force and 5 years thereafter. Policy records shall be maintained to show clearly the policy period, basis for rating, and any imposition of additional exclusions from or exceptions to coverage. If a policy is terminated, either by the insurer or the policyholder, documentation supporting the termination and account records indicating a return of premiums, if any, shall also be maintained. Policy records need not be segregated from the policy records of other states if the records are readily available to market conduct examiners as required under this chapter.

II. Policy records shall include the following:

(a) Any application and accompanying records for each contract. The application shall bear a clearly legible means by which an examiner can identify a producer involved in the transaction. The examiners shall be provided with information clearly identifying the producer involved in the transaction;

(b) Any declaration pages (the initial page and any subsequent pages), the insurance contract, any certificates evidencing coverage under a group contract, any endorsements or riders associated with a policy, any termination notices, and any written or electronic correspondence to or from the insured pertaining to the coverage. If any of these records has already been filed with the commissioner, a separate copy of the record need not be maintained in the individual policy files to which the record pertains; provided, that it is clear from the insurer's other records or systems that the record applies to a particular policy and that any data contained in the record relating to the policy, as well as the actual policy issued to the insured, can be retrieved or recreated;

(c) Any binder; and

(d) Any guidelines, manuals, or other information necessary for the reconstruction of the rating, underwriting, policy owner service, and claims handling of the policy. The maintenance at the site of a market conduct examination of a single copy of each of the above shall satisfy this requirement. These types of records include, but are not limited to, the application, the policy form including any amendments or endorsements, rating manuals, underwriting rules, credit reports or scores, claims history reports, previous insurance coverage reports (e.g., MIB), questionnaires, internal reports, and underwriting and rating notes.

III. A declined underwriting file shall be maintained and shall include an application, any documentation substantiating the decision to decline an issuance of a policy, any binder issued without the insurer issuing a policy, any documentation substantiating the decision not to add additional coverage when requested, and the declination notification. Notes regarding requests for quotations that do not result in a completed application for coverage need not be maintained for purposes of this chapter. The insurer shall retain declined underwriting files for the current year plus 5 years.


Source. 2005, 221:1, eff. Sept. 3, 2005. 2021, 56:2, eff. July 24, 2021.

    400-B:5 Claim File. 

I. A claim file and accompanying records shall be maintained for the calendar year in which the claim is closed plus 5 years. The claim file shall be maintained to show clearly the inception, handling, and disposition of each claim. The claim file shall be sufficiently clear and specific so that pertinent events and dates of these events can be reconstructed. A claim file shall, at a minimum, include the following items:

(a) For property and casualty: the file or files containing the notice of claim, claim forms, proof of loss, or other form of claim submission, settlement demands, accident reports, policy reports, adjusters' logs, claim investigation documentation, inspection reports, supporting bills, estimates and valuation worksheets, medical records, correspondence to and from insureds and claimants or their representatives, notes, contracts, declaration pages, certificates evidencing coverage under a group contract, endorsements or riders, work papers, any written communication, any documented or recorded telephone communication related to the handling of a claim, including the investigation, payment, or denial of the claim, copies of checks, drafts, check numbers and amounts, numeric identifying information for debit cards, bank cards, or other similar cards, including date of issue and amounts, releases, all applicable notices, correspondence used for determining and concluding claim payments or denials, subrogation and salvage documentation, any other documentation created and maintained in a paper or electronic format, necessary to support claim handling activity, and any claim manuals or other information necessary for reviewing the claim.

(b) For life and annuity: the file or files containing the notice of claim, claim forms, proofs of loss, medical records, correspondence to and from insureds and claimants or their representatives, claim investigation documentation, claim handling logs, copies of checks or drafts, check numbers and amounts, releases, correspondence, all applicable notices, and correspondence used for determining and concluding claim payments or denials, any written communication, any documented or recorded telephone communication related to the handling of a claim, including the investigation, and any other documentation, maintained in a paper or electronic format, necessary to support claim handling activity.

(c) For health: the file or files containing the notice of claim, claim forms, medical records, bills, electronically submitted bills, proofs of loss, correspondence to and from insureds and claimants or their representatives, claim investigation documentation, health facility pre-admission certification or utilization review documentation, claim handling logs, copies of explanation of benefit statements, any written communication, any documented or recorded telephone communication related to the handling of a claim, including the investigation, copies of checks or drafts, or check numbers and amounts, releases, correspondence, all applicable notices, and correspondence used for determining and concluding claim payments or denials, and any other documentation, maintained in a paper or electronic format, necessary to support claim handling activity.

II. Where a particular document pertains to more than one file, insurers may satisfy the requirements of this section by making available, at the site of an examination, a single copy of each document.

III. Documents in a claim file received from an insured, the insured's agent, a claimant, the department or any other insurer shall bear the initial date of receipt by the insurer, date stamped in a legible form of ink, in an electronic format, or some other permanent manner. Unless the company provides the examiners with written procedures to the contrary, the earliest date indicated on a document shall be considered the initial date of receipt.

IV. If an insurer, as its regular business practice, places the responsibility for handling certain types of claims upon company personnel other than its claims personnel, the insurer need not duplicate its files for maintenance by claims personnel. These claims records shall be maintained as part of the records of the insurer's operations and shall be readily available to examiners.


Source. 2005, 221:1. 2014, 31:1, eff. July 26, 2014.

    400-B:6 Licensing Records. 

Records to be maintained relating to the insurer's compliance with licensing requirements shall include the licensing records of each producer associated with the insurer. Licensing records shall be maintained to show clearly the licensing status of the producer at the time of solicitation, negotiation, or procurement, as well as the dates of the appointments and terminations of each producer. A screen print from the producer database (PDB) may serve to provide adequate proof only of a producer's current licensing status.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    400-B:7 Complaint Records. 

The complaint records required to be maintained under RSA 417 shall include a complaint log or register, or grievance log or register for health insurers, in addition to the actual written complaints. The complaint log or register shall show clearly the total number of complaints for the current year plus the immediately preceding 5 years, the classification of each complaint by line of insurance and by complainant, the nature of each complaint, the insurer's disposition of each complaint, the time it took to process each complaint, and the complaint number assigned by the department, if applicable. If the insurer maintains the file in a computer format, the reference in the complaint log or register for locating the documentation shall be an identifier such as the policy number or other code. The codes shall be provided to the examiners at the time of an examination.


Source. 2005, 221:1. 2006, 196:15, eff. July 30, 2006.

    400-B:8 Format of Records. 

I. Any record required to be maintained by an insurer may be created and stored in the form of paper, photograph, magnetic, mechanical, or electronic medium; or any process that accurately forms a durable reproduction of the record, so long as the record is capable of duplication to a hard copy that is as legible as the original document. Documents that are produced and sent to an insured by use of a template and an electronic mail list shall be considered to be sufficiently reproduced if the insurer can provide proof of mailing of the document and a copy of the template. Documents that require the signature of the insured or insurer's producer shall be maintained in any format listed in this chapter; provided, that evidence of the signature is preserved in that format.

II. The maintenance of records in a computer-based format shall be archival in nature, to preclude the alteration of the record after the initial transfer to a computer format. Upon request of an examiner, all records shall be capable of duplication to a hard copy that is as legible as the original document. The records shall be maintained according to written procedures developed and adhered to by the insurer. The written procedures shall be made available to the commissioner during an examination.

III. Photographs, microfilms, or other image-processing reproductions of records shall be equivalent to the originals and may be certified as the same in actions or proceedings before the commissioner unless inconsistent with RSA 541-A.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    400-B:9 Location of Files. 

I. All records required to be maintained under this chapter shall be kept in a location that will allow the records to be produced for examination within the time period required. When, under normal circumstances, someone other than the insurer maintains a required record or type of record, the other person's responsibility to maintain the records shall be set forth in a written agreement, a copy of which shall be maintained by the insurer and shall be available to the examiners for purposes of examination.

II. If required by law or otherwise available, the insurer shall maintain disaster preparedness or disaster recovery procedures that include provisions for the maintenance or reconstruction of original or duplicate records at another location. These procedures shall be provided for review during the examination.


Source. 2005, 221:1, eff. Sept. 3, 2005.

    401-B:1 Definitions. 

In this chapter:

I. An "
affiliate
" of, or person "
affiliated
" with, a specific person, is a person that directly, or indirectly through one or more intermediaries, controls, or is controlled by, or is under common control with, the person specified.

II. "
Commissioner
" means the insurance commissioner.

III. "
Control
" (including the terms "
controlling
," "
controlled by
" and "
under common control with
") means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or non-management services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. Control shall be presumed to exist if any person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing, 10 percent or more of the voting securities of any other person. This presumption may be rebutted by a showing made in the manner provided by RSA 401-B:4, XI that control does not exist in fact. The commissioner may determine, after furnishing all persons in interest notice and opportunity to be heard and making specific findings of fact to support such determination, that control exists in fact, notwithstanding the absence of a presumption to that effect.

IV. "
Department
" means the department of insurance.

IV-a. "
Group-wide supervisor
" means the regulatory official authorized to engage in conducting and coordinating group-wide supervision activities who is determined or acknowledged by the commissioner under RSA 401-B:7-a to have sufficient significant contacts with the internationally active insurance group.

IV-b. "
Group capital calculation instructions
" means the group capital calculation instructions as adopted by the NAIC and as amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

V. An "
insurance holding company system
" consists of 2 or more affiliated persons, one or more of which is an insurer.

VI. "Insurer" shall have the same meaning as set forth in RSA 401-B:3-a, IV(b)(3)(A) except that it shall not include agencies, authorities or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.

VI-a. "
Internationally active insurance group
" means an insurance holding company system that:

(a) Includes an insurer registered under RSA 401-B:4; and

(b) Meets the following criteria:

(1) Premiums written in at least 3 countries;

(2) The percentage of gross premiums written outside the United States is at least 10 percent of the insurance holding company system's total gross written premiums; and

(3) Based on a 3-year rolling average, the total assets of the insurance holding company system are at least $50,000,000,000, or the total gross written premiums of the insurance holding company system are at least $10,000,000,000.

VII. "
Enterprise risk
" means any activity, circumstance, event or series of events involving one or more affiliates of an insurer that, if not remedied promptly, is likely to have a material adverse effect upon the financial conditions or liquidity of the insurer or its insurance holding company system as a whole, including, but not limited to, anything that would cause the insurer's risk-based capital to fall into company action level as set forth in RSA 404-F:3 or would cause the insurer to be in hazardous financial condition (Ins 2900).

VIII. "
NAIC
" means the National Association of Insurance Commissioners.

VIII-a. "
NAIC liquidity stress test framework
" means a separate NAIC publication which includes a history of the NAIC's development of regulatory liquidity stress testing, the scope criteria applicable for a specific data year, and the liquidity stress test instructions and reporting templates for a specific data year, such scope criteria, instructions, and reporting template being as adopted by the NAIC and as amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

IX. "
Person
" means an individual, a corporation, a limited liability company, a partnership, an association, a joint stock company, a trust, an unincorporated organization, any similar entity or any combination of the foregoing acting in concert, but shall not include any joint venture partnership exclusively engaged in owning, managing, leasing, or developing real or tangible personal property.

IX-a. "
Scope criteria
" means, as detailed in the NAIC liquidity stress test framework, the designated exposure bases, along with minimum magnitudes thereof for the specified data year, used to establish a preliminary list of insurers considered scoped in the NAIC liquidity stress test framework for that data year.

X. A "
security holder
" of a specified person is one who owns any security of such person, including common stock, preferred stock, debt obligations, and any other security convertible into or evidencing the right to acquire any of the foregoing.

XI. A "
subsidiary
" of a specified person is an affiliate controlled by such person directly, or indirectly through one or more intermediaries.

XII. "
Voting security
" shall include any security convertible into or evidencing a right to acquire a voting security.


Source. 2013, 152:1, eff. Jan. 1, 2014. 2022, 41:1-4, eff. May 3, 2022.

    401-B:10 Injunctions;  Prohibitions Against Voting Securities;  Sequestration of Voting Securities. 

I. Injunctions. Whenever it appears to the commissioner that any insurer or any director, officer, employee, or agent thereof has committed or is about to commit a violation of this chapter or of any rule, regulation, or order issued by the commissioner hereunder, the commissioner may apply to the superior court for the county in which the principal office of the insurer is located or if such insurer has no office in this state then to the superior court for Merrimack county for an order enjoining the insurer or director, officer, employee, or agent thereof from violating or continuing to violate this chapter or any rule, regulation or order, and for such other equitable relief as the nature of the case and the interest of the insurer's policyholders, creditors, and shareholders or the public may require.

II. Voting of Securities; When Prohibited. No security which is the subject of any agreement or arrangement regarding acquisition, or which is acquired or to be acquired, in contravention of the provisions of this chapter or of any rule, regulation, or order issued by the commissioner hereunder may be voted at any shareholders' meeting, or may be counted for quorum purposes, and any action of shareholders requiring the affirmative vote of a percentage of shares may be taken as though the securities were not issued and outstanding; but no action taken at any such meeting shall be invalidated by the voting of the securities, unless the action would materially affect control of the insurer or unless the courts of this state have so ordered. If an insurer or the commissioner has reason to believe that any security of the insurer has been or is about to be acquired in contravention of the provisions of this chapter or of any rule, regulation, or order issued by the commissioner hereunder; the insurer or the commissioner may apply to the superior court for Merrimack county or to the superior court for the county in which the insurer has its principal place of business to enjoin any offer, request, invitation, agreement or acquisition made in contravention of RSA 401-B:3 or any rule, regulation, or order issued by the commissioner thereunder to enjoin the voting of any security so acquired, to void any vote of the security already cast at any meeting of shareholders, and for such other equitable relief as the nature of the case and the interest of the insurer's policyholders, creditors and shareholders or the public may require.

III. Sequestration of Voting Securities. In any case where a person has acquired or is proposing to acquire any voting securities in violation of this chapter or any rule, regulation, or order issued by the commissioner hereunder, the superior court for Merrimack county or the superior court for the county in which the insurer has its principal place of business may, on such notice as the court deems appropriate, upon the application of the insurer or the commissioner seize or sequester any voting securities of the insurer owned directly or indirectly by the person, and issue such order as may be appropriate to effectuate the provisions of this chapter. Notwithstanding any other provisions of law, for the purposes of this chapter, the situs of the ownership of the securities of domestic insurers shall be deemed to be in this state.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:11 Sanctions. 

I. Any insurer failing, without just cause, to file any registration statement as required in this chapter shall be required, after notice and hearing, to pay a penalty of $2,500 for each day's delay, to be recovered by the commissioner. The commissioner may reduce the penalty if the insurer demonstrates to the commissioner that the imposition of the penalty would constitute a financial hardship to the insurer.

II. Every director or officer of an insurance holding company system who knowingly violates, participates in, or assents to, or who knowingly shall permit any of the officers or agents of the insurer to engage in transactions or make investments which have not been properly reported or submitted pursuant to RSA 401-B:4, I; RSA 401-B:5, I(b) and II or which violate this chapter, shall pay, in individual capacity, a civil forfeiture of not more than $2,500 per violation, after notice and hearing before the commissioner. In determining the amount of the civil forfeiture, the commissioner shall take into account the appropriateness of the forfeiture with respect to the gravity of the violation, the history of previous violations, and such other matters as justice may require.

III. Whenever it appears to the commissioner that any insurer subject to this chapter or any director, officer, employee, or agent thereof has engaged in any transaction or entered into a contract which is subject to RSA 401-B:5 and which would not have been approved had the approval been requested, the commissioner may order the insurer to cease and desist immediately any further activity under that transaction or contract. After notice and hearing the commissioner may also order the insurer to void any contracts and restore the status quo if the action is in the best interest of the policyholders, creditors, or the public.

IV. Whenever it appears to the commissioner that any insurer or any director, officer, employee, or agent thereof has committed a willful violation of this chapter, the commissioner may cause criminal proceedings to be instituted pursuant to RSA 400-A:16, V by the court for the county in which the principal office of the insurer is located of if the insurer has no office in this state, then by the Merrimack County superior court against the insurer or the responsible director, officer, employee, or agent thereof. Any insurer which willfully violates this chapter may be fined pursuant to RSA 651:2, IV. Any individual who willfully violates this chapter may be fined in his or her individual capacity pursuant to RSA 651:2, IV or be imprisoned for not more than one to 3 years or both.

V. Any officer, director, or employee of an insurance holding company system who willfully and knowingly subscribes to or makes or causes to be made any false statements or false reports or false filings with the intent to deceive the commissioner in the performance of his or her duties under this chapter, upon conviction shall be imprisoned for not more than one to 3 years or fined pursuant to RSA 651:2, IV or both. Any fines imposed shall be paid by the officer, director, or employee in his or her individual capacity.

VI. Whenever it appears to the commissioner that any person has committed a violation of RSA 401-B:3 and which prevents the full understanding of the enterprise risk to the insurer by affiliates or by the insurance holding company system, the violation may serve as an independent basis for disapproving dividends or distributions and for placing the insurer under an order of supervision in accordance with RSA 402-C.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:12 Receivership. 

Whenever it appears to the commissioner that any person has committed a violation of this chapter which so impairs the financial condition of a domestic insurer as to threaten insolvency or make the further transaction of business by it hazardous to its policyholders, creditors, shareholders, or the public, the commissioner may proceed as provided in RSA 402-C to take possession of the property of such domestic insurer and to conduct its business.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:13 Recovery. 

I. If an order for liquidation or rehabilitation of a domestic insurer has been entered, the receiver appointed under the order shall have a right to recover on behalf of the insurer:

(a) From any parent corporation or holding company or person or affiliate who otherwise controlled the insurer, the amount of distributions (other than distributions of shares of the same class of stock) paid by the insurer on its capital stock; or

(b) Any payment in the form of a bonus, termination settlement, or extraordinary lump sum salary adjustment made by the insurer or its subsidiary to a director, officer or employee, where the distribution or payment pursuant to subparagraphs (a) or (b) is made at any time during the one year preceding the petition for liquidation, conservation or rehabilitation, as the case may be, subject to the limitations of paragraphs II-IV.

II. No distribution shall be recoverable if the parent or affiliate shows that when paid the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.

III. Any person who was a parent corporation or holding company or a person who otherwise controlled the insurer or affiliate at the time the distributions were paid shall be liable up to the amount of distributions or payments under paragraph I which the person received. Any person who otherwise controlled the insurer at the time the distributions were declared shall be liable up to the amount of distributions that would have been received if they had been paid immediately. If 2 or more persons are liable with respect to the same distributions, they shall be jointly and severally liable.

IV. The maximum amount recoverable under this section shall be the amount needed in excess of all other available assets of the impaired or insolvent insurer to pay the contractual obligations of the impaired or insolvent insurer and to reimburse any guaranty funds.

V. To the extent that any person liable under paragraph III is insolvent or otherwise fails to pay claims due from it, its parent corporation or holding company or person who otherwise controlled it at the time the distribution was paid shall be jointly and severally liable for any resulting deficiency in the amount recovered from the parent corporation or holding company or person who otherwise controlled it.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:14 Revocation, Suspension, or Nonrenewal of Insurer's License. 

Whenever it appears to the commissioner that any person has committed a violation of this chapter which makes the continued operation of an insurer contrary to the interests of policyholders or the public, the commissioner may, after giving notice and opportunity to be heard, suspend, revoke or refuse to renew the insurer's license or authority to do business in this state for such period as the commissioner finds is required for the protection of policyholders or the public. Any such determination shall be accompanied by specific findings of fact and conclusions of law.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:15 Appeal. 

I. Judicial Review, Mandamus. Any person aggrieved by any act, determination, rule, regulation, or order of any other action of the commissioner pursuant to this chapter may appeal in accordance with RSA 541. The court shall conduct its review without a jury and by trial de novo, except that if all parties, including the commissioner, so stipulate, the review shall be confined to the record. Portions of the record may be introduced by stipulation into evidence in a trial de novo as to those parties so stipulating.

II. The filing of an appeal pursuant to this section shall stay the application of any rule, regulation, order, or other action by the commissioner to the appealing party unless the court, after giving the party notice and an opportunity to be heard, determines that a stay would be detrimental to the interest of policyholders, shareholders, creditors or the public.

III. Any person aggrieved by any failure of the commissioner to act or make a determination required by this chapter may petition the Merrimack county superior court for a writ of mandamus or a peremptory mandamus directing the commissioner to act or make a determination.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:16 Time Limits for Agency Action. 

The time limits specified in this chapter for the commissioner to act on any holding company application, petition, or request and the provisions in this chapter under which an application, petition, or request may or may not be deemed to be approved when the commissioner does not act after a specified period of time shall control, and RSA 541-A:29 and RSA 541-A:29-a shall not apply.


Source. 2018, 279:21, eff. Jan. 1, 2019.

    401-B:2 Subsidiaries of Insurers. 

I. Authorization. Any domestic insurer, either by itself or in cooperation with one or more persons, may organize or acquire one or more subsidiaries. The subsidiaries may conduct any kind of business or businesses and their authority to do so shall not be limited by reasons of the fact that they are subsidiaries of a domestic insurer.

II. Additional Investment Authority. In addition to investments in common stock, preferred stock, debt obligations and other securities permitted under this title, a domestic insurer may also:

(a) Invest, in common stock, preferred stock, debt obligations, and other securities of one or more subsidiaries, amounts which do not exceed the lesser of 10 percent of the insurer's assets or 50 percent of the insurer's surplus as regards policyholders, provided that after such investments, the insurer's surplus as regards policyholders will be reasonable in relation to the insurer's outstanding liabilities and adequate to meet its financial needs. In calculating the amount of such investments, investments in domestic or foreign insurance subsidiaries and health maintenance organizations shall be excluded, and there shall be included:

(1) Total net moneys or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of the subsidiary whether or not represented by the purchase of capital stock or issuance of other securities; and

(2) All amounts expended in acquiring additional common stock, preferred stock, debt obligations, and other securities; and all contributions to the capital or surplus of a subsidiary subsequent to its acquisition or formation.

(b) Invest any amount in common stock, preferred stock, debt obligations, and other securities of one or more subsidiaries engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer, provided that each such subsidiary agrees to limit its investments in any asset so that such investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations specified in subparagraph II(a). For the purpose of this paragraph, "
the total investment of the insurer
" shall include:

(1) Any direct investment by the insurer in an asset; and

(2) The insurer's proportionate share of any investment in an asset by any subsidiary of the insurer, which shall be calculated by multiplying the amount of the subsidiary's investment by the percentage of the ownership of the subsidiary.

(c) With the approval of the commissioner, invest any greater amount in common stock, preferred stock, debt obligations, or other securities of one or more subsidiaries; provided that after the investment the insurer's surplus as regards policyholders will be reasonable in relation to the insurer's outstanding liabilities and adequate to its financial needs.

III. Exemption from Investment Restrictions. Investments in common stock, preferred stock, debt obligations, or other securities of subsidiaries made pursuant to paragraph II, shall not be subject to any of the otherwise applicable restrictions or prohibitions contained in this chapter applicable to such investments of insurers.

IV. Qualification of Investment; When Determined. Whether any investment made pursuant to paragraph II meets the applicable requirements of that paragraph is to be determined before the investment is made, by calculating the applicable investment limitations as though the investment had already been made, taking into account the then outstanding principal balance on all previous investments in debt obligations, and the value of all previous investments in equity securities as of the day they were made, net of any return of capital invested, not including dividends.

V. Cessation of Control. If an insurer ceases to control a subsidiary, it shall dispose of any investment therein made pursuant to this section within 3 years from the time of the cessation of control or within such further time as the commissioner may prescribe, unless at any time after the investment shall have been made, the investment shall have met the requirements for investment under any other section of this chapter, and the insurer has notified the commissioner.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:3-a Acquisitions Involving Insurers Not Otherwise Covered. 

I. Definitions. In this section:

(a) "
Acquisition
" means any agreement, arrangement or activity, the consummation of which results in a person acquiring directly or indirectly the control of another person, and includes but is not limited to the acquisition of voting securities, the acquisition of assets, bulk reinsurance and mergers.

(b) An "
involved insurer
" includes an insurer which either acquires or is acquired, is affiliated with an acquirer or acquired, or is the result of a merger.

II. Scope.

(a) Except as exempted in subparagraph II(b), this section applies to any acquisition in which there is a change in control of an insurer authorized to do business in this state.

(b) This section shall not apply to the following:

(1) A purchase of securities solely for investment purposes as long as the securities are not used by voting or otherwise to cause or attempt to cause the substantial lessening of competition in any insurance market in this state. If a purchase of securities results in a presumption of control under RSA 401-B:1, III, it is not solely for investment purposes unless the commissioner of the insurer's state of domicile accepts a disclaimer of control or affirmatively finds that control does not exist and the disclaimer action or affirmative finding is communicated by the domiciliary commissioner to the commissioner of this state.

(2) The acquisition of a person by another person when both persons are neither directly nor through affiliates primarily engaged in the business of insurance, if pre-acquisition notification is filed with the commissioner in accordance with subparagraph III(a) 30 days prior to the proposed effective date of the acquisition. However, such pre-acquisition notification is not required for exclusion from this section if the acquisition would otherwise be excluded from this section by any other provision of RSA 401-B:3-a, II(b).

(3) The acquisition of already affiliated persons.

(4) An acquisition if, as an immediate result of the acquisition:

(A) In no market would the combined market share of the involved insurers exceed 5 percent of the total market.

(B) There would be no increase in any market share; or

(C) In no market would:

(i) The combined market share of the involved insurers exceed 12 percent of the total market; and

(ii) The market share increase by more than 2 percent of the total market.

For the purpose of this subparagraph, a market means direct written insurance premium in this state for a line of business as contained in the annual statement required to be filed by insurers licensed to do business in this state.

(5) An acquisition for which a pre-acquisition notification would be required pursuant to this section due solely to the resulting effect on the ocean marine insurance line of business.

(6) An acquisition of an insurer whose domiciliary commissioner affirmatively finds that such insurer is in failing condition; there is a lack of feasible alternative to improving such condition; the public benefits of improving the insurer's condition through the acquisition exceed the public benefits that would arise from not lessening competition; and the findings are communicated by the domiciliary commissioner to the commissioner of this state.

III. Pre-Acquisition Notification; Waiting Period. An acquisition covered by paragraph II may be subject to an order pursuant to paragraph V, unless the acquiring person files a pre-acquisition notification and the waiting period has expired. The acquired person may file a pre-acquisition notification. The commissioner shall give confidential treatment to information submitted under this paragraph in the same manner as provided in RSA 401-B:8.

(a) The pre-acquisition notification shall be in such form and contain such information as prescribed by the NAIC relating to those markets which, under subparagraph II(b)(4), cause the acquisition not to be exempted from the provisions of this section. The commissioner may require such additional material and information as deemed necessary to determine whether the proposed acquisition, if consummated, would violate the competitive standard of paragraph IV. The required information may include an opinion of an economist as to the competitive impact of the acquisition in this state accompanied by a summary of the education and experience of such person indicating his or her ability to render an informed opinion.

(b) The waiting period required shall begin on the date of receipt of the commissioner of a pre-acquisition notification and shall end on the earlier of the thirtieth day after the date of the receipt, or termination of the waiting period, by the commissioner. Prior to the end of the waiting period, the commissioner on a one-time basis may require the submission of additional needed information relevant to the proposed acquisition, in which event the waiting period shall end on the earlier of the thirtieth day after receipt of the additional information by the commissioner or termination of the waiting period by the commissioner.

IV. Competitive Standard.

(a) The commissioner may enter an order under subparagraph V(a) with respect to an acquisition if there is substantial evidence that the effect of the acquisition may be substantially to lessen competition in any line of insurance in this state or tend to create a monopoly or if the insurer fails to file adequate information in compliance with paragraph III.

(b) In determining whether a proposed acquisition would violate the competitive standard of subparagraph IV(a) the commissioner shall consider the following:

(1) Any acquisition covered under paragraph II involving 2 or more insurers competing in the same market is prima facie evidence of violation of the competitive standards:

(A) If the market is highly concentrated and the involved insurers possess the following shares of the market:

 
 
Insurer A
 
Insurer B
 
 
 4 percent
 4 percent or more
 
 10 percent
 2 percent or more
 
 15 percent
 1 percent or more
 
 


(B) Or, if the market is not highly concentrated and the involved insurers possess the following shares of the market:

 
 
Insurer A
 
Insurer B
 
 
 5 percent
 5 percent or more
 
 10 percent
 4 percent or more
 
 15 percent
 3 percent or more
 
 19 percent
 1 percent or more
 
 


A highly concentrated market is one in which the share of the 4 largest insurers is 75 percent or more of the market. Percentages not shown in the tables are interpolated proportionately to the percentages that are shown. If more than 2 insurers are involved, exceeding the total of the 2 columns in the table is prima facie evidence of violation of the competitive standard in subparagraph IV(a). For the purpose of this subparagraph, the insurer with the largest share of the market shall be deemed to be insurer A.

(2) There is a significant trend toward increased concentration when the aggregate market share of any grouping of the largest insurers in the market, from the 2 largest to the 8 largest, has increased by 7 percent or more of the market over a period of time extending from any base year 5 to 10 years prior to the acquisition up to the time of the acquisition. Any acquisition or merger covered under paragraph II involving 2 or more insurers competing in the same market is prima facie evidence of violation of the competitive standard in subparagraph IV(a) if:

(A) There is a significant trend toward increased concentration in the market;

(B) One of the insurers involved is one of the insurers in a grouping of large insurers showing the requisite increase in the market share; and

(C) Another involved insurer's market is 2 percent or more.

(3) For the purposes of subparagraph IV(b):

(A) The term "
insurer
" includes any company or group of companies under common management, ownership, or control.

(B) The term "
market
" means the relevant product and geographical markets. In determining the relevant product and geographical markets, the commissioner shall give due consideration to, among other things, the definitions or guidelines, if any, promulgated by the NAIC and to information, if any, submitted by parties to the acquisition. In the absence of sufficient information to the contrary, the relevant product market is assumed to be the direct written insurance premium for a line of business, such line being that used in the annual statement required to be filed by insurers doing business in this state, and the relevant geographical market is assumed to be this state.

(C) The burden of showing prima facie evidence of violation of the competitive standard rests upon the commissioner.

(4) Even though an acquisition is not prima facie violative of the competitive standard under subparagraphs IV(b)(1) and (2), the commissioner may establish the requisite anti-competitive effect based upon other substantial evidence. Even though an acquisition is prima facie violative of the competitive standard under subparagraphs IV(b)(1) and (2), a party may establish the absence of the requisite anti-competitive effect based upon other substantial evidence. Relevant factors in making a determination under this subparagraph include, but are not limited to, the following: market shares, volatility of ranking of market leaders, number of competitors, concentration, trend of concentration in the industry, and ease of entry and exit into the market.

(c) An order may not be entered under subparagraph V(a) if:

(1) The acquisition will yield substantial economies of scale or economies in resource utilization that cannot be feasibly achieved in any other way, and the public benefits which would arise from such economies exceed the public benefits which would arise from not lessening competition; or

(2) The acquisition will substantially increase the availability of insurance, and the public benefits of the increase exceed the public benefits which would arise from not lessening competition.

V. Orders and Penalties.

(a)(1) If an acquisition violates the standards of this section, the commissioner may enter an order:

(A) Requiring an involved insurer to cease and desist from doing business in this state with respect to the line or lines of insurance involved in the violation; or

(B) Denying the application of an acquired or acquiring insurer for a license to do business in this state.

(2)(A) Such an order shall not be entered unless:

(i) There is a hearing;

(ii) Notice of such hearing to be issued prior to the end of the waiting period and not less than 15 days prior to the hearing; and

(iii) The hearing is concluded and the order is issued no later than 60 days after the date of the filing of the pre-acquisition notification with the commissioner.

(B) Every order shall be accompanied by a written decision of the commissioner setting forth findings of fact and conclusions of law.

(3) An order pursuant to subparagraph V(a) shall not apply if the acquisition is not consummated.

(b) Any person who violates a cease and desist order of the commissioner under subparagraph V(a) and while the order is in effect may, after notice and hearing and upon order of the commissioner be subject at the discretion of the commissioner to one or more of the following:

(1) A monetary penalty of not more than $10,000 for every day of violation; or

(2) Suspension or revocation of the person's license.

(c) Any insurer or other person who fails to make any filing required by this section, and who also fails to demonstrate a good faith effort to comply with any such filing requirement, shall be subject to an administrative fine of not more than $50,000.

VI. Inapplicable Provisions. RSA 401-B:10, II and III and RSA 401-B:12 shall not apply to acquisitions covered under paragraph II.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:3 Acquisition of Control of or Merger With Domestic Insurer. 

I. Filing Requirements.

(a) No person other than the issuer shall make a tender offer for or a request or invitation for tenders of, or enter into any agreement to exchange securities for, seek to acquire, or acquire, in the open market or otherwise, any voting security of a domestic insurer if, after the consummation thereof, such person would, directly or indirectly (or by conversion or by exercise of any right to acquire) be in control of the insurer, and no person shall enter into an agreement to merge with or otherwise to acquire control of a domestic insurer or any person controlling a domestic insurer unless, at the time the offer, request, or invitation is made or the agreement is entered into, or prior to the acquisition of such securities if no offer or agreement is involved, such person has filed with the commissioner and has sent to the insurer a statement containing the information required by this section and the offer, request, invitation, agreement, or acquisition has been approved by the commissioner in the manner hereinafter prescribed.

(b) For purposes of this section, any controlling person of a domestic insurer seeking to divest its controlling interest in the domestic insurer, in any manner, shall file with the commissioner, with a copy to the insurer, confidential notice of its proposed divestiture at least 30 days prior to the cessation of control. The commissioner shall determine those instances in which the party seeking to divest or to acquire a controlling interest in an insurer, shall be required to file for and obtain approval of the transaction. The information shall remain confidential until the conclusion of the transaction unless the commissioner, in his or her discretion, determines that confidential treatment will interfere with enforcement of this section. If the statement referred to in subparagraph (a) is otherwise filed, this subparagraph shall not apply.

(c) With respect to a transaction subject to this section, the acquiring person shall also file a pre-acquisition notification with the commissioner, which shall contain the information set forth in RSA 401-B:3-a, III(a). Failure to file the notification may subject the acquiring person to the penalties specified in RSA 401-B:3-a, V(c).

(d) For purposes of this section, a domestic insurer shall include any person controlling a domestic insurer unless the person as determined by the commissioner, is either directly or through its affiliates primarily engaged in business other than the business of insurance. For the purposes of this section, "person" shall not include any securities broker holding, in the usual and customary broker's function, less than 20 percent of the voting securities of an insurance company or of any person which controls an insurance company.

II. Content of Statement. The statement to be filed with the commissioner shall be made under oath or affirmation and shall contain the following:

(a) The name and address of each person by whom or on whose behalf the merger or other acquisition of control referred to in paragraph I is to be effected (hereinafter called "acquiring party"); and

(1) If such person is an individual, his or her principal occupation and all offices and positions held during the past 5 years, and any conviction of crimes other than minor traffic violations during the past 10 years;

(2) If the person is not an individual, a report of the nature of its business operations during the past 5 years or for the lesser period as the person and any predecessors shall have been in existence; an informative description of the business intended to be done by the person and the person's subsidiaries; and a list of all individuals who are or who have been selected to become directors or executive officers of the person, or who perform or will perform functions appropriate to such positions. The list shall include for each individual the information required by subparagraph (a)(1).

(b) The source, nature, and amount of the consideration used or to be used in effecting the merger or other acquisition of control, a description of any transaction where funds were or are to be obtained for any such purpose, including any pledge of the insurer's stock, or the stock of any of its subsidiaries or controlling affiliates, and the identity of persons furnishing consideration, provided, however, that where a source of consideration is a loan made in the lender's ordinary course of business, the identity of the lender shall remain confidential, if the person filing the statement so requests.

(c) Fully audited financial information as to the earnings and financial condition of each acquiring party for the preceding 5 fiscal years of each the acquiring party (or for such lesser period as the acquiring party and any predecessors thereof shall have been in existence), and similar unaudited information as of a date not earlier than 90 days prior to the filing of the statement.

(d) Any plans or proposals which each acquiring party may have to liquidate the insurer, to sell its assets or merge or consolidate it with any person, or to make any other material change in its business or corporate structure or management.

(e) The number of shares of any security referred to in paragraph I which each acquiring party proposes to acquire, and the terms of the offer, request, invitation, agreement, or acquisition referred to in paragraph I and a statement as to the method by which the fairness of the proposal was determined.

(f) The amount of each class of any security referred to in paragraph I which is beneficially owned or concerning which there is a right to acquire beneficial ownership by each acquiring party.

(g) A full description of any contracts, arrangements, or understandings with respect to any security referred to in paragraph I in which any acquiring party is involved, including but not limited to transfer of any of the securities, joint ventures, loan or option arrangements, puts or calls, guarantees of loans, guarantees against loss or guarantees of profits, division of losses or profits, or the giving or withholding of proxies. The description shall identify the persons with whom the contracts, arrangements or understandings have been entered into.

(h) A description of the purchase of any security referred to in paragraph I during the 12 calendar months preceding the filing of the statement by any acquiring party, including the dates of purchase, names of the purchasers, and consideration paid or agreed to be paid.

(i) A description of any recommendations to purchase any security referred to in paragraph I made during the 12 calendar months preceding the filing of the statement by any acquiring party, or by anyone based upon interviews or at the suggestion of the acquiring party.

(j) Copies of all tender offers for, requests or invitations for tenders of, exchange offers for, and agreements to acquire or exchange any securities referred to in paragraph I and (if distributed) of additional soliciting material relating to them.

(k) The terms of any agreement, contract, or understanding made with or proposed to be made with any broker-dealer as to solicitation of securities referred to in paragraph I for tender, and the amount of any fees, commissions, or other compensation to be paid to broker-dealers with regard thereto.

(l) An agreement by the person required to file the statement referred to in paragraph I that it will provide the annual report specified in RSA 401-B:4, XII for as long as control exists.

(m) An acknowledgement by the person required to file the statement referred to in paragraph I that the person and all subsidiaries within its control in the insurance holding company system will provide information to the commissioner upon request as necessary to evaluate enterprise risk to the insurer.

(n) Such additional information as the commissioner may by rule prescribe as necessary or appropriate for the protection of policyholders of the insurer or in the public interest.

III. If the person required to file the statement referred to in paragraph I is a partnership, limited partnership, syndicate or other group, the commissioner may require that the information called for by subparagraphs II(a) through (n) shall be given with respect to each partner of the partnership or limited partnership, each member of the syndicate or group, and each person who controls the partner or member. If any partner, member, or person is a corporation or a person required to file the statement referred to in paragraph I is a corporation, the commissioner may require that the information called for by subparagraphs II(a) through (n) shall be given with respect to such corporation, each officer and director of such corporation, and each person who is directly or indirectly the beneficial owner of more than 10 percent of the outstanding voting securities of the corporation.

IV. Changes. If any material change occurs in the facts set forth in the statement filed with the commissioner and sent to such insurer pursuant to paragraph II or III, an amendment setting forth such change, together with copies of all documents and other material relevant to such change, shall be filed with the commissioner and sent to the insurer within 2 business days after the person learns of the change.

V. Alternative Filing Materials. If any offer, request, invitation, agreement, or acquisition referred to in paragraph I is proposed to be made by means of a registration statement under the Securities Act of 1933 or in circumstances requiring the disclosure of similar information under the Securities Exchange Act of 1934, or under a state law requiring similar registration or disclosure, the person required to file the statement referred to in paragraph I may utilize the documents in furnishing the information called for by that statement.

VI. Approval by Commissioner; Hearings.

(a) The commissioner shall approve any merger or other acquisition of control referred to in paragraph I unless, after a public hearing, the commissioner finds that:

(1) After the change of control the domestic insurer referred to in paragraph I would not be able to satisfy the requirements for the issuance of a license to write the line or lines of insurance for which it is presently licensed;

(2) The effect of the merger or other acquisition of control would be substantially to lessen competition in insurance in this state or tend to create a monopoly. In applying the competitive standard in this subparagraph:

(A) The informational requirements of RSA 401-B:3-a, III(a) and the standards of RSA 401-B:3-a, IV(b) shall apply;

(B) The merger or other acquisition shall not be disapproved if the commissioner finds that any of the situations meeting the criteria provided by RSA 401-B:3-a, IV(c) exist; and

(C) The commissioner may condition the approval of the merger or other acquisition on the removal of the basis of disapproval within a specified period of time.

(3) The financial condition of any acquiring party is such as might jeopardize the financial stability of the insurer, or prejudice the interest of its policyholders;

(4) The plans or proposals which the acquiring party has to liquidate the insurer, sell its assets or consolidate or merge it with any person, or to make any other material change in its business or corporate structure or management, are unfair and unreasonable to policyholders of the insurer and not in the public interest;

(5) The competence, experience, and integrity of those persons who would control the operation of the insurer are such that it would not be in the interest of policyholders of the insurer and of the public to permit the merger or other acquisition of control; or

(6) The acquisition is likely to be hazardous or prejudicial to the insurance buying public.

(b) The public hearing referred to in subparagraph VI(a) shall be held within 30 days after the statement required by paragraph I is filed and at least 20 days' notice shall be given by the commissioner to the person filing the statement. Not less than 7 days' notice of the public hearing shall be given by the person filing the statement to the insurer and to such other persons as may be designated by the commissioner. The insurer shall give such notice to its security holders. The commissioner shall make a determination within 30 days after the conclusion of the hearing. At such hearing, the person filing the statement, the insurer, any person to whom notice of hearing was sent, and any other person whose interest may be affected shall have the right to present evidence, examine and cross-examine witnesses, and offer oral and written arguments and in connection therewith shall be entitled to conduct discovery proceedings in the same manner as is presently allowed in the superior court of this state. All discovery proceedings shall be concluded not later than 3 days prior to the commencement of the public hearing.

(c) If the proposed acquisition of control will require the approval of more than one commissioner, the public hearing referred to in subparagraph (b) may be held on a consolidated basis upon request of the person filing the statement referred to in paragraph I. Such person shall file the statement referred to in paragraph I with the National Association of Insurance Commissioners (NAIC) within 5 days of making the request for a public hearing. A commissioner may opt out of a consolidated hearing, and shall provide notice to the applicant of the opt-out within 10 days of the receipt of the statement referred to in paragraph I. A hearing conducted on a consolidated basis shall be public and shall be held within the United States before the commissioners of the states in which the insurers are domiciled. Such commissioners shall hear and receive evidence. A commissioner may attend such hearing, in person or by telecommunication.

(d) In connection with a change of control of a domestic insurer, any determination by the commissioner that the person acquiring control of the insurer shall be required to maintain or restore the capital of the insurer to the level required by the laws and regulations of this state shall be made not later than 60 days after the date of notification of the change in control submitted pursuant to subparagraph I(a).

(e) The commissioner may retain at the acquiring person's expense any attorneys, actuaries, accountants, and other experts not otherwise a part of the commissioner's staff as may be reasonably necessary to assist the commissioner in reviewing the proposed acquisition of control.

VII. Exemptions. The provisions of this section shall not apply to any offer, request, invitation, agreement, or acquisition which the commissioner by order shall exempt as not having been made or entered into for the purpose and not having the effect of changing or influencing the control of a domestic insurer, or as otherwise not comprehended within the purposes of this section.

VIII. Violations. The following shall be violations of this section:

(a) The failure to file any statement, amendment, or other material required to be filed pursuant to paragraph I or II.

(b) The effectuation or any attempt to effectuate an acquisition of control of, divestiture of, or merger with, a domestic insurer unless the commissioner has given approval.

IX. Jurisdiction; Consent to Service of Process. The courts of this state are hereby vested with jurisdiction over every person not resident, domiciled, or authorized to do business in this state who files a statement with the commissioner under this section, and over all actions involving such person arising out of violations of this section, and each the person shall be deemed to have performed acts equivalent to and constituting an appointment by the person of the commissioner to be his true and lawful attorney upon whom may be served all lawful process in any action, suit or proceeding arising out of violations of this section. Copies of all lawful process shall be served on the commissioner and transmitted by registered or certified mail by the commissioner to the person at his last known address.


Source. 2013, 152:1, eff. Jan. 1, 2014. 2021, 56:3, eff. July 24, 2021.

    401-B:4 Registration of Insurers. 

I. Registration.

(a) Every insurer which is authorized to do business in this state and which is a member of an insurance holding company system shall register with the commissioner, except a foreign insurer subject to registration requirements and standards adopted by statute or rule in the jurisdiction of its domicile which are substantially similar to those contained in:

(1) RSA 401-B:4; and

(2) RSA 401-B:5, I(a), II and IV; and

(3) Either RSA 401-B:5, I(b) or a provision such as the following: Each registered insurer shall keep current the information required to be disclosed in its registration statement by reporting all material changes or additions within 15 days after the end of the month in which it learns of each change or addition.

(b) Any insurer which is subject to registration under this section shall register within 15 days after it becomes subject to registration and annually thereafter by August 1 of each year for the previous calendar year, unless the commissioner for good cause shown extends the time for registration, and then within the extended time. The commissioner may require any insurer authorized to do business in this state which is a member of an insurance holding company system, and which is not subject to registration under this section, to furnish a copy of the registration statement, the summary specified in paragraph III, or other information filed by such insurance company with the insurance regulatory authority of its domiciliary jurisdiction.

II. Information and Form Required. Every insurer subject to registration shall file a registration statement with the commissioner on a form and in a format prescribed by NAIC which shall contain the following current information:

(a) The capital structure, general financial condition, ownership, and management of the insurer and any person controlling the insurer;

(b) The identity and relationship of every member of the insurance holding company system;

(c) The following agreements in force and transactions currently outstanding or which have occurred during the last calendar year between the insurer and its affiliates:

(1) Loans, investments, purchases, sales, or exchanges of securities of the affiliates by the insurer or of the insurer by its affiliates;

(2) Purchases, sales, or exchanges of assets;

(3) Transactions not in the ordinary course of business;

(4) Guarantees or undertakings for the benefit of an affiliate which result in an actual contingent exposure of the insurer's assets to liability, other than insurance contracts entered into in the ordinary course of the insurer's business;

(5) All management and service contracts and all cost-sharing arrangements;

(6) Reinsurance agreements;

(7) Dividends and other distributions to shareholders; and

(8) Consolidated tax allocation agreements.

(d) Any pledge of the insurer's stock, including stock of any subsidiary or controlling affiliate for a loan made to any member of the insurance holding company system.

(e) If requested by the commissioner, the insurer shall include financial statements of or within an insurance holding company system, including all affiliates. Financial statements may include but are not limited to annual audited financial statements filed with the United States Securities and Exchange Commission (SEC) pursuant to the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended. An insurer required to file financial statements pursuant to this subparagraph may satisfy the request by providing the commissioner with the most recently filed parent corporation financial statements that have been filed with the SEC.

(f) Other matters concerning transactions between registered insurers and any affiliates as may be included from time to time in any registration forms adopted or approved by the commissioner.

(g) Statements that the insurer's board of directors oversees corporate governance and internal controls and that the insurer's officers or senior management have approved, implemented, and continue to maintain and monitor corporate governance and internal control procedures.

(h) Any other information required by the commissioner by rule or regulation.

III. Summary of Changes to Registration Statement. All registration statements shall contain a summary outlining all items in the current registration statement representing changes from the prior registration statement.

IV. Materiality. No information need be disclosed on the registration statement filed pursuant to paragraph II, if the information is not material for the purposes of this section. Unless the commissioner by rule, regulation, or order provides otherwise, sales, purchases, exchanges, loans or extensions of credit, investments, or guarantees involving 
1/2 of one percent or less of an insurer's admitted assets as of the 31st day of December next preceding shall not be deemed material for purposes of this section. The definition of materiality provided in this paragraph shall not apply for purposes of the group capital calculation or the liquidity stress test framework.

V. Reporting of Dividends to Shareholders. Subject to RSA 401-B:5, II, each registered insurer shall report to the commissioner all dividends and other distributions to shareholders within 15 business days following the declaration thereof.

VI. Information of Insurers. Any person within an insurance holding company system subject to registration shall be required to provide complete and accurate information to an insurer, where the information is reasonably necessary to enable the insurer to comply with the provisions of this chapter.

VII. Termination of Registration. The commissioner shall terminate the registration of any insurer which demonstrates that it no longer is a member of an insurance holding company system.

VIII. Consolidated Filing. The commissioner may require or allow 2 or more affiliated insurers subject to registration to file a consolidated registration statement.

IX. Alternative Registration. The commissioner may allow an insurer which is authorized to do business in this state and which is part of an insurance holding company system to register on behalf of any affiliated insurer which is required to register under paragraph I, and to file all information and material required to be filed under this section.

X. Exemptions. The provisions of this section shall not apply to any insurer, information or transaction if and to the extent that the commissioner by rule, regulation, or order shall exempt the same from the provisions of this section.

XI. Disclaimer. Any person may file with the commissioner a disclaimer of affiliation with any authorized insurer or a disclaimer may be filed by the insurer or any member of an insurance holding company system. The disclaimer shall fully disclose all material relationships and bases for affiliation between the person and the insurer as well as the basis for disclaiming the affiliation. A disclaimer of affiliation shall be deemed to have been granted unless the commissioner, within 30 days following receipt of a complete disclaimer, notifies the filing party the disclaimer is disallowed. In the event of disallowance, the disclaiming party may request an administrative hearing, which shall be granted. The disclaiming party shall be relieved of its duty to register under this section if approval of the disclaimer has been granted by the commissioner, or if the disclaimer is deemed to have been approved.

XII. Enterprise Risk Filing.

(a) The ultimate controlling person of every insurer subject to registration shall also file an annual enterprise risk report. The report shall, to the best of the ultimate controlling person's knowledge and belief, identify the material risks within the insurance holding company system that could pose enterprise risk to the insurer. The report shall be filed with the lead state commissioner of the insurance holding company system as determined by the procedures within the Financial Analysis Handbook adopted by the NAIC.

(b) Group Capital Calculation. Except as provided in this subparagraph, the ultimate controlling person of every insurer subject to registration shall concurrently file with the registration an annual group capital calculation as directed by the lead state commissioner. The report shall be completed in accordance with the NAIC group capital calculation instructions, which may permit the lead state commissioner to allow a controlling person that is not the ultimate controlling person to file the group capital calculation. The report shall be filed with the lead state commissioner of the insurance holding company system as determined by the commissioner in accordance with the procedures within the financial analysis handbook adopted by the NAIC. Insurance holding company systems described below are exempt from filing the group capital calculation:

(1) An insurance holding company system that has only one insurer within its holding company structure, that only writes business and is only licensed in its domestic state, and assumes no business from any other insurer;

(2) An insurance holding company system that is required to perform a group capital calculation specified by the United States Federal Reserve Board. The lead state commissioner shall request the calculation from the Federal Reserve Board under the terms of information sharing agreements in effect. If the Federal Reserve Board cannot share the calculation with the lead state commissioner, the insurance holding company system is not exempt from the group capital calculation filing;

(3) An insurance holding company system whose non-U.S. group-wide supervisor is located within a reciprocal jurisdiction as described in RSA 405:47, IV-b(a) that recognizes the U.S. state regulatory approach to group supervision and group capital;

(4) An insurance holding company system:

(A) That provides information to the lead state that meets the requirements for accreditation under the NAIC financial standards and accreditation program, either directly or indirectly through the group-wide supervisor, who has determined such information is satisfactory to allow the lead state to comply with the NAIC group supervision approach, as detailed in the NAIC financial analysis handbook; and

(B) Whose non-U.S. group-wide supervisor that is not in a reciprocal jurisdiction recognizes and accepts, as specified by the commissioner in regulation, the group capital calculation as the world-wide group capital assessment for U.S. insurance groups who operate in that jurisdiction.

(5) Notwithstanding the provisions of subparagraphs (3) and (4) above, a lead state commissioner shall require the group capital calculation for U.S. operations of any non-U.S. based insurance holding company system where, after any necessary consultation with other supervisors or officials, it is deemed appropriate by the lead state commissioner for prudential oversight and solvency monitoring purposes or for ensuring the competitiveness of the insurance marketplace.

(6) Notwithstanding the exemptions from filing the group capital calculation stated in subparagraphs (1)-(4), the lead state commissioner has the discretion to exempt the ultimate controlling person from filing the annual group capital calculation or to accept a limited group capital filing or report in accordance with criteria as specified by the commissioner in regulation.

(7) If the lead state commissioner determines that an insurance holding company system no longer meets one or more of the requirements for an exemption from filing the group capital calculation under this section, the insurance holding company system shall file the group capital calculation at the next annual filing date unless given an extension by the lead state commissioner based on reasonable grounds shown.

(c) Liquidity Stress Test. The ultimate controlling person of every insurer subject to registration and also scoped into the NAIC liquidity stress test framework shall file the results of a specific year's liquidity stress test. The filing shall be made to the lead state insurance commissioner of the insurance holding company system as determined by the procedures within the financial analysis handbook adopted by the National Association of Insurance Commissioners.

(1) The NAIC liquidity stress test framework includes scope criteria applicable to a specific data year. These scope criteria are reviewed at least annually by the financial stability task force or its successor. Any change to the NAIC liquidity stress test framework or to the data year for which the scope criteria are to be measured shall be effective on January 1 of the year following the calendar year when such changes are adopted. Insurers meeting at least one threshold of the scope criteria are considered scoped into the NAIC liquidity stress test framework for the specified data year unless the lead state insurance commissioner, in consultation with the NAIC financial stability task force or its successor, determines the insurer should not be scoped into the framework for that data year. Similarly, insurers that do not trigger at least one threshold of the scope criteria are considered scoped out of the NAIC liquidity stress test framework for the specified data year, unless the lead state insurance commissioner, in consultation with the NAIC financial stability task force or its successor, determines the insurer should be scoped into the framework for that data year.

(2) Regulators wish to avoid having insurers scoped in and out of the NAIC liquidity stress test framework on a frequent basis. The lead state insurance commissioner, in consultation with the financial stability task force or its successor, will assess this concern as part of the determination for an insurer.

(3) The performance of, and filing of the results from, a specific year's liquidity stress test shall comply with the NAIC liquidity stress test framework's instructions and reporting templates for that year and any lead state insurance commissioner determinations, in conjunction with the financial stability task force or its successor, provided within the framework.

XIII. Violations. The failure to file a registration statement or any summary of the registration statement or enterprise risk filing required by this section within the time specified for such filing shall be a violation of this section.


Source. 2013, 152:1, eff. Jan. 1, 2014. 2021, 56:4, eff. July 24, 2021. 2022, 41:5, 6, eff. May 3, 2022.

    401-B:5 Standards and Management of an Insurer Within a Holding Company System. 

I. Transactions Within an Insurance Holding Company System.

(a) Transactions within an insurance holding company system to which an insurer subject to registration is a party shall be subject to the following standards:

(1) The terms shall be fair and reasonable.

(2) Agreements for cost sharing services and management shall include such provisions as required by rule and regulation issued by the commissioner.

(3) Charges or fees for services performed shall be reasonable.

(4) Expenses incurred and payment received shall be allocated to the insurer in conformity with customary insurance accounting practices consistently applied.

(5) The books, accounts, and records of each party to all such transactions shall be so maintained as to clearly and accurately disclose the nature and details of the transactions, including such accounting information as is necessary to support the reasonableness of the charges or fees to the respective parties.

(6) The insurer's surplus as regards policyholders following any dividends or distributions to shareholder affiliates shall be reasonable in relation to the insurer's outstanding liabilities and adequate to meet its financial needs.

(7) If an insurer subject to RSA 401-B is deemed by the commissioner to be in a hazardous financial condition as defined by insurance department rules or a condition that would be grounds for supervision, conservation, or a delinquency proceeding, then the commissioner may require the insurer to secure and maintain either a deposit, held by the commissioner, or a bond, as determined by the insurer at the insurer's discretion, for the protection of the insurer for the duration of the contract or agreement, or the existence of the condition for which the commissioner required the deposit or the bond. In determining whether a deposit or a bond is required, the commissioner should consider whether concerns exist with respect to the affiliated person's ability to fulfill the contract or agreement if the insurer were to be put into liquidation. Once the insurer is deemed to be in a hazardous financial condition or a condition that would be grounds for supervision, conservation, or a delinquency proceeding, and a deposit or bond is necessary, the commissioner has discretion to determine the amount of the deposit or bond, not to exceed the value of the contract or agreement in any one year, and whether such deposit or bond should be required for a single contract, multiple contracts or a contract only with a specific person(s).

(8) All records and data of the insurer held by an affiliate are and remain the property of the insurer, are subject to control of the insurer, are identifiable, and are segregated, or readily capable of segregation at no additional cost to the insurer, from all other persons' records and data. This includes all records and data that are otherwise the property of the insurer, in whatever form maintained, including, but not limited to, claims and claim files, policyholder lists, application files, litigation files, premium records, rate books, underwriting manuals, personnel records, financial records, or similar records within the possession, custody, or control of the affiliate. At the request of the insurer, the affiliate shall provide that the receiver can obtain a complete set of all records of any type that pertain to the insurer's business; obtain access to the operating systems on which the data is maintained; obtain the software that runs those systems either through assumption of licensing agreements or otherwise; and restrict the use of the data by the affiliate if it is not operating the insurer's business. The affiliate shall provide a waiver of any landlord lien or other encumbrance to give the insurer access to all records and data in the event of the affiliate's default under a lease or other agreement.

(9) Premiums or other funds belonging to the insurer that are collected by or held by an affiliate are the exclusive property of the insurer and are subject to the control of the insurer. Any right of offset in the event an insurer is placed into receivership shall be subject to RSA 402-C.

(b) The following transactions involving a domestic insurer and any person in its holding company system, including amendments or modifications of affiliate agreements previously filed pursuant to this section, which are subject to any materiality standards contained in RSA 401-B:5, I (b)(1)-(7), may not be entered into unless the insurer has notified the commissioner in writing of its intention to enter into the transaction at least 30 days prior thereto, or such shorter period as the commissioner may permit, and the commissioner has not disapproved it within such period. The notice for amendments or modifications shall include the reasons for the change and the financial impact on the domestic insurer. Informal notice shall be reported, within 30 days after a termination of a previously filed agreement, to the commissioner for determination of the type of filing required, if any.

(1) Sales, purchases, exchanges, loans, extensions of credit, or investments, provided the transactions are equal to or exceed:

(A) With respect to nonlife insurers, the lesser of 3 percent of the insurer's admitted assets or 25 percent of surplus as regards policyholders; as of December 31, next preceding.

(B) With respect to life insurers, 3 percent of the insurer's admitted assets as of December 31, next preceding.

(2) Loans or extensions of credit to any person who is not an affiliate, where the insurer makes such loans or extensions of credit with the agreement or understanding that the proceeds of such transactions, in whole or in substantial part, are to be used to make loans or extensions of credit to, to purchase assets of, or to make investments in, any affiliate of the insurer making the loans or extensions of credit provided the transactions are equal to or exceed:

(A) With respect to nonlife insurers, the lesser of 3 percent of the insurer's admitted assets or 25 percent of surplus as regards policyholders as of December 31, next preceding;

(B) With respect to life insurers, 3 percent of the insurer's admitted assets, as of December 31, next preceding.

(3) Reinsurance agreements or modifications thereto, including:

(A) All reinsurance pooling agreements;

(B) Agreements in which the reinsurance premium or a change in the insurer's liabilities, or projected reinsurance premium or a change in the insurer's liabilities in any of the next 3 years, equals or exceeds 5 percent of the insurer's surplus as regards policyholders, as of the December 31, next preceding, including those agreements which may require as consideration the transfer of assets from an insurer to a non-affiliate, if an agreement or understanding exists between the insurer and non-affiliate that any portion of the assets will be transferred to one or more affiliates of the insurer.

(4) All management agreements, service contracts, tax allocation agreements, guarantees, and all cost-sharing arrangements.

(5) Guarantees when made by a domestic insurer; provided, however, that a guarantee which is quantifiable as to amount is not subject to the notice requirements of this paragraph unless it exceeds the lesser of 
1/2 of one percent of the insurer's admitted assets or 10 percent of surplus as regards policyholders as of December 31, next preceding. Further, all guarantees which are not quantifiable as to amount are subject to the notice requirements of this paragraph.

(6) Direct or indirect acquisitions or investments in a person that controls the insurer or in an affiliate of the insurer in an amount which, together with its present holdings in such investments, exceeds 2
1/2 percent of the insurer's surplus to policyholders. Direct or indirect acquisitions or investments in subsidiaries acquired pursuant to RSA 401-B:2 or authorized under any other section of this chapter, or in non-subsidiary insurance affiliates that are subject to the provisions of this chapter, are exempt from this requirement;

(7) Any material transactions, specified by rule, which the commissioner determines may adversely affect the interests of the insurer's policyholders.

(c) Nothing in this paragraph shall be deemed to authorize or permit any transactions which, in the case of an insurer not a member of the same holding company system, would be otherwise contrary to law.

(d) A domestic insurer may not enter into transactions which are part of a plan or series of like transactions with persons within the insurance holding company system if the purpose of those separate transactions is to avoid the statutory threshold amount and thus avoid the review that would occur otherwise. If the commissioner determines that separate transactions were entered into over any 12-month period for that purpose, the commissioner may exercise his or her authority under RSA 401-B:11.

(e) The commissioner, in reviewing transactions pursuant to subparagraph I(b), shall consider whether the transactions comply with the standards of subparagraph I(a) and whether they may adversely affect the interests of policyholders. 

(f) The commissioner shall be notified within 30 days of any investment of the domestic insurer in any one corporation if the total investment in the corporation by the insurance holding company system exceeds 10 percent of the corporation's voting securities. 

(g) Supervision, seizure, conservatorship, or receivership proceedings.

(1) Any affiliate that is party to an agreement or contract with a domestic insurer that is subject to RSA 401-B:5, I(b)(4) shall be subject to the jurisdiction of any supervision, seizure, conservatorship or receivership proceedings against the insurer and to the authority of any supervisor, conservator, rehabilitator or liquidator for the insurer appointed pursuant to RSA 401-B:7-a or RSA 402-C:5 for the purpose of interpreting, enforcing and overseeing the affiliate's obligations under the agreement or contract to perform services for the insurer that:

(A) Are an integral part of the insurer's operations, including, but not limited to management, administrative, accounting, data processing, marketing, underwriting, claims handling, investment or any other similar functions; or

(B) Are essential to the insurer's ability to fulfill its obligations under insurance policies.

(2) The commissioner may require that an agreement or contract pursuant to RSA 401-B:5, I(b)(4) for the provision of services described in (1)(A) and (B) above specify that the affiliate consents to the jurisdiction as set forth in this subparagraph.

II. Dividends and Other Distributions.

(a) No domestic insurer shall pay any extraordinary dividend or make any other extraordinary distribution to its shareholders until:

(1) Thirty days after the commissioner has received notice of the declaration thereof and has not within that period disapproved the payment; or

(2) Until the commissioner has approved the payment within the 30-day period.

(b)(1) For the purposes of this section, an extraordinary dividend or distribution includes any dividend or distribution of cash or other property, whose fair market value together with that of other dividends or distributions made within the preceding 12 months exceeds the lesser of:

(A) Ten percent of such insurer's surplus as regards policyholders as of the December 31, next preceding; or

(B) The net gain from operations of the insurer, if the insurer is a life insurer, or the net income, if the insurer is not a life insurer, not including realized capital gains, for the 12-month period ending December 31, next preceding, but shall not include pro rata distributions of any class of the insurer's own securities.

(2) In determining whether a dividend or distribution is extraordinary, an insurer other than a life insurer may carry forward net income from the previous 2 calendar years that has not already been paid out as dividends. This carry-forward shall be computed by taking the net income from the second and third preceding calendar years, not including realized capital gains, less dividends paid in the second and immediate preceding calendar years.

(c) Notwithstanding any other provision of law, an insurer may declare an extraordinary dividend or distribution which is conditional upon the commissioner's approval, and the declaration shall confer no rights upon shareholders until:

(1) The commissioner has approved the payment of the dividend or distribution; or

(2) The commissioner has not disapproved the payment within the 30-day period referred to above.

III. Management of Domestic Insurers Subject to Registration.

(a) Notwithstanding the control of a domestic insurer by any person, the officers and directors of the insurer shall not thereby be relieved of any obligation or liability to which they would otherwise be subject by law, and the insurer shall be managed so as to assure its separate operating identify consistent with this chapter.

(b) Nothing in this section shall preclude a domestic insurer from having or sharing a common management or cooperative or joint use of personnel, property or services with one or more other persons under arrangements meeting the standards of subparagraph I(a).

(c) Not less than 
1/3 of the directors of a domestic insurer, and not less than 
1/3 of the member of each committee of the board of directors of any domestic insurer shall be persons who are not officers or employees of the insurer or of any entity controlling, controlled by, or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or entity. At least one such person shall be included in any quorum for the transaction of business at any meeting of the board of directors or any committee thereof.

(d) The board of directors of a domestic insurer shall establish one or more committees comprised solely of directors who are not officers or employees of the insurer or of any entity controlling, controlled by, or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or any such entity. The committee or committees shall have responsibility for nominating candidates for director for election by shareholders or policyholders, evaluating the performance of officers deemed to be principal officers of the insurer and recommending to the board of directors the selection and compensation of the principal officers.

(e) The provisions of subparagraphs (c) and (d) shall not apply to a domestic insurer if the person controlling the insurer, such as an insurer, a mutual insurance holding company, or a public held corporation, has a board of directors and committees thereof that meet the requirements of subparagraphs (c) and (d) with respect to such controlling entity.

(f) An insurer may make application to the commissioner for a waiver from the requirements of this paragraph, if the insurer's annual direct written and assumed premium, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, is less than $300,000,000. An insurer may also make application to the commissioner for a waiver from the requirements of this paragraph based upon unique circumstances. The commissioner may consider various factors including, but not limited to, the type of business entity, volume of business written, availability of qualified board members, or the ownership or organizational structure of the entity.

IV. Adequacy of Surplus. For purposes of this chapter, in determining whether an insurer's surplus as regards policyholders is reasonable in relation to the insurer's outstanding liabilities and adequate to meet its financial needs, the following factors, among others, shall be considered:

(a) The size of the insurer as measured by its assets, capital and surplus, reserves, premium writing, insurance in force, and other appropriate criteria.

(b) The extent to which the insurer's business is diversified among several lines of insurance.

(c) The number and size of risks insured in each line of business.

(d) The extent of the geographical dispersion of the insurer's insured risks.

(e) The nature and extent of the insurer's reinsurance program.

(f) The quality, diversification, and liquidity of the insurer's investment portfolio.

(g) The recent past and projected future trend in the size of the insurer's investment portfolio.

(h) The surplus as regards policyholders maintained by other comparable insurers.

(i) The adequacy of the insurer's reserves.

(j) The quality and liquidity of investment in affiliates. The commissioner may treat any such investment as a disallowed asset for purposes of determining the adequacy of surplus as regards policyholders whenever in the judgment of the commissioner the investment so warrants.


Source. 2013, 152:1, eff. Jan. 1, 2014. 2019, 183:3, eff. Sept. 8, 2019. 2022, 41:7, 8, eff. May 3, 2022.

    401-B:6 Examination. 

I. Power of Commissioner. Subject to the limitation contained in this section and in addition to the powers which the commissioner has under Title XXXVII relating to the examination of insurers, the commissioner shall have the power to examine any insurer registered under RSA 401-B:4 and its affiliates to ascertain the financial condition of the insurer including the enterprise risk to the insurer by the ultimate controlling party, or by any entity or combination of entities within the insurance holding company system, or by the insurance holding company system on a consolidated basis.

II. Access to Books and Records.

(a) The commissioner may order any insurer registered under RSA 401-B:4 to produce such records, books, or other information papers in the possession of the insurer or its affiliates as are reasonably necessary to determine compliance with this chapter.

(b) To determine compliance with this chapter, the commissioner may order any insurer registered under RSA 401-B:4 to produce information not in the possession of the insurer if the insurer can obtain access to such information pursuant to contractual relationships, statutory obligations, or other method. In the event the insurer cannot obtain the information requested by the commissioner, the insurer shall provide the commissioner a detailed explanation of the reason that the insurer cannot obtain the information and the identity of the holder of information. Whenever it appears to the commissioner that the detailed explanation is without merit, the commissioner may require, after notice and hearing, the insurer to pay a penalty of $2,500 for each day's delay, or may suspend or revoke the insurer's license.

III. Use of Consultants. The commissioner may retain, without appropriation under RSA 9, without qualifying as a department expenditure under RSA 4:15, and at the registered insurer's expense such attorneys, actuaries, accountants, and other experts not otherwise a part of the commissioner's staff as shall be reasonably necessary to assist in the conduct of the examination under paragraph I. Any persons so retained shall be under the direction and control of the commissioner and shall act in a purely advisory capacity.

IV. Expenses. Each registered insurer producing for examination records, books and papers pursuant to paragraph I, shall be liable for, and shall pay the expense of examination in accordance with RSA 400-A:37.

V. Compelling Production. In the event the insurer fails to comply with an order, the commissioner shall have the power to examine the affiliates to obtain the information. The commissioner shall also have the power to issue subpoenas, to administer oaths, and to examine under oath any person for purposes of determining compliance with this section. Upon the failure or refusal of any person to obey a subpoena, the commissioner may petition a court of competent jurisdiction, and upon proper showing, the court may enter an order compelling the witness to appear and testify or produce documentary evidence. Failure to obey the court order shall be punishable as contempt of court. Every person shall be obliged to attend as a witness at the place specified in the subpoena, when subpoenaed, anywhere within the state. He or she shall be entitled to the same fees and mileage, if claimed, as a witness in RSA 516:13 and RSA 516:14, which fees, mileage, and actual expense, if any, necessarily incurred in securing the attendance of witnesses, and their testimony, shall be itemized and charged against, and be paid by, the company being examined.


Source. 2013, 152:1, eff. Jan. 1, 2014. 2019, 346:151, eff. July 1, 2019.

    401-B:7-a Group-wide Supervision of Internationally Active Insurance Groups. 

I. The commissioner is authorized to act as the group-wide supervisor for any internationally active insurance group in accordance with the provisions of this section. However, the commissioner may otherwise acknowledge another regulatory official as the group-wide supervisor where the internationally active insurance group:

(a) Does not have substantial insurance operations in the United States;

(b) Has substantial insurance operations in the United States, but not in this state; or

(c) Has substantial insurance operations in the United States and this state, but the commissioner has determined pursuant to the factors set forth in paragraphs III and VIII that the other regulatory official is the appropriate group-wide supervisor.

II. An insurance holding company system that does not otherwise qualify as an internationally active insurance group may request that the commissioner make a determination or acknowledgment as to a group-wide supervisor pursuant to this section.

III. In cooperation with other state, federal, and international regulatory agencies, the commissioner shall identify a single group-wide supervisor for an internationally active insurance group. The commissioner may determine that the commissioner is the appropriate group-wide supervisor for an internationally active insurance group that conducts substantial insurance operations concentrated in this state. However, the commissioner may acknowledge that a regulatory official from another jurisdiction is the appropriate group-wide supervisor for the internationally active insurance group. The commissioner shall consider the following factors when making a determination or acknowledgment under this paragraph:

(a) The place of domicile of the insurers within the internationally active insurance group that hold the largest share of the group's written premiums, assets, or liabilities;

(b) The place of domicile of the top-tiered insurer or insurers in the insurance holding company system of the internationally active insurance group;

(c) The location of the executive offices or largest operational offices of the internationally active insurance group;

(d) Whether another regulatory official is acting or is seeking to act as the group-wide supervisor under a regulatory system that the commissioner determines to be:

(1) Substantially similar to the system of regulation provided under the laws of this state, or

(2) Otherwise sufficient in terms of providing for group-wide supervision, enterprise risk analysis, and cooperation with other regulatory officials; and

(e) Whether another regulatory official acting or seeking to act as the group-wide supervisor provides the commissioner with reasonably reciprocal recognition and cooperation.

IV. However, the person identified under paragraph III as the group-wide supervisor may determine that it is appropriate to acknowledge another supervisor to serve as the group-wide supervisor. The acknowledgment of the group-wide supervisor shall be made after consideration of the factors listed in subparagraphs III(a) through (e), and shall be made in cooperation with and subject to the acknowledgment of other regulatory officials involved with supervision of members of the internationally active insurance group, and in consultation with the internationally active insurance group.

V. Notwithstanding any other provision of law, when another regulatory official is acting as the group-wide supervisor of an internationally active insurance group, the commissioner shall acknowledge that regulatory official as the group-wide supervisor. However, in the event of a material change in the internationally active insurance group that results in the internationally active insurance group's insurers domiciled in this state holding the largest share of the group's premiums, assets, or liabilities; or this state being the place of domicile of the top-tiered insurer or insurers in the insurance holding company system of the internationally active insurance group, the commissioner shall make a determination or acknowledgment as to the appropriate group-wide supervisor for such an internationally active insurance group pursuant to paragraph III.

VI. Pursuant to RSA 401-B:6, the commissioner is authorized to collect from any insurer registered pursuant to RSA 401-B:4 all information necessary to determine whether the commissioner may act as the group-wide supervisor of an internationally active insurance group or if the commissioner may acknowledge another regulatory official to act as the group-wide supervisor. Prior to issuing a determination that an internationally active insurance group is subject to group-wide supervision by the commissioner, the commissioner shall notify the insurer registered pursuant to RSA 401-B:4 and the ultimate controlling person within the internationally active insurance group. The internationally active insurance group shall have not less than 30 days to provide the commissioner with additional information pertinent to the pending determination. The commissioner shall publish on the department's Internet website the identity of internationally active insurance groups that the commissioner has determined are subject to group-wide supervision by the commissioner.

VII. If the commissioner is the group-wide supervisor for an internationally active insurance group, the commissioner is authorized to engage in any of the following group-wide supervision activities:

(a) Assess the enterprise risks within the internationally active insurance group to ensure that:

(1) The material financial condition and liquidity risks to the members of the internationally active insurance group that are engaged in the business of insurance are identified by management, and

(2) Reasonable and effective mitigation measures are in place.

(b) Request, from any member of an internationally active insurance group subject to the commissioner's supervision, information necessary and appropriate to assess enterprise risk, including, but not limited to, information about the members of the internationally active insurance group regarding:

(1) Governance, risk assessment, and management;

(2) Capital adequacy; and

(3) Material intercompany transactions.

(c) Coordinate and, through the authority of the regulatory officials of the jurisdictions where members of the internationally active insurance group are domiciled, compel development and implementation of reasonable measures designed to ensure that the internationally active insurance group is able to timely recognize and mitigate enterprise risks to members of such internationally active insurance group that are engaged in the business of insurance.

(d) Communicate with other state, federal, and international regulatory agencies for members within the internationally active insurance group and share relevant information subject to the confidentiality provisions of RSA 401-B:8, through supervisory colleges as set forth in RSA 401-B:7 or otherwise.

(e) Enter into agreements with or obtain documentation from any insurer registered under RSA 401-B:4, any member of the internationally active insurance group, and any other state, federal, and international regulatory agencies for members of the internationally active insurance group, providing the basis for or otherwise clarifying the commissioner's role as group-wide supervisor, including provisions for resolving disputes with other regulatory officials. Such agreements or documentation shall not serve as evidence in any proceeding that any insurer or person within an insurance holding company system not domiciled or incorporated in this state is doing business in this state or is otherwise subject to jurisdiction in this state.

(f) Other group-wide supervision activities, consistent with the authorities and purposes under this paragraph, as considered necessary by the commissioner.

VIII. If the commissioner acknowledges that another regulatory official from a jurisdiction that is not accredited by the NAIC is the group-wide supervisor, the commissioner is authorized to reasonably cooperate, through supervisory colleges or otherwise, with group-wide supervision undertaken by the group-wide supervisor, provided that:

(a) The commissioner's cooperation is in compliance with the laws of this state; and

(b) The regulatory official acknowledged as the group-wide supervisor also recognizes and cooperates with the commissioner's activities as a group-wide supervisor for other internationally active insurance groups where applicable. Where such recognition and cooperation is not reasonably reciprocal, the commissioner is authorized to refuse recognition and cooperation.

IX. The commissioner is authorized to enter into agreements with or obtain documentation from any insurer registered under RSA 401-B:4, any affiliate of the insurer, and other state, federal, and international regulatory agencies for members of the internationally active insurance group, that provide the basis for or otherwise clarify a regulatory official's role as group-wide supervisor.

X. The commissioner may adopt rules under RSA 541-A as necessary for the administration of this section.

XI. A registered insurer subject to this section shall be liable for and shall pay the reasonable expenses of the commissioner's participation in the administration of this section, including the engagement of attorneys, actuaries, and any other professionals and all reasonable travel expenses.


Source. 2017, 130:1, eff. June 16, 2017.

    401-B:7 Supervisory Colleges. 

I. Power of Commissioner. With respect to any insurer registered under RSA 401-B:4, and in accordance with paragraph III, the commissioner shall also have the power to participate in a supervisory college for any domestic insurer that is part of an insurance holding company system with international operations in order to determine compliance by the insurer with this chapter. The powers of the commissioner with respect to supervisory colleges include, but are not limited to, the following:

(a) Initiating the establishment of a supervisory college;

(b) Clarifying the membership and participation of other supervisors in the supervisory college;

(c) Clarifying the functions of the supervisory college and the role of other regulators, including the establishment of a group-wide supervisor;

(d) Coordinating the ongoing activities of the supervisory college, including planning meetings, supervisory activities, and processes for information sharing; and

(e) Establishing a crisis management plan.

II. Expenses. Each registered insurer subject to this section shall be liable for and shall pay the reasonable expenses of the commissioner's participation in a supervisory college in accordance with paragraph III, including reasonable travel expenses. For purposes of this section, a supervisory college may be convened as either a temporary or permanent forum for communication and cooperation between the regulators charged with the supervision of the insurer or its affiliates, and the commissioner may establish a regular assessment to the insurer for the payment of these expenses.

III. Supervisory College. In order to assess the business strategy, financial position, legal and regulatory position, risk exposure, risk management and governance processes, and as part of the examination of individual insurers in accordance with RSA 401-B:6, the commissioner may participate in a supervisory college with other regulators charged with supervision of the insurer or its affiliates, including other state, federal, and international regulatory agencies. The commissioner may enter into agreements in accordance with RSA 401-B:8, III providing the basis for cooperation between the commissioner and the other regulatory agencies, and the activities of the supervisory college. Nothing in this section shall delegate to the supervisory college the authority of the commissioner to regulate or supervise the insurer or its affiliates within its jurisdiction.


Source. 2013, 152:1, eff. Jan. 1, 2014.

    401-B:8 Confidential Treatment. 

I. Documents, materials, or other information in the possession or control of the insurance department that are obtained by or disclosed to the commissioner or any other person in the course of an examination or investigation made pursuant to RSA 401-B:6 and all information reported pursuant to RSA 401-B:3, II(l) and (m), RSA 401-B:4, RSA 401-B:5, RSA 401-B:7, and RSA 401-B:7-a are recognized as being proprietary and to contain trade secrets and shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials or other information public without the prior written consent of the insurer to which it pertains unless the commissioner, after giving the insurer and its affiliates who would be affected thereby notice and opportunity to be heard, determines that the interests of policyholders, shareholders, or the public will be served by the publication thereof, in which event the commissioner may publish all or any part in such manner as may be deemed appropriate.

(a) For purposes of the information reported and provided to the insurance department pursuant to RSA 401-B:4, XII(b), the commissioner shall maintain the confidentiality of the group capital calculation and group capital ratio produced within the calculation and any group capital information received from an insurance holding company supervised by the Federal Reserve Board or any U.S. group-wide supervisor.

(b) For purposes of the information reported and provided to the insurance department pursuant to RSA 401-B:4, XII(c), the commissioner shall maintain the confidentiality of the liquidity stress test results and supporting disclosures and any liquidity stress test information received from an insurance holding company supervised by the Federal Reserve Board and non-U.S. group-wide supervisors.

II. Neither the commissioner or any person who received documents, materials, or other information while acting under the authority of the commissioner or with whom such documents, materials, or other information are shared pursuant to this chapter shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to RSA 401-B:8, I.

III. In order to assist in the performance of the commissioner's duties, the commissioner:

(a) May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to paragraph I, including proprietary and trade secret documents and materials, with other state, federal and international regulatory agencies, with the NAIC, with any third party consultants designated by the commissioner, and with state, federal, and international law enforcement authorities, including members of any supervisory college described in RSA 401-B:7, provided that the recipient agrees in writing to maintain the confidentiality and privileged status of the document, material or other information, and has verified in writing the legal authority to maintain confidentiality.

(b) Notwithstanding subparagraph (a), the commissioner shall only share confidential and privileged documents, material or information reported pursuant to RSA 401-B:4, XII, with commissioner of states having statutes or regulations substantially similar to RSA 401-B:8, I and who have agreed in writing not to disclose such information.

(c) May receive documents, materials, or information, including otherwise confidential and privileged documents, materials or information, including proprietary and trade secret information, from the NAIC and its affiliates and subsidiaries and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and

(d) Shall enter into written agreements with the NAIC and any third party consultant designated by the commissioner governing sharing and use of information provided pursuant to this chapter consistent with this paragraph and shall:

(1) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third party consultant designated by the commissioner pursuant to this chapter, including procedures and protocols for sharing by the NAIC with other state, federal, or international regulators. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the documents, materials, or other information and has verified in writing the legal authority to maintain such confidentiality;

(2) Specify that ownership of information shared with the NAIC or a third party consultant pursuant to this chapter remains with the commissioner and the NAIC's or a third party consultant's, as designated by the commissioner, use of the information is subject to the direction of the commissioner;

(3) Excluding documents, material, or information reported pursuant to RSA 401-B:4, XII(c), prohibit the NAIC or third party consultant designated by the commissioner from storing the information shared pursuant to this chapter in a permanent database after the underlying analysis is completed;

(4) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third party consultant designated by the commissioner pursuant to this chapter is subject to a request or subpoena to the NAIC or a third party consultant designated by the commissioner for disclosure or production; 

(5) Require the NAIC or a third party consultant designated by the commissioner to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third party consultant designated by the commissioner may be required to disclose confidential information about the insurer and shared with the NAIC or a third party consultant designated by the commissioner pursuant to this chapter; and

(6) For documents, material, or information reporting pursuant to RSA 401-B:4, XII(c), in the case of an agreement involving a third party consultant, provide for notification of the identity of the consultant to the applicable insurers.

IV. The sharing of information by the commissioner pursuant to this chapter shall not constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely responsible for the administration, execution and enforcement of the provisions of this chapter.

V. No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in RSA 401-B:8, III.

VI. Documents, materials or other information in the possession or control of the NAIC or a third party consultant designated by the commissioner pursuant to this chapter shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.

VII. The group capital calculation and resulting group capital ratio required under RSA 401-B:4, XII(b) and the liquidity stress test along with its results and supporting disclosures required under RSA 402-B:4, XII(c) are regulatory tools for assessing group risks and capital adequacy and group liquidity risks, respectively, and are not intended as a means to rank insurers or insurance holding company systems generally. Therefore, except as otherwise may be required under the provisions of this chapter, the making, publishing, disseminating, circulating or placing before the public, or causing directly or indirectly to be made, published, disseminated, circulated or placed before the public in a newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station or any electronic means of communication available to the public, or in any other way as an advertisement, announcement or statement containing a representation or statement with regard to the group capital calculation, group capital ratio, the liquidity stress test results, or supporting disclosures for the liquidity stress test of any insurer or any insurer group, or of any component derived in the calculation by any insurer, broker, or other person engaged in any manner in the insurance business would be misleading and is therefore prohibited; provided, however, that if any materially false statement with respect to the group capital calculation, resulting group capital ratio, an inappropriate comparison of any amount to an insurer's or insurance group's group capital calculation or resulting group capital ratio, liquidity stress test result, supporting disclosures for the liquidity stress test, or an inappropriate comparison of any amount to an insurer's or insurance group's liquidity stress test result or supporting disclosures is published in any written publication and the insurer is able to demonstrate to the commissioner with substantial proof the falsity of such statement or the inappropriateness, as the case may be, then the insurer may publish announcements in a written publication if the sole purpose of the announcement is to rebut the materially false statement.


Source. 2013, 152:1. 2017, 130:2, eff. June 16, 2017. 2022, 41:9, eff. May 3, 2022.

    401-B:9 Rules and Orders. 

The commissioner may, upon notice and opportunity for all interested persons to be heard, issue such rules and orders as shall be necessary to carry out the provisions of this chapter. To assist in the review of any transaction, or to otherwise determine compliance with this chapter, the commissioner may retain, without appropriation under RSA 9 and without qualifying as a department expenditure under RSA 4:15, attorneys, appraisers, independent actuaries, independent certified public accountants, or other professionals and specialists, the cost of which shall be borne by the company subject to such review. The company shall pay the retained professional or specialists directly for their costs. The commissioner shall conduct oversight of such independent reviewers in a manner that is consistent with standards for the use of independent reviewers established by the National Association of Insurance Commissioners in its Financial Condition Examiners Handbook and Market Regulation Handbook and shall ensure that costs are reasonable for the work performed.


Source. 2013, 152:1. 2017, 218:6, eff. July 10, 2017.

    401-C:1 Purpose and Scope. 

I. The purpose of this chapter is to provide the requirements for maintaining a risk management framework and completing Own Risk and Solvency Assessment (ORSA) and provide guidance and instructions for filing an ORSA summary report with the insurance commissioner of this state.

II. The requirements of this chapter shall apply to all insurers domiciled in this state unless exempt pursuant to RSA 401-C:6.

III. The general court finds and declares that the ORSA summary report will contain confidential and sensitive information related to an insurer or insurance group's identification of risks material and relevant to the insurer or insurance group filing the report. This information will include proprietary and trade secret information that has the potential for harm and competitive disadvantage to the insurer or insurance group if the information is made public. It is the intent of this chapter that the ORSA summary report shall be a confidential document filed with the commissioner, that the ORSA summary report will be shared only as stated in this chapter and to assist the commissioner in the performance of his or her duties, and that in no event shall the ORSA summary report be subject to public disclosure.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:10 Severability Clause. 

If any provision of this chapter, or the application thereof to any person or circumstance, is held invalid, such invalidity shall not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or applications, and to that end the provisions of this chapter are severable.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:2 Definitions. 

In this chapter:

I. For the purpose of conducting an ORSA, "
insurance group
" means those insurers and affiliates included within an insurance holding company system as defined in RSA 401-B.

II. "
Insurer
" shall have the same meaning as set forth in RSA 401-C:2, except that it shall not include agencies, authorities, or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.

III. "
Own risk and solvency assessment
" or "
ORSA
" means a confidential internal assessment, appropriate to the nature, scale, and complexity of an insurer or insurance group, conducted by that insurer or insurance group of the material and relevant risks associated with the insurer or insurance group's current business plan, and the sufficiency of capital resources to support those risks.

IV. "
ORSA guidance manual
" means the current version of the Own Risk and Solvency Assessment Guidance Manual developed and adopted by the National Association of Insurance Commissioners (NAIC) and as amended from time to time. A change in the ORSA guidance manual shall be effective on the January 1 following the calendar year in which the changes have been adopted by the NAIC.

V. "
ORSA summary report
" means a confidential high-level summary of an insurer or insurance group's ORSA.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:3 Risk Management Framework. 

An insurer shall maintain a risk management framework to assist the insurer with identifying, assessing, monitoring, managing, and reporting on its material and relevant risks. This requirement may be satisfied if the insurance group of which the insurer is a member maintains a risk management framework applicable to the operations of the insurer.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:4 ORSA Requirement. 

Subject to RSA 401-C:6, an insurer, or the insurance group of which the insurer is a member, shall regularly conduct an ORSA consistent with a process comparable to the ORSA guidance manual. The ORSA shall be conducted no less than annually but also at any time when there are significant changes to the risk profile of the insurer or the insurance group of which the insurer is a member.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:5 ORSA Summary Report. 

I. Upon the commissioner's request, and no more than once each year, an insurer shall submit to the commissioner an ORSA summary report or any combination of reports that together contain the information described in the ORSA guidance manual, applicable to the insurer and/or the insurance group of which it is a member. Notwithstanding any request from the commissioner, if the insurer is a member of an insurance group, the insurer shall submit the report or reports required by this section if the commissioner is the lead state commissioner of the insurance group as determined by the procedures within the Financial Analysis Handbook adopted by the National Association of Insurance Commissioners.

II. The report shall include a signature of the insurer or insurance group's chief risk officer or other executive having responsibility for the oversight of the insurer's enterprise risk management process attesting to the best of his or her belief and knowledge that the insurer applies the enterprise risk management process described in the ORSA summary report and that a copy of the report has been provided to the insurer's board of directors or the appropriate committee thereof.

III. An insurer may comply with paragraph I by providing the most recent and substantially similar reports provided by the insurer or another member of an insurance group of which the insurer is a member to the commissioner of another state or to a supervisor or regulator of a foreign jurisdiction, if that report provides information that is comparable to the information described in the ORSA guidance manual. Any such report in a language other than English shall be accompanied by a translation of that report into the English language.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:6 Exemption. 

I. An insurer shall be exempt from the requirements of this chapter, if:

(a) The insurer has annual direct written and unaffiliated assumed premium, including international direct and assumed premium but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, less than $500,000,000; and

(b) The insurance group of which the insurer is a member has annual direct written and unaffiliated assumed premium including international direct and assumed premium, but excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, less than $1,000,000,000.

II. If an insurer qualifies for exemption pursuant to subparagraph I(a), but the insurance group of which the insurer is a member does not qualify for exemption pursuant to subparagraph I(b), then the ORSA summary report that may be required pursuant to RSA 401-C:5 shall include every insurer within the insurance group. This requirement may be satisfied by the submission of more than one ORSA summary report for any combination of insurers provided any combination of reports includes every insurer within the insurance group.

III. If an insurer does not qualify for exemption pursuant to subparagraph I(a), but the insurance group of which it is a member qualifies for exemption pursuant to subparagraphs I(b), then the only ORSA summary report that may be required pursuant to RSA 401-C:5 shall be the report applicable to that insurer.

IV. An insurer that does not qualify for exemption pursuant to paragraph I may apply to the commissioner for a waiver from the requirements of this chapter based upon unique circumstances. In deciding whether to grant the insurer's request for waiver, the commissioner may consider the type and volume of business written, ownership and organizational structure, and any other factor the commissioner considers relevant to the insurer or insurance group of which the insurer is a member. If the insurer is part of an insurance group with insurers domiciled in more than one state, the commissioner shall coordinate with the lead state commissioner and with the other domiciliary commissioners in considering whether to grant the insurer's request for a waiver.

V. Notwithstanding the exemptions stated in this section:

(a) The commissioner may require that an insurer maintain a risk management framework, conduct an ORSA and file an ORSA summary report based on unique circumstances including, but not limited to, the type and volume of business written, ownership and organizational structure, federal agency requests, and international supervisor requests.

(b) The commissioner may require that an insurer maintain a risk management framework, conduct an ORSA and file an ORSA summary report if the insurer has risk-based capital for company action level event as set forth in RSA 404-F:3, meets one or more of the standards of an insurer deemed to be in hazardous financial condition, as defined in Ins 1500, or otherwise exhibits qualities of a troubled insurer as determined by the commissioner.

VI. If an insurer that qualifies for an exemption pursuant to paragraph I subsequently no longer qualifies for that exemption due to changes in premium as reflected in the insurer's most recent annual statement or in the most recent annual statements of the insurers within the insurance group of which the insurer is a member, the insurer shall have one year following the year the threshold is exceeded to comply with the requirements of this chapter.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:7 Contents of ORSA Summary Report. 

I. The ORSA summary report shall be prepared consistent with the ORSA guidance manual subject to the requirements of paragraph II. Documentation and supporting information shall be maintained and made available upon examination or upon request of the commissioner.

II. The review of the ORSA summary report, and any additional requests for information, shall be made using similar procedures currently used in the analysis and examination of multi-state or global insurers and insurance groups. To assist in the review of ORSA summary reports, the commissioner may retain, without appropriation under RSA 9 and without qualifying as a department expenditure under RSA 4:15, attorneys, appraisers, independent actuaries, independent certified public accountants, or other professionals and specialists, the cost of which shall be borne by the company subject to such review. The company shall pay the retained professional or specialists directly for their costs. The commissioner shall conduct oversight of such independent reviewers in a manner that is consistent with standards for the use of independent reviewers established by the National Association of Insurance Commissioners in its Financial Condition Examiners Handbook and Market Regulation Handbook and shall ensure that costs are reasonable for the work performed. The amount paid by the company under this paragraph in any fiscal year shall be applied as a nontransferable credit against and to the extent of the company's administrative fee under RSA 400-A:39 in the subsequent fiscal year and not thereafter.


Source. 2013, 152:2. 2017, 218:7, eff. July 10, 2017. 2022, 143:3, eff. Aug. 6, 2022.

    401-C:8 Confidentiality. 

I. Documents, materials, or other information, including the ORSA summary report, in the possession of or control of the insurance department that are obtained by, created by or disclosed to the commissioner or any other person under this chapter, is recognized by this state as being proprietary and to contain trade secrets. All such documents, materials, or other information shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials, or other information public without the prior written consent of the insurer.

II. Neither the commissioner nor any person who received documents, materials, or other ORSA related information, through examination or otherwise, while acting under the authority of the commissioner or with whom such documents, materials, or other information are shared pursuant to this chapter shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to paragraph I.

III. In order to assist in the performance of the commissioner's regulatory duties, the commissioner:

(a) May, upon request, share documents, materials, or other ORSA related information, including the confidential and privileged documents, materials, or information subject to paragraph I, including proprietary and trade secret documents and materials with other state, federal, and international financial regulatory agencies, including members of any supervisory college as defined in RSA 401-B:7, with the NAIC and with any third party consultants designated by the commissioner, provided that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA related documents, materials, or other information and has verified in writing the legal authority to maintain confidentiality; and

(b) May receive documents, materials, or other ORSA related information, including otherwise confidential and privileged documents, materials, or information, including proprietary and trade secret information or documents, from regulatory officials of other foreign or domestic jurisdictions, including members of any supervisory college as defined in RSA 401-B:7, and from the NAIC, and shall maintain as confidential or privileged any documents, materials, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information.

(c) Shall enter into a written agreement with the NAIC or a third-party consultant governing sharing and use of information provided pursuant to this chapter, consistent with this subsection that shall:

(1) Specify procedures and protocols regarding the confidentiality and security of information shared with the NAIC or a third-party consultant pursuant to this chapter, including procedures and protocols for sharing by the NAIC with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the ORSA related documents, materials or other information and has verified in writing the legal authority to maintain confidentiality;

(2) Specify that ownership of information shared with the NAIC or a third-party consultant pursuant to this chapter remains with the commissioner and the NAIC's or third-party consultant's use of the information is subject to the direction of the commissioner;

(3) Prohibit the NAIC or third-party consultant from storing the information shared pursuant to this chapter in a permanent database after the underlying analysis is completed;

(4) Require prompt notice to be given to an insurer whose confidential information in the possession of the NAIC or a third-party consultant pursuant to this chapter is subject to a request or subpoena to the NAIC or a third-party consultant for disclosure or production;

(5) Require the NAIC or a third-party consultant to consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third-party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third-party consultant pursuant to this chapter; and

(6) In the case of an agreement involving a third-party consultant, provide for the insurer's written consent.

IV. The sharing of information and documents by the commissioner pursuant to this chapter shall not constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely responsible for the administration, execution, and enforcement of the provisions of this chapter.

V. No waiver of any applicable privilege or claim of confidentiality in the documents, proprietary and trade secret materials or other ORSA related information shall occur as a result of disclosure of such ORSA related information or documents to the commissioner under this section or as a result of sharing as authorized in this chapter.

VI. Documents, materials, or other information in the possession or control of the NAIC or a third-party consultant pursuant to this chapter shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-C:9 Sanctions. 

Any insurer failing, without just cause, to timely file the ORSA summary report as required in this chapter shall be required, after notice and hearing, to pay a penalty of $2,500 for each day's delay, to be recovered by the commissioner and the penalty so recovered shall be paid into the general revenue fund of this state. The commissioner may reduce the penalty if the insurer demonstrates to the commissioner that the imposition of the penalty would constitute a financial hardship to the insurer.


Source. 2013, 152:2, eff. Jan. 1, 2015.

    401-D:1 Purpose and Scope. 

I. The purpose of this chapter is to:

(a) Provide the insurance commissioner with a summary of an insurer or insurance group's corporate governance structure, policies and practices to permit the commissioner to gain and maintain an understanding of the insurer's corporate governance framework.

(b) Outline the requirements for completing a corporate governance annual disclosure with the insurance commissioner.

(c) Provide for the confidential treatment of the corporate governance annual disclosure and related information that will contain confidential and sensitive information related to an insurer or insurance group's internal operations and proprietary and trade secret information which, if made public, could potentially cause the insurer or insurance group competitive harm or disadvantage.

II. Nothing in this chapter shall be construed to prescribe or impose corporate governance standards and internal procedures beyond that which is required under applicable state corporate law. Nothing in this chapter shall be construed to limit the commissioner's authority, or the rights or obligations of third parties, under RSA 400-A:37.

III. The requirements of this chapter shall apply to all insurers domiciled in this state.


Source. 2016, 316:1, eff. Jan. 1, 2017. 2018, 36:1, eff. May 15, 2018.

    401-D:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Corporate governance annual disclosure
" or "
CGAD
" means a confidential report filed by the insurer or insurance group made in accordance with the requirements of this chapter.

III. "
Insurance group
" means those insurers and affiliates included with an insurance holding company system as defined in RSA 401-B.

IV. "Insurer" shall have the same meaning as set forth in RSA 401-B:3-a, I(b) except that it shall not include agencies, authorities, or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia, or a state or political subdivision of a state.

V. "
NAIC
" means the National Association of Insurance Commissioners.

VI. "
ORSA summary report
" means the report filed in accordance with RSA 401-C.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:3 Disclosure Requirement. 

I. An insurer, or the insurance group of which the insurer is a member, shall, no later than June 1 of each calendar year, submit to the commissioner a CGAD that contains the information described in RSA 401-D:5. Notwithstanding a request from the commissioner made pursuant to paragraph III, if the insurer is a member of an insurance group, the insurer shall submit the report required by this section to the commissioner of the lead state for the insurance group, in accordance with the laws of the lead state, as determined by the procedures outlined in the most recent financial analysis handbook adopted by the NAIC.

II. The CGAD shall include a signature of the insurer or insurance group's chief executive officer or corporate secretary attesting to the best of that individual's belief and knowledge that the insurer has implemented the corporate governance practices and that a copy of the disclosure has been provided to the insurer's board of directors or the appropriate committee of such board.

III. An insurer not required to submit a CGAD under this section shall do so upon the commissioner's request.

IV. For purposes of completing the CGAD, the insurer or insurance group may provide information regarding corporate governance at the ultimate controlling parent level, an intermediate holding company level, and/or the individual legal entity level, depending upon how the insurer or insurance group has structured its system of corporate governance. The insurer or insurance group is encouraged to make CGAD disclosures at the level at which the insurer's or insurance group's risk appetite is determined, or at which the earnings, capital, liquidity, operations, and reputation of the insurer are overseen collectively and at which the supervision of those factors are coordinated and exercised, or the level at which legal liability for failure of general corporate governance duties would be placed. If the insurer or insurance group determines the level of reporting based on these criteria, it shall indicate which of the 3 criteria was used to determine the level of reporting and explain any subsequent changes in the level of reporting.

V. The review of the CGAD and any additional requests for information shall be made through the lead state as determined by the procedures within the most recent financial analysis handbook referenced in paragraph I.

VI. Insurers providing information substantially similar to the information required by this chapter in other documents provided to the commissioner, including proxy statements filed in conjunction with Form B requirements, or other state or federal filings provided to the department shall not be required to duplicate that information in the CGAD, but shall only be required to cross reference the document in which the information is included.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:4 Rules and Regulations. 

The commissioner, may, upon notice and opportunity for all interested persons to be heard, issue such rules, regulations and orders as shall be necessary to carry out the provisions of this chapter.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:5 Contents of Corporate Governance Annual Disclosure;  Rulemaking. 

I. The insurer or insurance group shall have discretion over the responses to the CGAD inquiries, provided the CGAD shall contain the material information necessary to permit the commissioner to gain an understanding of the insurer's or group's corporate governance structure, policies, and practices. The commissioner may request additional information that he or she deems material and necessary to provide the commissioner with a clear understanding of the corporate governance policies, the reporting or information system, or controls implementing those policies.

II. The commissioner may, pursuant to RSA 541-A, adopt rules to establish the material information necessary to meet the requirements of paragraph I.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:6 Confidentiality. 

I. Documents, materials, or other information, including the CGAD, in the possession or control of the insurance department that are obtained by, created by, or disclosed to the commissioner or any other person under this chapter are recognized by this state as being proprietary and to contain trade secrets. All such documents, materials, or other information shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties. The commissioner shall not otherwise make the documents, materials, or other information public without the prior written consent of the insurer. Nothing in this section shall be construed to require written consent of the insurer before the commissioner may share or receive confidential documents, materials, or other CGAD-related information pursuant to paragraph III to assist in the performance of the commissioner's regular duties.

II. Neither the commissioner nor any person who received documents, materials, or other CGAD-related information, through examination or otherwise, while acting under the authority of the commissioner, or with whom such documents, materials, or other information are shared pursuant to this chapter shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to paragraph I.

III. The commissioner:

(a) May, upon request, share documents, materials, or other CGAD-related information, including the confidential and privileged documents, materials, or information subject to paragraph I, including proprietary and trade secret documents and materials with other state, federal, and international financial regulatory agencies, including members of any supervisory college, as defined in RSA 401-B:7, with the NAIC, and with third party consultants pursuant to RSA 401-D:7; provided, that the recipient agrees in writing to maintain the confidentiality and privileged status of the CGAD-related documents, materials, or other information and has verified in writing the legal authority to maintain confidentiality.

(b) May receive documents, materials, or other CGAD-related information, including otherwise confidential and privileged documents, materials, or information, including proprietary and trade secret information or documents, from regulatory officials of other state, federal, and international financial regulatory agencies, including members of any supervisory college as defined in RSA 401-B:7, and from the NAIC, and shall maintain as confidential or privileged any documents, materials, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information.

IV. The sharing of information and documents by the commissioner pursuant to this chapter shall not constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely responsible for the administration, execution, and enforcement of the provisions of this chapter.

V. No waiver of any applicable privilege or claim of confidentiality in the documents, proprietary and trade secret materials, or other CGAD-related information shall occur as a result of disclosure of such CGAD-related information or documents to the commissioner under this section or as a result of sharing as authorized in this chapter.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:7 NAIC and Third-Party Consultants. 

I. The commissioner may retain, at the insurer's expense, third-party consultants, including attorneys, actuaries, accountants, and other experts not otherwise a part of the commissioner's staff as may be reasonably necessary to assist the commissioner in reviewing the CGAD and related information or the insurer's compliance with this chapter.

II. Any persons retained under paragraph I shall be under the direction and control of the commissioner and shall act in a purely advisory capacity.

III. The NAIC and third-party consultants shall be subject to the same confidentiality standards and requirements as the commissioner.

IV. As part of the retention process, a third-party consultant shall verify to the commissioner, with notice to the insurer, that it is free of a conflict of interest and that it has internal procedures in place to monitor compliance with a conflict and to comply with the confidentiality standards and requirements of this chapter.

V. A written agreement with the NAIC and/or a third-party consultant governing sharing and use of information provided pursuant to this chapter shall contain the following provisions and expressly require the written consent of the insurer prior to making public information provided under this chapter:

(a) Specific procedures and protocols for maintaining the confidentiality and security of CGAD-related information shared with the NAIC or a third-party consultant pursuant to this chapter.

(b) Procedures and protocols for sharing by the NAIC only with other state regulators from states in which the insurance group has domiciled insurers. The agreement shall provide that the recipient agrees in writing to maintain the confidentiality and privileged status of the CGAD-related documents, materials, or other information and has verified in writing the legal authority to maintain confidentiality.

(c) A provision specifying that ownership of the CGAD-related information shared with the NAIC or a third party consultant remains with the insurance department and the NAIC's or third party consultant's use of the information is subject to the direction of the commissioner.

(d) A provision that prohibits the NAIC or a third party consultant from storing the information shared pursuant to this chapter in a permanent database after the underlying analysis is completed.

(e) A provision requiring the NAIC or third party consultant to provide prompt notice to the commissioner and to the insurer or insurance group regarding any subpoena, request for disclosure, or request for production of the insurer's CGAD-related information.

(f) A requirement that the NAIC or a third party consultant consent to intervention by an insurer in any judicial or administrative action in which the NAIC or a third party consultant may be required to disclose confidential information about the insurer shared with the NAIC or a third party consultant pursuant to this chapter.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:8 Sanctions. 

Any insurer failing, without just cause, to timely file the CGAD as required in this chapter shall be required, after notice and hearing, to pay a penalty of $100 for each day's delay up to a maximum of $2,500, to be recovered by the commissioner. The penalty so recovered shall be deposited in the general fund. The commissioner may reduce the penalty if the insurer demonstrates to the commissioner that the imposition of the penalty would constitute a financial hardship to the insurer.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401-D:9 Severability Clause. 

If any provision of this chapter other than RSA 401-D:6, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect the provisions or applications of this chapter which can be given effect without the invalid provision or application, and to that end the provisions of this chapter, with the exception of RSA 401-D:6, are severable.


Source. 2016, 316:1, eff. Jan. 1, 2017.

    401:1-a Purposes;  Miscellaneous Insurance. 

I. Any corporation formed or authorized for the purpose of conducting one or more of the kinds of insurance found in RSA 401:1, or licensed or authorized pursuant to RSA 405, shall be permitted to conduct other kinds of insurance not enumerated in RSA 401:1 as the commissioner may permit by rule pursuant to paragraph II below.

II. If the commissioner determines that there exists a kind of insurance which is not enumerated in RSA 401:1 and such kind of insurance is properly the subject of insurance, and is in the public interest, the commissioner may by rule adopted under RSA 541-A permit corporations to conduct said kind or kinds of insurance as miscellaneous insurance. Corporations may conduct miscellaneous insurance in combination with one or more other kinds of insurance specified in RSA 401:1 as permitted by the commissioner. However, no corporation shall conduct a kind of miscellaneous insurance unless that kind of miscellaneous insurance has been specifically permitted by the commissioner.

III. An insurance company or other insurer need not have its physical license or authorization amended to permit it to write a kind of miscellaneous insurance provided the company or other insurer has been notified by the commissioner of a decision made pursuant to paragraph II.


Source. 1983, 15:4, eff. April 6, 1983.

    401:1 Purposes. 

Subject to the additional or varied requirements stated in this chapter, a corporation with capital stock may be formed, pursuant to the provisions of RSA 293-A, and a corporation to carry on business on the mutual plan may be formed pursuant to the provisions of RSA 292, for the purpose of conducting the following kinds of insurance business:

I. On property and rents and use and occupancy, against loss or damage by fire, smoke, smoke smudge, and lightning (whether such loss or damage is caused by burning or otherwise); against loss or damage by earthquake, hail, flood, rain, or drought, rising of the waters of the ocean or its tributaries, windstorm, or other action of the elements; against loss or damage from insects, diseases, or other causes to trees, crops, or other products of the soil; explosion (other than the explosion of steam boilers or flywheels); riot, strike, or civil commotion; war, sabotage, bombardment, invasion, military or usurped power; vandalism or malicious mischief; impact by aircraft or vehicles; breakage or leakage of water pipes or other conduits or containers or against loss or damage by water entering through leaks or openings in buildings; breakage or leakage of apparatus erected for extinguishing fires and on such apparatus against loss or damage by accidental injury and against liability of the insured for loss or damage to property caused thereby.

II. On vessels, aircraft, cars or other vehicles, freight, goods, money, effects, and money loaned on bottomry and respondentia, against loss or damage from the perils of the sea and other perils usually insured against by marine insurance, or from the risk of inland navigation and transportation; and all personal property floater risks; and on motor vehicles and aircraft, excluding the liability of the insured for the death, injury, or disability of another person arising out of the ownership, maintenance, or use of motor vehicles, and aircraft, their fittings and contents and use and occupancy, against loss or damage from accident, collision, theft, or other casualty, and against liability of the owner or user thereof for injury or damage to property caused thereby.

III. On the lives of persons and every insurance pertaining thereto or connected therewith, including endowments, and to grant, purchase, or dispose of annuities, including variable annuities.

IV. Against bodily injury or death by accident, and against disablement resulting from sickness and every insurance pertaining thereto, including quarantine and identification; or providing for the mental and emotional welfare of an individual and members of his family by defraying the costs of legal services.

V. Against the liability of the insured for the death or disability or damage to property of another and on motor vehicles and aircraft, their fittings and contents and use and occupancy, against loss or damage from accident, collision, fire, theft or other casualty.

VI. On property and rents and use and occupancy, against loss or damage and against liability of the insured therefor from explosions of steam boilers, tanks, and engines, their connection and machinery connected therewith, and breakage of flywheels and machinery and glass, and to make inspections thereof; and against loss of or damage to any property resulting from burglary, theft, larceny, robbery, forgery, fraud, vandalism, malicious mischief, confiscation or wrongful conversion, disposal or concealment by any person or persons, or from any attempt at any of the foregoing and against loss or damage from collision and against loss or damage from breakage of glass.

VII. Insurance of the performance of contracts and to guarantee the fidelity and the faithful discharge of duties of persons holding positions of trust in private or public employment or responsibility, and may, if accepted and approved by the superior court, obligee or person competent to approve such bond, act as joint or sole surety upon the official bond or the bond, recognizance or other undertaking in civil and criminal procedure of any person or corporation to the United States, to the state, or to any county, city, town, judge of probate, or other court, sheriff, magistrate or other public officer, or to any corporation or association public or private; and also may act as joint or sole surety upon any bond or undertaking to any person or corporation or to the state conditioned upon the performance of any duty or trusts, or for the doing or not doing of anything in said bond specified, and upon bonds to indemnify against loss any person or persons who are responsible as surety or sureties upon a written instrument or otherwise for the performance by others of any office, employment, contract or trust. If by law 2 or more sureties are required upon any obligation upon which such company is authorized to act as surety, it may act as joint or sole surety thereon, and may be accepted as such by the court, justice, magistrate or other officer or person authorized to approve the sufficiency of such bond or undertaking. The insurance commissioner shall transmit forthwith to each clerk, to the clerk of each district and municipal court, to each clerk of the superior court and the clerk of the supreme court, the names of all corporate surety companies as they become or cease to be qualified to do business in the state.

VIII. Other casualty risks. Insurance against any other casualty risk not otherwise specified under paragraph V, which may lawfully be the subject of insurance, if such insurance is not disapproved by the commissioner as being contrary to law or public policy.


Source. 1917, 80:1; 157:1. 1925, 10:1. PL 272:1. 1931, 135:1. 1937, 128:1. 1939, 25:1. 1941, 6:1. RL 322:1. 1943, 109:1. 1947, 153:1; 182:1. RSA 401:1. 1967, 156:2; 272:1. 1983, 15:3; 399:1. 2001, 224:1. 2006, 196:4. 2011, 88:20, eff. July 1, 2011.

    401:10 Applicability of General Corporation Law. 

Insurance corporations organized under the laws of this state, whether by special charter or by the general law, shall be subject to only those provisions of the laws relating to corporations in general that are not inconsistent with the provisions of Title XXXVII, the insurance code.


Source. 1917, 80:9. PL 272:10. RL 322:10. RSA 401:10. 1971, 232:1. 1973, 235:9. 1983, 15:8, eff. April 6, 1983.

    401:11 Merger of Insurance Companies. 

I. Subject to the approval of the insurance commissioner as provided by law, any insurance corporation organized under the laws of this state, whether by special charter or under the general law, except mutual insurance companies, may merge or consolidate with any other corporation or corporations in the manner provided in RSA 293-A.

II. Subject to the approval of the insurance commissioner of the plan of merger, any mutual insurance company or other voluntary insurance corporation organized under the laws of this state, whether by special charter or under general law, may merge or consolidate with any like corporation or corporations in the manner provided in RSA 292 and by a majority vote of those members voting in person or by proxy at a meeting called for that purpose.


Source. 1971, 232:2. 1983, 15:9. 2002, 207:31, eff. July 15, 2002.

    401:12 Clerk;  Registered Agent;  Registered Office. 

In lieu of the provisions of RSA 293-A:8.40(c), every insurer subject to this chapter may have and continuously maintain in this state a clerk who shall be the registered agent of the insurer and who shall be an individual resident of this state whose residence or business office shall be the registered office of the insurer.


Source. 1983, 15:10. 1992, 255:10, eff. Jan. 1, 1993.

    401:13 Officers. 

I. The officers of an insurer who is subject to the provisions of this chapter shall consist of a president, a clerk or secretary who shall be the agent for service of process, and a treasurer, each of whom shall be elected by the board of directors at a time and in a manner as may be prescribed by the bylaws. Such other officers and assistant officers and agents as may be deemed necessary may be elected or appointed by the board of directors or chosen in such other manner as may be prescribed by the bylaws. Any 2 or more offices may be held by the same person.

II. All officers and agents of the insurer, as between themselves and the insurer, shall have the authority to perform the duties in the management of the insurer as may be provided in the bylaws, or as may be determined by resolution of the board of directors not inconsistent with the bylaws.


Source. 1983, 15:10, eff. April 6, 1983.

    401:14 Restated Articles of Incorporation. 

A copy of all restated articles of incorporation to the extent they are adopted shall be filed with the insurance department.


Source. 1983, 15:10, eff. April 6, 1983.

    401:15 Name. 

Corporations subject to regulation by the insurance commissioner shall not be subject to the requirements of RSA 293-A:4.01(a)(1) pertaining to the designation of the corporate status and the corporate name but shall be subject to all other provisions of RSA 293-A:4.01, except that any filings, including trade names, shall be subject to the examination by and approval of the insurance commissioner before filing with the secretary of state.


Source. 1983, 15:10. 1992, 255:11, eff. Jan. 1, 1993.

    401:16 Name Reservation. 

I. The reservation of the name of an insurer, including trade names, shall be made by filing an application, executed by the applicant with the insurance commissioner to reserve a specified name, and by paying a fee as set by RSA 400-A:29. If the commissioner finds that the name is available for use, he shall reserve the name for the exclusive use of the applicant for a period of 120 days.

II. The right to the exclusive use of a specified name, including trade names, so reserved may be transferred to any other person or corporation by filing, with the office of the insurance commissioner, a request for the transfer, executed by the applicant for whom the name was reserved, by specifying the name and address of the transferee and other information as required by the insurance commissioner and by paying a fee equal to the original application fee.


Source. 1983, 15:10, eff. April 6, 1983.

    401:17 Perpetual Existence;  Presumption. 

Unless otherwise expressly approved by the commissioner, all insurance companies or other insurers subject to this chapter shall have perpetual existence.


Source. 1983, 15:10, eff. April 6, 1983.

    401:18 Maximum Risk Retention. 

The maximum net amount of risk which may be retained by a property and liability company for an individual risk shall be no greater than 10 percent of the company's capital and surplus.


Source. 1990, 92:3, eff. June 9, 1990.

    401:2 Incorporators. 

For the formation of such a corporation there shall be not less than 10 incorporators, who shall be residents of this state.


Source. 1917, 80:2. PL 272:2. RL 322:2.

    401:3 Capital Stock. 

Such a corporation may have a capital stock or may do business on the mutual plan. No such mutual corporations shall be incorporated after the first of July, 1969, to transact any kinds of insurance business on the assessment plan requiring as a condition for granting insurance the signing of a premium deposit note by the insured, which note is given for the purpose of establishing a limit of liability to assessment. Any such company currently licensed and operating on such plans shall be restricted to the lines of business in which it was engaged on July 1, 1969, provisions of RSA 401:7 notwithstanding.


Source. 1917, 80:3. PL 272:3. RL 322:3. 1947, 182:2. RSA 401:3. 1969, 293:4, eff. June 30, 1969.

    401:4 Paid-up Capital. 

All stock companies organized under the provisions of this chapter shall have a paid-up capital of at least $800,000.


Source. 1917, 80:4. PL 272:4. RL 322:4. 1947, 182:3. RSA 401:4. 1965, 51:1. 1969, 283:1, eff. June 25, 1969.

    401:5 Combinations of Business. 

Articles of agreement of such a stock or mutual company may provide for the transaction of any combinations of 2 or more kinds of insurance authorized by RSA 401:1 except that specified by paragraph III of said section which may only be combined with insurance specified in paragraph IV or V, or both. The articles of agreement of a mutual company issuing assessable policies may not provide for the transaction of any but the following combinations of business: That specified in paragraph I of RSA 401:1 with that specified in paragraph II; That specified in paragraphs III, IV, and V or any 2 of said paragraphs; That specified in paragraphs IV, V, VI, and VII or in any 2 or more of said paragraphs, unless such company shall have and maintain a policyholders' surplus of at least $400,000.


Source. 1917, 80:5. PL 272:5. 1939, 25:2. RL 322:5. 1947, 182:4. RSA 401:5. 1969, 283:2, eff. June 25, 1969.

    401:6 Certification of Agreement. 

The articles of agreement shall be submitted to the insurance commissioner, who shall examine same. The commissioner shall not approve the articles of agreement of a company until he is satisfied, by such examination as he may make and such evidence as he may require, that: (1) the incorporators are of good repute and intend in good faith to operate the company; (2) the company has capable management; (3) the company has a reasonable prospect for success in the kind or kinds of business which it proposes to transact; (4) the actuarial projections, policy forms, rates, dividends, commissions, and other expenses contemplated as well as reinsurance, market and taxes are sound and reasonable; and (5) the articles of agreement otherwise comply with the law. Upon satisfying himself that the foregoing requirements have been met, the commissioner shall so certify by an endorsement upon said articles of agreement, which shall then be recorded in accordance with the provisions of RSA 293-A:1.20 and RSA 293-A:2.02 provided that copies of the original documents filed with the secretary of state shall also be filed with the insurance commissioner.


Source. 1917, 80:6. PL 272:6. 1937, 24:1. RL 322:6. RSA 401:6. 1969, 283:11. 1983, 15:5. 1992, 255:8, eff. Jan. 1, 1993.

    401:7 Amendment of Charter or Articles of Incorporation. 

Any insurance company organized under the laws of the state, whether by special charter or under the general law, shall be entitled to amend its charter or articles of incorporation, so as to acquire the authority to do any or all kinds of insurance business which corporations organized under the provisions of this chapter are authorized to do, and may otherwise amend its charter or articles, in any manner not inconsistent with this chapter, by a majority vote of all its stock, or, if a mutual company, by a majority vote of those members present and voting, at a meeting called for that purpose. Any such company may, with approval of the commissioner, increase or reduce its capital stock and, subject to the limitations hereinafter provided, may change the par value of the shares of its capital stock at a meeting called for the purpose, by vote of its stockholders as provided by RSA 293-A:10.01 through RSA 293-A:10.09. The par value of the shares of stock of any such company now outstanding or hereafter issued may be such an amount as the commissioner may approve.


Source. 1917, 80:7. PL 272:7. 1933, 145:1. RL 322:7. RSA 401:7. 1955, 6:1. 1983, 15:6. 1992, 255:9, eff. Jan. 1, 1993.

    401:8 Certification of Amendments. 

All proposed amendments, duly certified to by the president and secretary of such company, shall be submitted to the commissioner for examination and endorsement of approval in the same manner as provided by this chapter as to the original articles of agreement. Copies of all documents required by this section to be submitted to the commissioner shall be filed with him.


Source. 1917, 80:7. PL 272:8. 1937, 24:2. RL 322:8. RSA 401:8. 1983, 15:7, eff. April 6, 1983.

    401:9 Record. 

Such articles of amendment shall thereupon be recorded as provided in RSA 401:6, and shall then be deemed to be part of the charter or articles of the company.


Source. 1917, 80:7. PL 272:9. RL 322:9.

    402-A:1 Filing Reports. 

Every person who, on December 31, 1965, is directly or indirectly the beneficial owner of more than 10 percent of any class of equity security of a domestic stock insurance company, or who is a director or an officer of such company, and every person who becomes such a beneficial owner, director, or officer after that date shall file in the office of the commissioner on or before January 10, 1966, or within 10 days after he becomes such beneficial owner, director, or officer, whichever date is later, a statement in such form as the commissioner may prescribe, of the amount of all equity securities of such company of which he is the beneficial owner. Within 10 days after the close of each calendar month thereafter, if there has been a change in such ownership during such month, he shall file in the office of the commissioner a statement, in such form as the commissioner may prescribe, indicating his ownership at the close of the calendar month and such changes in his ownership as have occurred during such calendar month.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:2 Suit to Recover Profits. 

For the purpose of preventing the unfair use of information which may have been obtained by such beneficial owner, director, or officer by reason of his relationship to such company, any profit realized by him from any purchase and sale, or any sale and purchase, of any equity security of such company within any period of less than 6 months, unless such security was acquired in good faith in connection with a debt previously contracted, shall inure to and be recoverable by the company, irrespective of any intention on the part of such beneficial owner, director, or officer in entering into such transaction of holding the security purchased or of not repurchasing the security sold for a period exceeding 6 months. Suit to recover such profit may be instituted at law or in equity in any court of competent jurisdiction by the company, or by the owner of any security of the company in the name and in behalf of the company if the company shall fail or refuse to bring such suit within 60 days after request or shall fail diligently to prosecute the same thereafter. No such suit shall be brought more than 2 years after the date such profit was realized. This section shall not be construed to cover any transaction where such beneficial owner was not such both at the time of the purchase and sale, or the sale and purchase, of the security involved, or any transaction or transactions which the commissioner by rules and regulations may exempt as not comprehended within the purpose of this section.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:3 Prohibited Sales. 

It is unlawful for any such beneficial owner, director, or officer, directly or indirectly, to sell any equity security of such company if the person selling the security or his principal (a) does not own the security sold, or (b) if owning the security, does not deliver it against such sale within 20 days after the sale, or does not within 5 days after such sale deposit it in the mails or other usual channels of transportation. No person shall be deemed to have violated this section if he proves that notwithstanding the exercise of good faith he was unable to make such delivery or deposit within such time, or that to do so would cause undue inconvenience or expense.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:4 Sales by Dealers. 

The provisions of RSA 402-A:2 do not apply to any purchase and sale, or sale and purchase, and the provisions of RSA 402-A:3 do not apply to any sale, of an equity security of a domestic stock insurance company not then or theretofore held by him in an investment account, by a dealer in the ordinary course of his business and incident to the establishment or maintenance by him of a primary or secondary market (otherwise than on an exchange as defined in the Securities Exchange Act of 1934) for such security. The commissioner may, by such rules and regulations as he thinks necessary or appropriate in the public interest, define and prescribe terms and conditions with respect to securities held in an investment account and transactions made in the ordinary course of business and incident to the establishment or maintenance of a primary or secondary market.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:5 Arbitrage Transactions. 

The provisions of RSA 402-A:1, 2 and 3 do not apply to foreign or domestic arbitrage transactions unless made in contravention of such rules and regulations as the commissioner may adopt in order to carry out the purposes of this chapter.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:6 Equity Security. 

The term "equity security" when used in this chapter means any stock or similar security; or any security convertible, with or without consideration, into such a security or carrying any warrant or right to subscribe to or purchase such a security; or any such warrant or right; or any other security which the commissioner considers to be of similar nature and considers necessary or appropriate, by such rules and regulations as he may prescribe in the public interest or for the protection of investors, to treat as an equity security.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:7 Exemptions. 

The provisions of RSA 402-A:1, 2 and 3 do not apply to equity securities of a domestic stock insurance company if (a) such securities shall be registered, or shall be required to be registered, pursuant to section 12 of the Securities Exchange Act of 1934, as amended, or if (b) such domestic stock insurance company does not have any class of its equity securities held of record by 100 or more persons on the last business day of the year next preceding the year in which equity securities of the company would be subject to the provisions of RSA 402-A:1, 2 and 3 except for the provisions of this subsection (b).


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:8 Regulations on Insider Trading. 

The commissioner has the power to make such reasonable rules and regulations as may be necessary for the execution of the functions vested in him by RSA 402-A:1-7, and may for such purpose classify domestic stock insurance companies, securities, and other persons or matters within his jurisdiction. No provision of RSA 402-A:1, 2 and 3 imposing any liability applies to any act done or omitted in good faith in conformity with any rule or regulation of the commissioner, notwithstanding that such rule or regulation may, after such act or omission, be amended or rescinded or determined by judicial or other authority to be invalid for any reason.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-A:9 Regulations on Solicitation of Proxies. 

The insurance commissioner has the power to make reasonable rules and regulations concerning the solicitation by mail, or otherwise, of any proxy, consent, or authorization in respect of any stock of any domestic stock insurance company.


Source. 1965, 131:1, eff. Aug. 1, 1965.

    402-B:1 Prohibition. 

It is unlawful for any person, whether as agent or employee, to act directly or indirectly, as an insurance claims adjuster in this state for any insurance company unless licensed as provided in this chapter.


Source. 1969, 218:1, eff. Aug. 5, 1969.

    402-B:10-a Expiration. 

An insurance adjuster license shall remain in effect unless revoked or suspended as long as the fee set forth in RSA 400-A:29 is paid and educational requirements for resident individual adjusters are met by the due date.


Source. 1977, 232:3, eff. Aug. 14, 1977. 2019, 112:6, eff. Jan. 1, 2020.

    402-B:10 Repealed by 1971, 244:19, VII, eff. Aug. 17, 1971. 

    402-B:11 Expedited License. 

In the event of an emergency or disaster, the commissioner of insurance may, in his or her discretion, issue licenses to persons the commissioner determines are qualified. The fee for the expedited license shall be the same as that provided in RSA 402-B:8.


Source. 1969, 218:1, eff. Aug. 5, 1969. 2019, 112:7, eff. Jan. 1, 2020.

    402-B:12 License Denial, Nonrenewal, or Revocation. 

The commissioner may for good cause shown, after notice and hearing, deny, suspend, or revoke the insurance claims adjuster's license of any holder or subject him or her to an administrative fine not to exceed $2,500 per violation or any combination of actions. Such hearing may be held by the commissioner or any person designated by him or her. Any person aggrieved by said action of the commissioner or refused a license or renewal of the same by him may appeal in accordance with the provisions of RSA 541. Good cause includes, but is not limited to, the following:

I. Providing incorrect, misleading, incomplete, or materially untrue information in the license application.

II. Violating any insurance laws, or violating any rule, regulation, subpoena, or order of the commissioner or of another state's insurance commissioner.

III. Obtaining or attempting to obtain a license through misrepresentation or fraud.

IV. Improperly withholding, misappropriating, or converting any moneys or properties in the course of doing business.

V. Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance.

VI. Having been convicted of a felony.

VII. Having admitted to or been found to have committed any insurance unfair trade practice or fraud.

VIII. Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere.

IX. Having an insurance license, or its equivalent, denied, suspended, or revoked in any other state, province, district, or territory.

X. Forging another's name to an application for insurance or to any document related to an insurance transaction.

 XI. Improperly using notes or any other reference material to complete an examination for an insurance license.

 XII. Failing to comply with an administrative or court order imposing child support obligation.


Source. 1969, 218:1. 1975, 312:1, eff. Aug. 6, 1975. 2022, 223:1, eff. Aug. 16, 2022.

    402-B:13 Penalty. 

Any person who shall act within this state as an insurance claims adjuster without being licensed as herein provided, or any licensee who in the course of his work as an insurance claims adjuster shall misrepresent his identity or the identity of his principal or employer, or who shall wrongfully divulge information coming to him in his capacity as an insurance claims adjuster, shall:

I. Be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person; and

II. Be subject to suspension or revocation of his license and a fine not to exceed $2,500 for each violation.


Source. 1969, 218:1. 1973, 529:101. 1975, 312:2. 1991, 136:1, eff. Jan. 1, 1992.

    402-B:2 Definitions;  Exemption. 

I. "
Home state
" means the District of Columbia and any state or territory of the United States in which an insurance claims adjuster maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance claims adjuster. If such state does not issue an insurance claims adjuster license for the line of business sought, the insurance claims adjuster may designate as his or her "home state" any state in which the insurance claims adjuster qualifies pursuant to the provisions of RSA 402-B.

II. In this chapter, "
insurance claims adjuster
" means a person who investigates, negotiates, or settles property, casualty, or workers' compensation claims whether employed by or contracted by or with an insurer, a claims adjusting company, or a third party administrator.

III. The provisions of this chapter shall not apply to the following:

(a) Attorneys duly admitted to practice in this state pursuant to the provisions of RSA 311 when acting in their professional capacity as an attorney.

(b) A person employed solely to obtain facts surrounding a claim for a licensed insurance claims adjuster or to furnish technical assistance to a licensed insurance claims adjuster.

(c) An individual who is employed to investigate suspected insurance fraud and who does not adjust losses or determine claims payments.

(d) A person who, for purposes of portable electronics insurance claims, collects and enters claims information from, or furnishes claims information to, insureds or claimants, utilizing an automated claims adjudication system; provided, that no more than 25 such persons are under the supervision of a licensed insurance claims adjuster or a licensed insurance producer. A licensed insurance producer adjusting claims or acting as a supervisor pursuant to this subparagraph shall not also be required to be a licensed insurance claims adjuster. In this subparagraph:

(1) "
Automated claims adjudication system
" means a preprogrammed computer system that is utilized only by licensed insurance claims adjusters, licensed insurance producers, or supervised individuals operating pursuant to this subparagraph, designed for the collection, data entry, calculation, and final resolution and settlement of claims with respect to portable electronics insurance in compliance with the claims settlement requirements of the insurance laws of this state.

(2) "
Licensed insurance claims adjuster
" means a person licensed as an insurance claims adjuster under this chapter.

(3) "
Licensed insurance producer
" means a person licensed to sell, solicit, or negotiate portable electronics insurance under RSA 402-J.

(4) "
Portable electronics insurance
" shall have the same meaning as such term under RSA 402-K:1, VI.

(e) A person who solely performs executive, administrative, managerial, or clerical duties, or any combination thereof, and who does not investigate, negotiate, or settle claims with policyholders, claimants, or their legal representatives. Completion of a first notice of loss form is a clerical duty.


Source. 1969, 218:1. 2008, 212:1. 2013, 230:1. 2015, 93:1, eff. Aug. 4, 2015. 2018, 132:1, 2, eff. July 29, 2018.

    402-B:3 Applications. 

Applications for licenses as an insurance claims adjuster shall be made in writing to the commissioner of insurance on forms prescribed by him or her stating the age, domicile, line or lines of insurance for which the applicant desires a license, and the place of business of the individual applicant. The commissioner shall require the applicant to set forth personal and professional background information in the application as the commissioner may reasonably require to determine suitability for issuance of a license.


Source. 1969, 218:1. 2008, 18:9, eff. July 11, 2008.

    402-B:4 Examination. 

Except as hereinafter provided, the commissioner of insurance shall not issue an original claims adjuster's license to any applicant therefor unless and until said applicant shall have satisfactorily passed a reasonable written examination, which shall be administered by the commissioner, shall be in such form as said commissioner shall prescribe and shall be of sufficient scope to test the applicant's knowledge of insurance, the duties and responsibilities of a licensee, and the laws of the state applicable to insurance. The commissioner is authorized to publish and distribute printed material indicating the scope of the examination and suggested sources of study. The commissioner shall collect a fee as established by RSA 400-A:29.


Source. 1969, 218:1. 1983, 473:9, eff. Sept. 3, 1983. 2019, 112:1, eff. Jan. 1, 2020.

    402-B:5-a Continuing Education. 

Every 2 years, at least 60 days prior to the renewal date of their license, persons holding an adjusters license shall be certified by the insurance department as having completed 24 hours of continuing education instruction. Of the 24 continuing education hours required, at least 3 hours shall consist of courses approved for adjuster ethics credit. Licensees with workers' compensation authority shall comply with the approved 10 credit hours of workers' compensation and 10 credit hours of multi-line requirement pursuant to RSA 281-A:63. Those licensees without workers' compensation authority may satisfy their 24 credit hour requirement exclusively with multi-line approved credits or any combination of approved workers' compensation or multi-line courses. Such continuing education instruction shall be approved by the insurance department. If a nonresident licensee has complied with the continuing education requirements of his or her state of residence or designated home state, he or she will not be required to comply with the requirements of this state.


Source. 1993, 317:1. 1997, 324:4. 2001, 224:2. 2010, 212:5, eff. Jan. 1, 2011. 2019, 112:3, eff. Jan. 1, 2020.

    402-B:5 Exceptions. 

The commissioner shall waive the requirement of such examination in the following cases:

I. Nonresident applicants who are licensed as insurance claims adjusters in the states in which they reside, or if no license is required in said states, then nonresident applicants who have engaged in the business of claims adjusting for a period of 6 months;

II. Attorneys-at-law.

III. [Repealed.]


Source. 1969, 218:1, eff. Aug. 5, 1969. 2019, 112:2, eff. Jan. 1, 2020.

    402-B:6 Rules and Regulations. 

The commissioner may make reasonable rules and regulations necessary to effect the purposes of this chapter.


Source. 1969, 218:1, eff. Aug. 5, 1969.

    402-B:7 License to Issue. 

I. Upon satisfaction that such applicant is in all respects properly qualified and of good character, and that the granting of such license is not against the public interest, the commissioner shall, upon the payment of the required fee, issue said applicant an insurance claims adjuster's license.

II. Licensees shall inform the commissioner by any means acceptable to the commissioner of a change of address within 30 days of the change. Change of address shall be accompanied by the fee required pursuant to RSA 400-A:29.

III. A nonresident insurance adjuster license shall remain in effect unless revoked or suspended as long as the fee set forth in RSA 400-A:29 is paid and the nonresident's insurance adjuster license remains in good standing in his or her home state. Termination of the insurance adjuster's resident license shall be deemed termination of the New Hampshire nonresident insurance adjuster license unless the adjuster timely files a change of address pursuant to this chapter.

IV. An adjuster shall report to the commissioner any administrative action taken against the adjuster in another jurisdiction or by another governmental agency in this state within 30 days of the final disposition of the matter. This report shall include a copy of the order, consent to order, or other relevant legal documents.

V. Within 30 days of the initial pretrial hearing date, an adjuster shall report to the commissioner any criminal prosecution of the adjuster taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.


Source. 1969, 218:1, eff. Aug. 5, 1969. 2019, 112:4, eff. Jan. 1, 2020.

    402-B:8 Fees. 

The commissioner of insurance shall collect the following fees for use by the commissioner in administrating this title:

I. For each original insurance claims adjuster's license, as prescribed by RSA 400-A:29.

II. For each renewal, as prescribed by RSA 400-A:29.

III. An individual insurance adjuster who allows his or her license to lapse may, within 24 months from the due date of the renewal fee, reinstate the same license without the necessity of passing a written examination. However, a penalty in the amount of double the unpaid renewal fee shall be required for any renewal fee received after the due date, pursuant to RSA 400-A:29.


Source. 1969, 218:1. 1970, 37:5. 1971, 244:18. 2001, 224:11, eff. Sept. 9, 2001. 2019, 112:5, eff. Jan. 1, 2020.

    402-B:9 Form of License, Display. 

The insurance claims adjuster's license shall be in such form and contain such identifying information concerning the licensee as the commissioner of insurance shall prescribe. The licensee shall exhibit said license to each person, whether an insured, a claimant, a witness, a potential witness or any other informant with whom he may deal in the course of investigating or adjusting any claim or potential claim prior to any such dealings and shall identify the name of the company for which he works and the name of the insured.


Source. 1969, 218:1, eff. Aug. 5, 1969.

    402-C:1 Title, Construction and Purpose. 

I. 
Short Title. This chapter may be cited as the "Insurers Rehabilitation and Liquidation Act."

II. 
Construction: No Limitation of Powers. This chapter shall not be interpreted to limit the powers granted the commissioner by other provisions of the law.

III. 
Liberal Construction. This chapter shall be liberally construed to effect the purpose stated in paragraph IV.

IV. 
Purpose. The purpose of this chapter is the protection of the interests of insureds, creditors, and the public generally, with minimum interference with the normal prerogatives of proprietors, through:

(a) Early detection of any potentially dangerous condition in an insurer, and prompt application of appropriate corrective measures, neither unduly harsh nor subject to the kind of publicity that would needlessly damage or destroy the insurer;

(b) Improved methods for rehabilitating insurers, by enlisting the advice and management expertise of the insurance industry;

(c) Enhanced efficiency and economy of liquidation, through clarification and specification of the law, to minimize legal uncertainty and litigation;

(d) Equitable apportionment of any unavoidable loss;

(e) Lessening the problems of interstate rehabilitation and liquidation by facilitating cooperation between states in the liquidation process, and by extension of the scope of personal jurisdiction over debtors of the insurer outside this state; and

(f) Regulation of the insurance business by the impact of the law relating to delinquency procedures and substantive rules on the entire insurance business.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:10 Delinquency Proceedings. 

I. Every proceeding commenced before June 23, 1969, is deemed to have commenced under this chapter for the purpose of conducting the proceeding thereafter, except that in the discretion of the commissioner the proceeding may be continued, in whole or in part, as it would have been continued had this chapter not been enacted.

II. Until all payments of or on account of the insurer's contracted delegations by all guaranty associations, along with all expenses thereof and interest on all such payments and expenses, shall have been repaid to the guaranty associations or a plan of repayment by the insurer shall have been approved by the guaranty association, no insurer that is subject to any delinquency proceeding shall:

(a) Be released from such proceeding, unless such proceeding is converted into a judicial rehabilitation or liquidation proceeding;

(b) Be permitted to solicit or accept new business or accept the restoration of any suspended or revoked license or certificate of authority;

(c) Be returned to the control of its shareholders or private management; or

(d) Have any of its assets returned to the control of its shareholders or private management.


Source. 1969, 272:1. 1991, 96:2, eff. Jan. 1, 1992.

    402-C:11 Commissioner's Summary Orders. 

I. 
Summary Order After Hearing. Whenever the commissioner has reasonable cause to believe, and determines after a hearing held as prescribed in paragraph III, that any insurer has committed or engaged in, or is committing or engaging in or is about to commit or engage in any act, practice or transaction that would subject it to formal delinquency proceedings under this chapter, he may make and serve upon the insurer and any other persons involved, such orders other than seizure orders under RSA 402-C:12 and 13 as are reasonably necessary to correct, eliminate or remedy such conduct, condition or ground. If the order is for a restoration of or addition to capital, it may be carried out as provided in RSA 403.

II. 
Summary Order Before Hearing. If the conditions of paragraph I are satisfied, and if it appears to the commissioner that irreparable harm to the property or business of the insurer or to the interest of its policyholders, creditors or the public may occur unless he issues with immediate effect the orders described in paragraph I he may make and serve such orders without notice and before hearing, simultaneously serving upon the insurer notice of hearing under paragraph III.

III. 
Service, Notice, Hearing. The notice of hearing under paragraphs I or II and the summary order issued under paragraphs I or II shall be reasonably calculated to fairly and reasonably notify the recipient of the time and place of hearing, and the conduct, condition or ground upon which the commissioner would base his order; the notice of hearing under paragraph II shall state the time and place of hearing. Unless mutually agreed between the commissioner and the insurer, the hearing shall occur not less than 10 days nor more than 30 days after notice is served and shall be either in Concord or in some other place convenient to the parties to be designated by the commissioner.

IV. 
Judicial Relief. If the commissioner issues a summary order before hearing under paragraph II, the insurer may at any time waive the commissioner's hearing and apply for immediate judicial relief by means of any remedy afforded by law without first exhausting administrative remedies. Subsequent to a hearing the insurer or any person whose interests are substantially affected shall be entitled to judicial review of any order issued by the commissioner.

V. 
Sanction. If any person has violated any order issued under this section which as to him was then still in effect, he shall be liable to forfeit a sum not to exceed $10,000. The penalty shall be imposed and collected in an action brought by the attorney general and shall be paid into the state treasury.

VI. 
Enforcement by Injunction. The commissioner may apply for and any superior court may grant, such restraining orders, temporary and permanent injunctions and other orders as are deemed necessary to enforce a summary order.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:12 Court's Seizure Order. 

I. 
Issuance. Upon the filing by the commissioner in any superior court in this state of a verified petition alleging any ground that would justify a court order for a formal delinquency proceeding against an insurer under this chapter and that the interests of policyholders, creditors or the public will be endangered by delay, and setting out the order deemed necessary by the commissioner, the court shall issue forthwith, ex parte and without a hearing, the requested order which may a) direct the commissioner to take possession and control of all or a part of the property, books, accounts, documents and other records of an insurer and of the premises occupied by it for the transaction of its business, and b) until further order of the court, enjoin the insurer and its officers, managers, agents, and employees from disposition of its property and from transaction of its business except with the written consent of the commissioner.

II. 
Duration. The court shall specify in the order what its duration shall be, which shall be such time as the court deems necessary for the commissioner to ascertain the condition of the insurer. On motion of either party or on its own motion, the court may hold such hearings as it deems desirable after such notice as it deems appropriate, and may extend, shorten or modify the terms of the seizure order. The court shall vacate the seizure order if the commissioner fails to commence a formal proceeding under this chapter after having had a reasonable opportunity to do so. The issuance of an order of the court pursuant to a formal proceeding under this chapter vacates the seizure order.

III. 
Anticipatory Breach. Entry of a seizure order under this section shall not constitute an anticipatory breach of any contract of the insurer.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:13 Commissioner's Seizure Order. 

I. 
Issuance. If it appears to the commissioner that the interests of creditors, policyholders or the public will be endangered by the delay incident to asking for a court seizure order, then on any ground that would justify a court seizure order under RSA 402-C:12 without notice and without applying to the court, he may issue a seizure order which must contain a verified statement of the grounds of his action. As directed by the seizure order, the commissioner's representatives shall forthwith take possession and control of all or part of the property, books, accounts, documents and other records of the insurer, and of the premises occupied by the insurer for the transaction of its business. The commissioner shall retain possession and control until the order is vacated or is replaced by an order of the court pursuant to a proceeding commenced under paragraph II or a formal proceeding under this chapter.

II. 
Judicial Review. At any time after seizure under paragraph I, the insurer may apply to the superior court for Merrimack county or for the county in which the insurer's principal office is located. The court shall thereupon order the commissioner to appear forthwith and shall proceed thereafter as if the order were a court seizure order issued under RSA 402-C:12.

III. 
Duty to Assist Commissioner. Every law enforcement officer shall assist the commissioner in making and enforcing any such seizure, and every sheriff's and police department shall furnish with such deputies, patrolmen or officers as are necessary to assist him.

IV. 
Anticipatory Breach. Entry of a seizure order under this section shall not constitute an anticipatory breach of any contract of the insurer.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:14 Conduct of Hearings in Summary Proceedings. 

I. 
Confidentiality of Commissioner's Hearings. The commissioner shall hold all hearings in summary proceedings privately unless the insurer requests a public hearing, in which case the hearing shall be public.

II. 
Confidentiality of Court Hearings. The court may hold all hearings in summary proceedings and judicial reviews thereof privately in chambers, and shall do so on request of the insurer proceeded against.

III. 
Records. In all summary proceedings and judicial reviews thereof, all records of the company, other documents, and all insurance department files and court records and papers, so far as they pertain to or are a part of the record of the summary proceedings, shall be and remain confidential except as is necessary to obtain compliance therewith, unless the court, after hearing arguments from the parties in chamber, shall order otherwise, or unless the insurer requests that the matter be made public. Until such court order, all papers, filed with the clerk of the court shall be held by him in a confidential file.

IV. 
Parties. If at any time it appears to the court that any person whose interest is or will be substantially affected by an order did not appear at the hearing and has not been served, the court may order that notice be given and the proceedings be adjourned to give him opportunity to appear on such terms as may be just.

V. 
Sanctions. Any person having possession or custody of and refusing to deliver any of the property, books, accounts, documents or other records of an insurer against which a seizure order or a summary order has been issued by the commissioner or by the court, shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person.


Source. 1969, 272:1. 1973, 528:279, eff. Oct. 31, 1973 at 11:59 p.m.

    402-C:15 Grounds for Rehabilitation. 

The commissioner may apply by verified petition to the superior court for Merrimack county or for the county in which the principal office of the insurer is located for an order directing him to rehabilitate a domestic insurer or an alien insurer domiciled in this state on any one or more of the following grounds:

I. Any ground on which he may apply for an order of liquidation under RSA 402-C:20 whenever he believes that the insurer may be successfully rehabilitated without substantial increase in the risk of loss to creditors of the insurer or to the public;

II. That the commissioner has reasonable cause to believe that there has been embezzlement from the insurer, wrongful sequestration or diversion of the insurer's assets, forgery or fraud affecting the insurer or other illegal conduct in, by or with respect to the insurer, that if established would endanger assets in an amount threatening the solvency of the insurer;

III. That information coming into the commissioner's possession has disclosed substantial and not adequately explained discrepancies between the insurer's records and the most recent annual report or other official company reports;

IV. That the insurer has failed to remove any person who in fact has executive authority in the insurer, whether an officer, manager, general agent, employee or other person, if the person has been found by the commissioner after notice and hearing to be dishonest or untrustworthy in a way affecting the insurer's business;

V. That control of the insurer, whether by stock ownership or otherwise, and whether direct or indirect, is in one or more persons found by the commissioner after notice and hearing to be dishonest or untrustworthy;

VI. That any person who in fact has executive authority in the insurer, whether an officer, manager, general agent, employee or other person, has refused to be examined under oath by the commissioner concerning its affairs, whether in this state or elsewhere, and after reasonable notice of the fact the insurer has failed promptly and effectively to terminate the employment and status of the person and all his influence on management;

VII. That after demand by the commissioner the insurer has failed to submit promptly any of its own property, books, accounts, documents or other records, or those of any subsidiary or related company within the control of the insurer, or those of any person having executive authority in the insurer so far as they pertain to the insurer, to reasonable inspection or examination by the commissioner or his authorized representative. If the insurer is unable to submit the property, books, accounts, documents or other records of a person having executive authority in the insurer, it shall be excused from doing so if it promptly and effectively terminates the relationship of the person to the insurer;

VIII. That without first obtaining the written consent of the commissioner, the insurer has transferred, or attempted to transfer, substantially its entire property or business, or has entered into any transaction the effect of which is to merge, consolidate or reinsure substantially its entire property or business in or with the property or business of any other person;

IX. That the insurer or its property has been or is the subject of an application for the appointment of a receiver, trustee, custodian, conservator or sequestrator or similar fiduciary of the insurer or its property otherwise than as authorized under this chapter, and that such appointment has been made or is imminent, and that such appointment might oust the courts of this state of jurisdiction or prejudice orderly delinquency proceedings under this chapter;

X. That within the previous year the insurer has wilfully violated its charter or articles of incorporation or its bylaws or any insurance law or regulation of any state, or of the federal government, or any valid order of the commissioner under RSA 402-C:11 or having become aware within the previous year of an unintentional violation has failed to take all reasonable steps to remedy the situation resulting from the violation and to prevent future violations;

XI. That the directors of the insurer are deadlocked in the management of the insurer's affairs and that the members or shareholders are unable to break the deadlock and that irreparable injury to the insurer, its creditors, its policyholders or the public is threatened by reason thereof;

XII. That the insurer has failed to pay for 60 days after due date any obligation to this state or any political subdivision thereof or any judgment entered in this state, except that such nonpayment shall not be a ground until 60 days after any good faith effort by the insurer to contest the obligation has been terminated, whether it is before the commissioner or in the courts;

XIII. That the insurer has failed to file its annual report or other report within the time allowed by law, and after written demand by the commissioner has failed to give an adequate explanation immediately;

XIV. That 
2/3 of the board of directors, or the holders of a majority of the shares entitled to vote, or a majority of members or policyholders of an insurer subject to control by its members or policyholders, consent to rehabilitation under this chapter.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:16 Rehabilitation Orders. 

I. 
Appointment of Rehabilitator. An order to rehabilitate the business of a domestic insurer, or an alien insurer domiciled in this state, shall appoint the commissioner and his successors in office rehabilitator and shall direct the rehabilitator forthwith to take possession of the assets of the insurer and to administer them under the orders of the court. The filing or recording of the order with any register of deeds in the state imparts the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that register of deeds.

II. 
Anticipatory Breach. Entry of an order of rehabilitation shall not constitute an anticipatory breach of any contracts of the insurer.

III. Any order issued under this section shall require accountings to the court by the rehabilitator. Accountings shall be at such intervals as the court specifies in its order, but no less frequently than semi-annually.


Source. 1969, 272:1. 1991, 96:3, eff. Jan. 1, 1992.

    402-C:17 Powers and Duties of the Rehabilitator. 

I. 
Special Deputy Commissioner. The commissioner as rehabilitator shall make every reasonable effort to employ an active or retired senior executive from a successful insurer to serve as special deputy commissioner to rehabilitate the insurer. The special deputy shall have all of the powers of the rehabilitator granted under this section. To obtain a suitable special deputy, the commissioner may consult with and obtain the assistance and advice of executives of insurers doing business in this state. Subject to court approval, the commissioner shall make such arrangements for compensation as are necessary to obtain a special deputy of proven ability. The special deputy shall serve at the pleasure of the commissioner.

II. 
General Power. Subject to court approval, the rehabilitator may take such action as he deems necessary or expedient to reform and revitalize the insurer. He shall have all the powers of the officers and managers, whose authority shall be suspended, except as they are redelegated by the rehabilitator. He shall have full power to direct and manage, to hire and discharge employees subject to any contract rights they may have and to deal with the property and business of the insurer.

III. 
Advice From Experts. The rehabilitator may consult with and obtain formal or informal advice and aid of insurance experts.

IV. 
Pursuit of Insurer's Claims Against Insiders. If the rehabilitator finds that there has been criminal or tortious conduct or breach of any contractual or fiduciary obligation detrimental to the insurer by any officer, manager, agent, broker, employee or other person, he may pursue all appropriate legal remedies on behalf of the insurer.

V. 
Reorganization Plan. The rehabilitator may prepare a plan for the reorganization, consolidation, conversion, reinsurance, merger or other transformation of the insurer. Upon application of the rehabilitator for approval of the plan, and after such notice and hearing as the court prescribes, the court may either approve or disapprove the plan proposed, or may modify it and approve it as modified. If it is approved, the rehabilitator shall carry out the plan. In the case of a life insurer, the plan proposed may include the imposition of liens upon the equities of policyholders of the company, if all rights of shareholders are first relinquished. A plan for a life insurer may also propose imposition of a moratorium upon loan and cash surrender rights under policies, for such period and to such an extent as are necessary.

VI. 
Fraudulent Transfers. The rehabilitator shall have the power to avoid fraudulent transfers under RSA 402-C:30 and 31.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:18 Actions by and Against Rehabilitator. 

I. 
Stays in Pending Litigation. On request of the rehabilitator, any court in this state before which any action or proceeding by or against an insurer is pending when a rehabilitation order against the insurer is entered shall stay the action or proceeding for such time as is necessary for the rehabilitator to obtain proper representation and prepare for further proceedings. The court that entered the rehabilitation order shall order the rehabilitator to take such action respecting the pending litigation as the court deems necessary in the interests of justice and for the protection of creditors, policyholders and the public. The rehabilitator shall immediately consider all litigation pending outside this state and shall petition the courts having jurisdiction over that litigation for stays whenever necessary to protect the estate of the insurer.

II. 
Statutes of Limitations on Claims by Insurer. The time between the filing of a petition for rehabilitation against an insurer and denial of the petition or an order of rehabilitation shall not be considered to be a part of the time within which any action may be commenced by the insurer. Any action by the insurer that might have been commenced when the petition was filed may be commenced at least 60 days after the order of rehabilitation is entered.

III. 
Statutes of Limitations on Claims Against Insurer. The time between the filing of a petition for rehabilitation against an insurer and the denial of the petition or an order of rehabilitation shall not be considered to be a part of the time within which any action may be commenced against the insurer. Any action against the insurer that might have been commenced when the petition was filed may be commenced for at least 60 days after the order of rehabilitation is entered or the petition is denied.

IV. Any guaranty association or foreign guaranty association covering life or health insurance or annuities shall have standing to appear in any court proceeding concerning the rehabilitation of a life or health insurer if such association is or may become liable to act as a result of the rehabilitator.


Source. 1969, 272:1. 1991, 96:4, eff. Jan. 1, 1992.

    402-C:19 Termination of Rehabilitation. 

I. 
Transformation to Liquidation. Whenever he believes that further attempts to rehabilitate an insurer would substantially increase the risk of loss to creditors, policyholders, or the public, or would be futile, the rehabilitator may petition the court for an order of liquidation. A petition under this subsection shall have the same effect as a petition under RSA 402-C:20. The court shall permit the directors to defend against the petition and shall order payment from the estate of the insurer of such costs and other expenses of defense as justice requires.

II. 
Order to Return to Company. The rehabilitator may at any time petition the court for an order terminating rehabilitation of an insurer. If the court finds that rehabilitation has been accomplished and that grounds for rehabilitation under RSA 402-C:15 no longer exist, it shall order that the insurer be restored to possession of its property and the control of its business. The court may also make that finding and issue that order at any time upon its own motion.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:2 Persons Covered. 

The proceedings authorized by this chapter may be applied to:

I. All insurers who are doing, or have done, an insurance business in this state, and against whom claims arising from that business may exist now or in the future;

II. All insurers who purport to do an insurance business in this state;

III. All insurers who have insureds resident in this state;

IV. All other persons organized or in the process of organizing with the intent to do an insurance business in this state; and

V. All nonprofit health service corporations as defined in RSA 420-A and all fraternal benefit and mutual benefit societies as defined in RSA 418.


Source. 1969, 272:1. 1997, 190:4, eff. Jan. 1, 1998.

    402-C:20 Grounds for Liquidation. 

The commissioner may apply by verified petition to the superior court for Merrimack county or for the county in which the principal office of the insurer is located for an order directing him to liquidate a domestic insurer or an alien insurer domiciled in this state on any one or more of the following grounds:

I. Any ground on which he may apply for an order of rehabilitation under RSA 402-C:15 whenever he believes that attempts to rehabilitate the insurer would substantially increase the risk of loss to its creditors, its policyholders or the public, or would be futile, or that rehabilitation would serve no useful purpose;

II. That the insurer is or is about to become insolvent;

III. That the insurer is engaging in a systematic practice of reaching settlements with and obtaining releases from policyholders or third party claimants and then unreasonably delaying payment of or failing to pay the agreed upon settlements;

IV. That the insurer is in such condition that the further transaction of business would be hazardous, financially or otherwise, to its policyholders, its creditors or the public;

V. That the insurer has not transacted the business of insurance during the previous 12 months or has transacted only a token insurance business during that period, although authorized to do so throughout that period, or that more than 12 months after incorporation it has failed to become authorized to do an insurance business;

VI. That within the previous 12 months the insurer has systematically attempted to compromise with its creditors on the ground that it is financially unable to pay its claims in full;

VII. That the insurer has commenced, or within the previous year has attempted to commence, voluntary liquidation otherwise than under the insurance laws of this state;

VIII. That the insurer has concealed records or assets from the commissioner or improperly removed them from the jurisdiction;

IX. That the insurer does not satisfy the requirements that would be applicable if it were seeking initial authorization to do an insurance business in this state, except for:

(a) Requirements that are intended to apply only at the time the initial authorization to do business is obtained, and not thereafter; and

(b) Requirements that are expressly made inapplicable by the laws establishing the requirements;

X. That the holders of 
2/3 of the shares entitled to vote, or 
2/3 of the members or policyholders entitled to vote in an insurer controlled by its members or policyholders, have consented to a petition.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:21 Liquidation Orders. 

I. 
Order to Liquidate. An order to liquidate the business of a domestic insurer shall appoint the commissioner and his successors in office liquidator and shall direct the liquidator forthwith to take possession of the assets of the insurer and to administer them under the orders of the court. The liquidator shall be vested by operation of law with the title to all of the property, contracts and rights of action and all of the books and records of the insurer ordered liquidated, wherever located, as of the date of the filing of the petition for liquidation. He may recover and reduce the same to possession except that ancillary receivers in reciprocal states shall have, as to assets located in their respective states, the rights and powers which are prescribed in RSA 402-C:55, III for ancillary receivers appointed in this state as to assets located in this state. The filing or recording of the order with any register of deeds in this state imparts the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that register of deeds.

II. 
Fixing of Rights. Upon issuance of the order, the rights and liabilities of any such insurer and of its creditors, policyholders, shareholders, members and all other persons interested in its estate are fixed as of the date of filing of the petition for liquidation, except as provided in RSA 402-C:22 and 39.

III. 
Alien Insurer. An order to liquidate the business of an alien insurer domiciled in this state shall be in the same terms and have the same legal effect as an order to liquidate a domestic insurer, except that the assets and the business in the United States shall be the only assets and business included under the order.

IV. 
Declaration of Insolvency. At the time of petitioning for an order of liquidation, or at any time thereafter, the commissioner may petition the court to declare the insurer insolvent, and after such notice and hearing as it deems proper, the court may make the declaration.

V. Any order issued under this section shall require financial reports to the court by the liquidator. Financial reports shall include, at a minimum, the assets and liabilities of the insurer and all funds received or disbursed by the liquidator during the current period. Financial reports shall be filed within one year of the liquidation order and at least annually thereafter.

VI. (a) On or before January 6, 1992, or, if later, within 5 days after the initiation of an appeal of an order of liquidation, which order has not been stayed, the commissioner shall present for the court's approval a plan for the continued performance of the defendant company's policy claims obligations, including the duty to defend insureds under liability insurance policies, during the pendency of an appeal. Such plan shall provide for the continued performance and payment of policy claims obligations in the normal course of events, notwithstanding the grounds alleged in support of the order of liquidation including the ground of insolvency. If the defendant company's financial condition is, in the judgment of the commissioner, unable to support the full performance of all policy claims obligations during the appeal pendency period, the plan may prefer the claims of certain policyholders and claimants over creditors and interested parties as well as other policyholders and claimants, as the commissioner finds to be fair and equitable considering the relative circumstances of such policyholders and claimants. The court shall examine the plan submitted by the commissioner and if it finds the plan to be in the best interests of the parties, the court shall approve the plan. No action shall lie against the commissioner or any of his deputies, agents, clerks, assistants or attorneys by any party based on preference in an appeal pendency plan approved by the court.

(b) The appeal pendency plan shall not supersede or affect the obligations of any insurance guaranty association.

(c) Any such plans shall provide for equitable adjustments to be made by the liquidator to any distributions of assets to guaranty associations, in the event that the liquidator pays claims from assets of the estate, which would otherwise be the obligations of any particular guaranty association but for the appeal of the order of liquidation, such that all guaranty associations equally benefit on a pro rata basis from the assets of the estate. Further, in the event an order of liquidation is set aside upon any appeal, the company shall not be released from delinquency proceedings unless and until all funds advanced by any guaranty association, including reasonable administrative expenses in connection with the proceedings relating to obligations of the company, shall be repaid in full, together with interest at the judgment rate of interest or unless an arrangement for repayment thereof has been made with the consent of all applicable guaranty associations.


Source. 1969, 272:1. 1991, 96:5, eff. Jan. 1, 1992.

    402-C:22 Continuance of Coverage. 

I. All insurance policies issued by the insurer shall continue in force:

(a) For a period of 30 days from the date of entry of the liquidation order;

(b) Until the normal expiration of the policy coverage;

(c) Until the insured has replaced the insurance coverage with equivalent insurance in another insurer; or

(d) Until the liquidator has effected a transfer of the policy obligation pursuant to RSA 402-C:25, VIII; whichever time is less.

II. If the coverage continued under this section is replaced by insurance that is not equivalent, the coverage continued under this section shall be excess coverage over the replacement policy to the extent of the deficiency. Claims arising during the continuation of coverage shall be treated as if they arose immediately before the petition for liquidation. Coverage under this section shall not satisfy any legal obligation of the insured to carry insurance protection, whether the obligation is created by law or by contract.


Source. 1969, 272:1. 1991, 96:6, eff. Jan. 1, 1992.

    402-C:23 Dissolution of Insurer. 

The commissioner may petition for an order dissolving the corporate existence of a domestic insurer or the United States branch of an alien insurer domiciled in this state at the time he applies for a liquidation order. If the court issues a liquidation order, it also shall order dissolution if the commissioner has petitioned for it. The court shall order dissolution of the corporation upon petition by the commissioner at any time after a liquidation order has been granted. If the dissolution has not previously occurred, it shall be effected by operation of law upon the discharge of the liquidator.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:24 Federal Receivership. 

I. 
Petition for Federal Receiver. Whenever in the commissioner's opinion, liquidation of a domestic insurer or an alien insurer domiciled in this state would be facilitated by a federal receivership, and when any ground exists upon which the commissioner might petition the court for an order of rehabilitation or liquidation under RSA 402-C:15 or 20, or if an order of rehabilitation or liquidation has already been entered, the commissioner may request another commissioner or other willing resident of another state to petition any appropriate federal district court for the appointment of a federal receiver. The commissioner may intervene in any such action to support or oppose the petition, and may accept appointment as the receiver if he is so designated. So much of this chapter shall apply to the receivership as can be made applicable and is appropriate. Upon motion of the commissioner, the courts of this state shall relinquish all jurisdiction over the insurer for purposes of rehabilitation or liquidation.

II. 
Compliance With Federal Requirements. If the commissioner is appointed receiver under this section, he shall comply with any requirements necessary to give him title to and control over the assets and affairs of the insurer.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:25 Powers of Liquidator. 

The liquidator shall report to the court monthly, or at other intervals specified by the court, on the progress of the liquidation in whatever detail the court orders. Subject to the court's control, he may:

I. Appoint a special deputy to act for him under this chapter, and determine his compensation. The special deputy shall have all powers of the liquidator granted by this section. The special deputy shall serve at the pleasure of the liquidator.

II. Appoint or engage employees and agents, legal counsel, actuaries, accountants, appraisers, consultants and other personnel he deems necessary to assist in the liquidation. RSA 98 shall not apply to such persons.

III. Fix the compensation of persons under paragraph II, subject to the control of the court.

IV. Defray all expenses of taking possession of, conserving, conducting, liquidating, disposing of or otherwise dealing with the business and property of the insurer. If the property of the insurer does not contain sufficient cash or liquid assets to defray the costs incurred, the liquidator may advance the costs so incurred out of any available appropriation. Any amounts so paid shall be deemed expense of administration and shall be repaid for the credit of the insurance department out of the first available moneys of the insurer.

V. Hold hearings, subpoena witnesses and compel their attendance, administer oaths, examine any person under oath and compel any person to subscribe to his testimony after it has been correctly reduced to writing, and in connection therewith require the production of any books, papers, records or other documents which he deems relevant to the inquiry.

VI. Collect all debts and moneys due and claims belonging to the insurer, wherever located, and for this purpose institute timely action in other jurisdictions, in order to forestall garnishment and attachment proceedings against such debts; do such other acts as are necessary or expedient to collect, conserve or protect its assets or property, including sell, compound, compromise or assign for purposes of collection, upon such terms and conditions as he deems best, any bad or doubtful debts; and pursue any creditor's remedies available to enforce his claims.

VII. Conduct public and private sales of the property of the insurer in a manner prescribed by the court.

VIII. Use assets of the estate to transfer policy obligations to a solvent assuming insurer, if the transfer can be arranged without prejudice to applicable priorities under RSA 402-C:44.

IX. Acquire, hypothecate, encumber, lease, improve, sell, transfer, abandon or otherwise dispose of or deal with any property of the insurer at its market value or upon such terms and conditions as are fair and reasonable, except that no transaction involving property the market value of which exceeds $10,000 shall be concluded without express permission of the court. He also may execute, acknowledge and deliver any deeds, assignments, releases and other instruments necessary or proper to effectuate any sale of property or other transaction in connection with the liquidation. In cases where real property sold by the liquidator is located other than in the county where the liquidation is pending, the liquidator shall cause to be filed with the register of deeds for the county in which the property is located a certified copy of the order appointing him.

X. Borrow money on the security of the insurer's assets or without security and execute and deliver all documents necessary to that transaction for the purpose of facilitating the liquidation.

XI. Enter into such contracts as are necessary to carry out the order to liquidate, and affirm or disavow any contracts to which the insurer is a party.

XII. Continue to prosecute and institute in the name of the insurer or in his own name any suits and other legal proceedings, in this state or elsewhere, and abandon the prosecution of claims he deems unprofitable to pursue further. If the insurer is dissolved under RSA 402-C:23, he may apply to any court in this state or elsewhere for leave to substitute himself for the insurer as plaintiff.

XIII. Prosecute any action which may exist in behalf of the creditors, members, policyholders or shareholders of the insurer against any officer of the insurer, or any other person.

XIV. Remove any records and property of the insurer to the offices of the commissioner or to such other place as is convenient for the purposes of efficient and orderly execution of the liquidation.

XV. Deposit in one or more banks in this state such sums as are required for meeting current administration expenses and dividend distributions.

XVI. File any necessary documents for record in the office of any register of deeds or record office in this state or elsewhere where property of the insurer is located.

XVII. Assert all legal and equitable defenses available to the insurer as against third persons. A waiver of any defense by the insurer after a petition for liquidation has been filed shall not bind the liquidator.

XVIII. Exercise and enforce all the rights, remedies and powers of any creditor, shareholder, policyholder or member, including any power to avoid any transfer or lien that may be given by law and that is not included within RSA 402-C:30-32.

XIX. Intervene in any proceeding wherever instituted that might lead to the appointment of a receiver or trustee, and act as the receiver or trustee whenever the appointment is offered.

XX. Enter into agreements with any receiver or commissioner of any other state relating to the rehabilitation, liquidation, conservation or dissolution of an insurer doing business in both states.

XXI. Exercise all powers now held or hereafter conferred upon receivers by the laws of this state not inconsistent with this chapter.

XXII. The enumeration in this section of the powers and authority of the liquidator is not a limitation upon him, nor does it exclude his right to do such other acts not herein specifically enumerated or otherwise provided for as are necessary or expedient for the accomplishment of or in aid of the purpose of liquidation.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:26 Notice to Creditors and Others. 

I. 
Notice Required.

(a) 
General Requirements. The liquidator shall give notice of the liquidation order as soon as possible by first class mail and either by telegram or telephone to the insurance commissioner of each jurisdiction in which the insurer is licensed to do business, by first class mail within this state and by airmail outside this state to all insurance agents having a duty under RSA 402-C:27, and by first class mail within this state and by airmail outside this state at the last known address to all persons known or reasonably expected to have claims against the insurer, including all policyholders. He also shall publish notice in a newspaper of general statewide circulation or in Merrimack county, the last publication to be not less than 3 months before the earliest deadline specified in the notice under paragraph III.

(b) 
Special Requirements. Notice to agents shall inform them of their duties under RSA 402-C:27 and inform them what information they must communicate to insureds. Notice to policyholders shall include notice of impairment and termination of coverage under RSA 402-C:22. When it is applicable, notice to policyholders shall include 1) notice of withdrawal of the insurer from the defense of any case in which the insured is interested and 2) notice of the right to file a claim under RSA 402-C:40.

(c) 
Reports and Further Notice. Within 15 days of the date of entry of the order, the liquidator shall report to the court what notice has been given. The court may order such additional notice as it deems appropriate.

II. 
Notice Respecting Claims Filing. Notice to potential claimants under paragraph I shall require claimants to file with the liquidator their claims together with proper proofs thereof under RSA 402-C:38 on or before a date the liquidator specifies in the notice, which shall be no less than 6 months nor more than one year after entry of the order, except that the liquidator need not require persons claiming cash surrender values or other investment values in life insurance and annuities to file a claim. The liquidator may specify different dates for the filing of different kinds of claims.

III. 
Notice Conclusive. If notice is given in accordance with this section, the distribution of the assets of the insurer under this chapter shall be conclusive with respect to all claimants, whether or not they received notice.


Source. 1969, 272:1. 1975, 348:16, eff. Aug. 6, 1975.

    402-C:27 Duties of Agents. 

I. 
Written Notice. Every person who receives notice in the form prescribed in RSA 402-C:26 that an insurer which he represents as an independent agent is the subject of a liquidation order shall as soon as practicable give notice of the liquidation order. The notice shall be sent by first class mail to the last address contained in the agent's records to each policyholder or other person named in any policy issued through the agent by the company, if he has a record of the address of the policyholder or other person. A policy shall be deemed issued through an agent if the agent has a property interest in the expiration of the policy; or if the agent has had in his possession a copy of the declarations of the policy at any time during the life of the policy, except where the ownership of the expiration of the policy has been transferred to another. The written notice shall include the name and address of the insurer, the name and address of the agent, identification of the policy impaired and the nature of the impairment under RSA 402-C:22. Notice by a general agent satisfies the notice requirement for any agents under contract to him.

II. 
Sanctions. Any agent failing to give notice as required in paragraph I may be fined not more than $100 and may have his license suspended.

III. 
Oral Notice. So far as practicable, every insurance agent subject to paragraph I shall give immediate oral notice by telephone or otherwise, of the liquidation order to the same persons to whom he is obligated to give written notice. The oral notice shall include substantially the same information as the written notice.

IV. 
Unearned Premium Claims. It shall be the duty of each agent, subject to the provisions of this section, to prepare and file on forms prescribed by the liquidator or the association the claims for unearned premiums on behalf of the policyholders of the insolvent insurer for policies issued through said agent. Agents who fail to file valid claims of policyholders as required by this section shall be personally liable to the respective policyholders to whom the unearned premiums are due and owing by the insolvent insurer, but in no event shall the agent be liable to any individual policyholder for an amount more than said policyholder's unearned premium including unearned commission less the $50 deductible provision established under RSA 404-B:5, IV. Upon receipt of the unearned premium claims from the liquidator or the association, the agent shall promptly pay to each policyholder his just and proportionate share of said refund and in addition shall return to each policyholder the unearned commission due on each cancelled policy.


Source. 1969, 272:1. 1975, 348:11, eff. Aug. 6, 1975.

    402-C:28 Actions by and Against Liquidator. 

I. 
Termination of Actions Against Insurer by Order Appointing Liquidator. Upon issuance of any order appointing the commissioner liquidator of a domestic insurer or of an alien insurer domiciled in this state, all actions and all proceedings against the insurer whether in this state or elsewhere shall be abated and the liquidator shall not intervene in them, except as provided in this section. Whenever in the liquidator's judgment an action in this state has proceeded to a point where fairness or convenience would be served by its continuation to judgment, he may apply to the court for leave to defend or to be substituted for the insurer, and if the court gives him leave, the action shall not be abated. Whenever in the liquidator's judgment, protection of the estate of the insurer necessitates intervention in an action against the insurer that is pending outside this state, with approval of the court he may intervene in the action. The liquidator may defend any action in which he intervenes under this section at the expense of the estate of the insurer.

II. 
Statute of Limitations on Claims by Insurer. The liquidator may, within 2 years subsequent to the entry of an order for liquidation or within such further time as applicable law permits, institute an action or proceeding on behalf of the estate of the insurer upon any cause of action against which the period of limitation fixed by applicable law has not expired at the time of the filing of the petition upon which such order is entered. Where, by any agreement, a period of limitation is fixed for instituting a suit or proceeding upon any claim or for filing any claim, proof of claim, proof of loss, demand, notice or the like, or where in any proceeding, judicial or otherwise, a period of limitation is fixed, either in the proceeding or by applicable law, for taking any action, filing any claim or pleading or doing any act, and where in any such case the period had not expired at the date of the filing of the petition, the liquidator may, for the benefit of the estate, take any such action or do any such act, required of or permitted to the insurer, within a period of 60 days subsequent to the entry of an order for liquidation, or within such further period as is permitted by the agreement, or in the proceeding or by applicable law, or within such further period as is shown to the satisfaction of the court not to be unfairly prejudicial to the other party.

III. 
Statutes of Limitations on Claims Against Insurer. The time between the filing of a petition for liquidation against an insurer and the denial of the petition shall not be considered to be a part of the time within which any action may be commenced against the insurer. Any action against the insurer that might have been commenced when the petition was filed may be commenced for at least 60 days after the petition is denied.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:29 Collection and List of Assets. 

I. 
List of Assets Required. As soon as practicable after the liquidation order, the liquidator shall prepare in duplicate a list of the insurer's assets. The list shall be amended or supplemented as the court requires. One copy shall be filed in the office of the clerk of the court having jurisdiction over the liquidation proceedings and one copy shall be retained for the liquidator's files. All amendments and supplements shall be similarly filed.

II. 
Liquidation of Assets. The liquidator shall reduce the assets to a degree of liquidity that is consistent with the effective execution of the liquidation as rapidly and economically as he can.

III. 
Access to Assets.

(a) Within 120 days of a final determination of insolvency of a company by a court of competent jurisdiction of this state, the receiver shall make application to the court for approval of a proposal to disburse assets out of such company's marshalled assets, from time to time as such assets become available, to the New Hampshire Insurance Guaranty Association, the New Hampshire Life and Health Guaranty Association and to any similar organization in another state. The New Hampshire Insurance Guaranty Association, the New Hampshire Life and Health Guaranty Association and any similar organizations in other states shall hereafter be referred to collectively as the associations.

(b) Such proposals shall at least include provision for:

(1) Reserving amounts for the payment of the expenses of administration and the claims falling within priorities established in RSA 402-C:44, I-V;

(2) Disbursement of the assets marshalled to date and subsequent disbursements of assets as they become available;

(3) Equitable allocation of disbursements to each of the associations entitled thereto; and

(4) The securing by the receiver from each of the associations entitled to disbursements pursuant to this section of an agreement to return to the receiver such assets previously disbursed as may be required to pay claims as secured creditors and claims falling within the priorities established in RSA 402-C:44, I-VI in accordance with such priorities. No bonds shall be required of any such association.

(c) The receiver's proposal shall provide for disbursements to the associations in amounts at least equal to the payments made or to be made thereby for which such association could assert claims against the receiver and shall further provide that if the assets available for disbursement from time to time do not equal or exceed the amounts of such payments made or to be made by the associations then disbursements shall be in the amount of available assets.

(d) The receiver's proposal shall, with respect to an insolvent insurer writing life, health insurance or annuities, provide for disbursements of assets to the New Hampshire Life and Health Guaranty Association or to any other entity or organization reinsuring, assuming or guaranteeing policies or contracts of insurance under the provisions of RSA 404-D.

(e) Notice of such application shall be given to the associations in and to the commissioners of insurance of each of the states. Any such notice shall be deemed to have been given when deposited in the United States certified mails, first class postage prepaid, at least 30 days prior to submission of such application to the court. Action on the application may be taken by the court provided the above required notice has been given and provided further that the receiver's proposal complies with subparagraphs (b)(1) and (b)(4).


Source. 1969, 272:1. 1977, 566:1. 1998, 99:2, 3, eff. July 19, 1998.

    402-C:3 Definitions. 

For the purposes of this chapter:

I. "Commissioner" means the commissioner of insurance or equivalent insurance supervisory official.

II. "Receiver" means receiver, liquidator, rehabilitator or conservator, as the context requires.

III. "Insurer" means any person who is doing, has done, purports to do or is licensed to do an insurance business and is or has been subject to the authority of, or to liquidation, rehabilitation, reorganization or conservation by, a commissioner. For purposes of this chapter, all other persons included under this section shall be deemed to be insurers.

IV. "Delinquency proceeding" means any proceeding commenced against an insurer for the purpose of liquidating, rehabilitating, reorganizing or conserving such insurer, and any summary proceeding under RSA 402-C:11-14.

V. "State" means any state of the United States and the Panama Canal Zone.

VI. "Foreign country" means territory not in any state.

VII. "Domiciliary state" means the state in which an insurer is incorporated or organized or, in the case of an alien insurer, the state in which the insurer has, at the commencement of delinquency proceedings, the largest amount of its assets held in trust and on deposit for the benefit of policyholders and creditors in the United States.

VIII. "Ancillary state" means any state other than a domiciliary state.

IX. "Reciprocal state" means any state other than this state in which in substance and effect RSA 402-C:21, I, RSA 402-C:54, I and II and RSA 402-C:55, 57, and 60 are in force, and in which provisions are in force requiring that the commissioner be the receiver of a delinquent insurer, and in which some provision exists for the avoidance of fraudulent conveyances and preferential transfers.

X. "General assets" means all property, real, personal or otherwise, not specifically mortgaged, pledged, deposited or otherwise encumbered for the security or benefit of specified persons or limited classes of persons, and as to specifically encumbered property the term includes all such property or its proceeds in excess of the amount necessary to discharge the sums secured thereby. Assets held in trust and on deposit for the security or benefit of all policyholders or all policyholders and creditors, in more than a single state, shall be treated as general assets.

XI. "Preferred claim" means any claim with respect to which the law accords priority of payment from the general assets of the insurer.

XII. "Special deposit claim" means any claim secured by a deposit made pursuant to law for the security or benefit of one or more limited classes of persons, but not including any claim secured by general assets.

XIII. "Secured claim" means any claim secured by mortgage, trust deed, pledge, deposit as security, escrow or otherwise, but not including special deposit claims or claims against general assets. The term also includes claims which have become liens upon specific assets by reason of judicial process, except where they have been invalidated.

XIV. "Insolvency" means:

(a) For an insurer organized as a town or county mutual, the inability to pay any loss within 30 days after the due date specified in the first assessment notice issued after the date of the loss, or any other uncontested debt as it becomes due.

(b) For any other insurer, that it is unable to pay its debts or meet its obligations as they mature or that its assets do not exceed its liabilities plus the greater of 1.) any capital and surplus required by law to be constantly maintained, or 2.) its authorized and issued capital stock. For purposes of this subparagraph, "assets" includes 
1/2 of the maximum total assessment liability of the policyholders of the insurer, and "liabilities" includes reserves required by law. For policies issued on the basis of unlimited assessment liability, the maximum total liability, for purposes of determining solvency only, shall be deemed to be that amount that could be obtained if there were 100 percent collection of an assessment at the rate of 10 mills.

XV. "Fair consideration" is given for property or an obligation:

(a) When in exchange for such property or obligation, as a fair equivalent therefor, and in good faith, property is conveyed or services are rendered or obligation is incurred or an antecedent debt is satisfied; or

(b) When such property or obligation is received in good faith to secure a present advance or antecedent debt in amount not disproportionately small as compared to the value of the property or obligation obtained.

XVI. "Creditor" is a person having any claim, whether matured or unmatured, liquidated or unliquidated, secured or unsecured, absolute, fixed or contingent.

XVII. "Transfer" includes the sale and every other method, direct or indirect, of disposing of or of parting with property or with an interest therein or with the possession thereof or of fixing a lien upon property or upon an interest therein, absolutely or conditionally, voluntarily or involuntarily, by or without judicial proceedings. The retention of a security title to property delivered to a debtor shall be deemed a transfer suffered by the debtor.

XVIII. "Doing business" has the meaning designated in RSA 406-B:2.

XIX. "Association" means either the New Hampshire insurance guaranty association created under RSA 404-B:6 or the New Hampshire life and health insurance guaranty association created under RSA 404-D:6.


Source. 1969, 272:1. 1975, 348:10, eff. Aug. 6, 1975.

    402-C:30 Fraudulent Transfers Prior to Petition. 

I. 
Definition and Effect. Every transfer made or suffered and every obligation incurred by an insurer within one year prior to the filing of a successful petition for rehabilitation or liquidation under this chapter is fraudulent as to then existing and future creditors if made or incurred without fair consideration, or with actual intent to hinder, delay or defraud either existing or future creditors. A transfer made or an obligation incurred by an insurer ordered to be rehabilitated or liquidated under this chapter, which is fraudulent under this section, may be avoided by the receiver, except as to a person who in good faith is a purchaser, lienor or obligee for a present fair equivalent value; and except that any purchaser, lienor or obligee, who in good faith has given a consideration less than fair for such transfer, lien or obligation, may retain the property, lien or obligation as security for repayment. The court may, on due notice, order any such transfer or obligation to be preserved for the benefit of the estate, and in that event the receiver shall succeed to and may enforce the rights of the purchaser, lienor or obligee.

II. 
Perfection of Transfers.

(a) 
Personal Property. A transfer of property other than real property shall be deemed to be made or suffered when it becomes so far perfected that no subsequent lien obtainable by legal or equitable proceedings on a simple contract could become superior to the rights of the transferee under RSA 402-C:32, III.

(b) 
Real Property. A transfer of real property shall be deemed to be made or suffered when it becomes so far perfected that no subsequent bona fide purchaser from the insurer could obtain rights superior to the rights of the transferee.

(c) 
Equitable Liens. A transfer which creates an equitable lien shall not be deemed to be perfected if there are available means by which a legal lien could be created.

(d) 
Transfer Not Perfected Prior to Petition. Any transfer not perfected prior to the filing of a petition for liquidation shall be deemed to be made immediately before the filing of the successful petition.

(e) 
Actual Creditors Unnecessary. This paragraph applies whether or not there are or were creditors who might have obtained any liens or persons who might have become bona fide purchasers.

III. 
Fraudulent Reinsurance Transactions. Any transaction of the insurer with a reinsurer shall be deemed fraudulent and may be avoided by the receiver under paragraph I if:

(a) The transaction consists of the termination, adjustment or settlement of a reinsurance contract in which the reinsurer is released from any part of its duty to pay the originally specified share of losses that had occurred prior to the time of the transaction, unless the reinsurer gives a present fair equivalent value for the release; and

(b) Any part of the transaction took place within one year prior to the date of filing of the petition through which the receivership was commenced.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:31 Fraudulent Transfers After Petition. 

I. 
Effect of Petition: Real Property. After a petition for rehabilitation or liquidation, a transfer of any of the real property of the insurer made to a person acting in good faith shall be valid against the receiver if made for a present fair equivalent value or, if not made for a present fair equivalent value, then to the extent of the present consideration actually paid therefor, for which amount the transferee shall have a lien on the property so transferred. The recording of a copy of the petition for or order of rehabilitation or liquidation with the register of deeds in the county where any real property in question is located is constructive notice of the commencement of a proceeding in rehabilitation or liquidation. The exercise by a court of the United States or any state of jurisdiction to authorize or effect a judicial sale of real property of the insurer within any county in any state shall not be impaired by the pendency of such a proceeding unless the copy is recorded in the county prior to the consummation of the judicial sale.

II. 
Effect of Petition: Personal Property. After a petition for rehabilitation or liquidation and before either the receiver takes possession of the property of the insurer or an order of rehabilitation or liquidation is granted:

(a) A transfer of any of the property of the insurer, other than real property, made to a person acting in good faith shall be valid against the receiver if made for a present fair equivalent value or, if not made for a present fair equivalent value, then to the extent of the present consideration actually paid therefor, for which amount the transferee shall have a lien on the property so transferred.

(b) A person indebted to the insurer or holding property of the insurer may, if acting in good faith, pay the indebtedness or deliver the property or any part thereof to the insurer or upon his order, with the same effect as if the petition were not pending.

(c) A person having actual knowledge of the pending rehabilitation or liquidation shall be deemed not to act in good faith unless he has reasonable cause to believe that the petition is not well founded.

(d) A person asserting the validity of a transfer under this section shall have the burden of proof. Except as elsewhere provided in this section, no transfer by or in behalf of the insurer after the date of the petition for liquidation by any person other than the liquidator shall be valid against the liquidator.

III. 
Negotiability. Nothing in this chapter shall impair the negotiability of currency or negotiable instruments.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:32 Voidable Preferences and Liens. 

I. 
Preferences.

(a) 
Preference Defined. A preference is a transfer of any of the property of an insurer to or for the benefit of a creditor, for or on account of an antecedent debt, made or suffered by the insurer within one year before the filing of a successful petition for liquidation under this chapter the effect of which transfer may be to enable the creditor to obtain a greater percentage of his debt than another creditor of the same class would receive. If a liquidation order is entered while the insurer is already subject to a rehabilitation order, transfers otherwise qualifying shall be deemed preferences if made or suffered within one year before the filing of the successful petition for rehabilitation or within 2 years before the filing of the successful petition for liquidation, whichever time is shorter.

(b) 
Invalidation of Preferences. Any preference may be avoided by the liquidator, if 1) the insurer was insolvent at the time of the transfer, or 2) the transfer was made within 4 months before the filing of the petition, or 3) the creditor receiving it or to be benefited thereby or his agent acting with reference thereto had reasonable cause to believe at the time when the transfer was made that the insurer was insolvent or was about to become insolvent, or 4) the creditor receiving it was an officer, employee, attorney or other person who was in fact in a position of comparable influence in the insurer to an officer whether or not he held such position, or any shareholder holding directly or indirectly more than 5 percent of any class of any equity security issued by the insurer, or any other person with whom the insurer did not deal at arm's length. Where the preference is voidable, the liquidator may recover the property or if it has been converted, its value from any person who has received or converted the property, except a bona fide purchaser from or lienor of the debtor's transferee for a present fair equivalent value. Where the bona fide purchaser or lienor has given less than fair equivalent value, he shall have a lien upon the property to the extent of the consideration actually given by him. Where a preference by way of lien or security title is voidable, the court may on due notice order the lien or title to be preserved for the benefit of the estate, in which event the lien or title shall pass to the liquidator.

II. 
Perfection of Transfers.

(a) 
Personal Property. A transfer of property other than real property is deemed to be made or suffered when it becomes so far perfected that no subsequent lien obtainable by legal or equitable proceedings on a simple contract could become superior to the rights of the transferee.

(b) 
Real Property. A transfer of real property is deemed to be made or suffered when it becomes so far perfected that no subsequent bona fide purchaser from the insurer could obtain rights superior to the rights of the transferee.

(c) 
Equitable Liens. A transfer which creates an equitable lien is not deemed to be perfected if there are available means by which a legal lien could be created.

(d) 
Transfers Not Perfected Prior to Petition. A transfer not perfected prior to the filing of a petition for liquidation shall be deemed to be made immediately before the filing of the successful petition.

(e) 
Actual Creditors Unnecessary. This paragraph applies whether or not there are or were creditors who might have obtained liens or persons who might have become bona fide purchasers.

III. 
Liens by Legal or Equitable Proceedings.

(a) 
Definition. A lien obtainable by legal or equitable proceedings upon a simple contract is one arising in the ordinary course of such proceedings upon the entry or docketing of a judgment or decree, or upon attachment, garnishment, execution or like process, whether before, upon or after judgment or decree and whether before or upon levy. It does not include liens which under applicable law are given a special priority over other liens which are prior in time.

(b) 
When Liens are Superior. A lien obtainable by legal or equitable proceedings could become superior to the rights of a transferee, or a purchaser could obtain rights superior to the rights of a transferee within the meaning of paragraph II, if such consequences would follow only from the lien or purchase itself, or from the lien or purchase followed by any step wholly within the control of the respective lienholder or purchaser, with or without the aid of ministerial action by public officials. Such a lien could not, however, become superior and such a purchase could not create superior rights for the purpose of paragraph II through any acts subsequent to the obtaining of such a lien or subsequent to such a purchase which require the agreement or concurrence of any third party or which require any further judicial action, or ruling.

IV. 
Twenty-one Day Rule. A transfer of property for or on account of a new and contemporaneous consideration which is deemed under paragraph II to be made or suffered after the transfer because of delay in perfecting it does not thereby become a transfer for or on account of an antecedent debt if any acts required by the applicable law to be performed in order to perfect the transfer as against liens or bona fide purchasers' rights are performed within 21 days or any period expressly allowed by the law, whichever is less. A transfer to secure a future loan, if such a loan is actually made, or a transfer which becomes security for a future loan shall have the same effect as a transfer for or on account of a new and contemporaneous consideration.

V. 
Indemnifying Transfers Also Voidable. If any lien deemed voidable under subparagraph (b) of paragraph I has been dissolved by the furnishing of a bond or other obligation, the surety on which has been indemnified directly or indirectly by the transfer of or the creation of a lien upon any property of an insurer before the filing of a petition under this chapter which results in a liquidation order, the indemnifying transfer or lien shall also be deemed voidable.

VI. 
Avoidance of Lien. The property affected by any lien deemed voidable under subparagraph (b) of paragraph I and paragraph V is discharged from the lien, and that property and any of the indemnifying property transferred to or for the benefit of a surety shall pass to the liquidator, except that the court may on due notice order the lien to be preserved by the benefit of the estate and the court may direct that a conveyance be executed which is adequate to evidence the title of the liquidator.

VII. 
Hearings to Determine Rights. The court shall have summary jurisdiction of any proceeding by the liquidator to hear and determine the rights of any parties under this section. Reasonable notice of any hearing in the proceeding shall be given to all parties in interest, including the obligee of a releasing bond or other like obligation. Where an order is entered for the recovery of indemnifying property in kind or for the avoidance of an indemnifying lien, the court, upon application of any party in interest, shall in the same proceeding ascertain the value of the property or lien, and if the value is less than the amount for which the property is indemnity or than the amount of the lien, the transferee or lienholder may elect to retain the property or lien upon payment of its value, as ascertained by the court, to the liquidator within such reasonable times as the court fixes.

VIII. 
Surety's Liability Discharged. The liability of a surety under a releasing bond or other like obligation shall be discharged to the extent of the value of the indemnifying property recovered or the indemnifying lien nullified and avoided or, where the property is retained under paragraph VII to the extent of the amount paid to the liquidator.

IX. 
Setoff of New Advances. If a creditor has been preferred and afterward in good faith gives the insurer further credit without security of any kind, for property which becomes a part of the insurer's estate, the amount of the new credit remaining unpaid at the time of the petition may be set off against the preference which would otherwise be recoverable from him.

X. 
Re-examination of Attorney's Fees. If an insurer, directly or indirectly, within 4 months before the filing of a successful petition for liquidation under this chapter or at any time in contemplation of a proceeding to liquidate it, pays money or transfers property to an attorney at law for services rendered or to be rendered, the transaction may be examined by the court on its own motion or shall be examined by the court on petition of the liquidator and shall be held valid only to the extent of a reasonable amount to be determined by the court, and the excess may be recovered by the liquidator for the benefit of the estate.

XI. 
Personal Liability.

(a) Every officer, manager, employee, shareholder, member, subscriber, attorney or any other person acting on behalf of the insurer who knowingly participates in giving any preference when he has reasonable cause to believe the insurer to be or about to become insolvent at the time of the preference shall be personally liable to the liquidator for the amount of the preference. It is permissible to infer that there is reasonable cause to so believe if the transfer was made within 4 months before the date of the filing of the successful petition for liquidation.

(b) Every person receiving any property from the insurer of the benefit thereof as a preference voidable under subparagraph (b) of paragraph I shall be personally liable therefor and shall be bound to account to the liquidator.

(c) Nothing in this paragraph shall prejudice any other claim by the liquidator against any person.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:33 Claims of Holders of Void or Voidable Rights. 

I. 
Disallowance for Failure to Surrender Property. No claims of a creditor who has received or acquired a preference, lien, conveyance, transfer, assignment or encumbrance, voidable under this chapter, shall be allowed unless he surrenders the preference, lien, conveyance, transfer, assignment or encumbrance. If the avoidance is effected by a proceeding in which a final judgment has been entered, the claim shall not be allowed unless the money is paid or the property is delivered to the liquidator within 30 days from the date of the entering of the final judgment, except that the court having jurisdiction over the liquidation may allow further time if there is an appeal or other continuation of the proceeding.

II. 
Time for Filing. A claim allowable under paragraph I by reason of the avoidance, whether voluntary or involuntary, of a preference lien, conveyance, transfer, assignment or encumbrance may be filed as an excused late filing under RSA 402-C:37 if filed within 30 days from the date of the avoidance or within the further time allowed by the court under paragraph I.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:34 Setoffs. 

I. 
Setoffs Allowed in General. Mutual debts or mutual credits between the insurer and another person in connection with any action or proceeding under this chapter shall be set off and the balance only shall be allowed or paid, except as provided in paragraph II.

II. 
Exceptions. No setoff shall be allowed in favor of any person where:

(a) The obligation of the insurer to the person would not at the date of the filing of a petition for liquidation entitle him to share as a claimant in the assets of the insurer;

(b) The obligation of the insurer to the person was purchased by or transferred to the person with a view to its being used as a setoff;

(c) The obligation of the person is to pay an assessment levied against the members or subscribers of the insurer, or is to pay a balance upon a subscription to the capital stock of the insurer, or is in any other way in the nature of a capital contribution; or

(d) [Repealed.]


Source. 1969, 272:1. 2003, 218:1, 2, 4, eff. Aug. 30, 2003.

    402-C:35 Assessments. 

I. 
Report to Court. As soon as practicable but not more than 2 years from the date of an order of liquidation under RSA 402-C:21 of an insurer issuing assessable policies, the liquidator shall make a report to the court setting forth:

(a) The reasonable value of the assets of the insurer;

(b) The insurer's probable total liabilities;

(c) The probable aggregate amount of the assessment necessary to pay all claims of creditors and expenses in full, including expenses of administration and costs of collecting the assessment; and

(d) A recommendation as to whether an assessment should be made and in what amount.

II. 
Levy of Assessment.

(a) Upon the basis of the report provided in paragraph I, including any supplements and amendments thereto, the court may approve, solely on application by the liquidator, one or more assessments against all members of the insurer who are subject to assessment. The order approving the assessment shall provide instructions regarding notice of the assessment, deadlines for payment, and other instructions to the liquidator regarding collection of the assessment.

(b) Subject to any applicable legal limits on assessability, the aggregate assessment shall be for the amount that the sum of the probable liabilities, the expenses of administration and the estimated cost of collection of the assessment exceeds the value of existing assets, with due regard being given to assessments that cannot be collected economically.

III. 
Order to Show Cause. After levy of assessment under paragraph II, the liquidator shall petition the court for an order directing each member who has not paid the assessment pursuant to the order to show cause why the liquidator shall not have a judgment therefor. If a member of the insurer also appears to be indebted to the insurer apart from the assessment, the court, upon application of the liquidator, may also direct the member to show cause why he should not pay the other indebtedness. Liability for such indebtedness shall be determined in the same manner and at the same time as the liability to pay the assessment.

IV. 
Notice. The liquidator shall give notice of the order to show cause by publication if so directed by the court and by first class mail to each member liable thereunder mailed at least 20 days before the date specified by the court in the order to show cause to his or her last known address as it appears on the records of the insurer. Failure of the member or subscriber to receive the notice of the assessment or of the order, within the time specified therein or at all, shall be no defense in any proceeding to collect the assessment.

V. 
Orders and Hearings.

(a) If a member does not appear and serve duly verified objections upon the liquidator upon the date specified by the court in the order to show cause under paragraph III, the court shall make an order adjudging the member liable for the amount of the assessment against him or her and other indebtedness, pursuant to paragraph III, together with costs, and the liquidator shall have a judgment against the member therefor.

(b) If on the date specified by the court in the order to show cause, the member appears and serves duly verified objections upon the liquidator, the court may hear and determine the matter or may appoint a referee to hear it and make such order as the facts warrant. Any order made by a referee under this paragraph shall have the same force and effect as if it were a judgment of the court, subject to review by the court upon application within 30 days.

VI. 
Collection. The liquidator may enforce any order or collect any judgment under paragraph V by any lawful means.

VII. 
Assessment.

(a) Any assessment of a subscriber or member of an insurer made by the liquidator pursuant to the order of the court fixing the aggregate amount of the assessment against all members or subscribers and approving the classification and formula made by the liquidator under this section shall be prima facie correct.

(b) Any claim filed by an assessee who fails to pay an assessment, after the conclusion of any legal action by the assessee objecting to the assessment, shall be deemed a late filed claim under RSA 402-C:37.


Source. 1969, 272:1. 2010, 212:6-9. 2014, 204:27, eff. July 11, 2014.

    402-C:36 Liability of Insurer. 

The amount recoverable by the liquidator from a reinsurer shall not be reduced as a result of delinquency proceedings regardless of whether the reinsurance contract provides, in substance, that in the event of the insolvency of the ceding insurer, the reinsurance shall be payable by the assuming insurer on the basis of the claims allowed against the ceding insurer in the insolvency proceedings, under contract or contracts reinsured without diminution because of the insolvency of the ceding insurer. Such payments shall be made directly to the ceding insurer or to its domiciliary liquidator or receiver except:

I. Where the contract specifically provides another payee of such reinsurance in the event of the insolvency of the ceding insurer; or

II. Where the assuming insurer with the consent of the direct insured or insured has assumed such policy obligations of the ceding insurer as direct obligations of the assuming insurer to the payees under such policies and in substitution for the obligations of the ceding insurer to such payees.


Source. 1969, 272:1. 2003, 218:3. 2005, 248:4, eff. Sept. 12, 2005.

    402-C:37 Filing of Claims. 

I. 
Deadline for Filing. Proof of all claims must be filed with the liquidator in the form required by RSA 402-C:38 on or before the last day for filing specified in the notice required under RSA 402-C:26, except that proof of preferred ownership claims and proprietary claims under RSA 402-C:44 need not be filed at all, and proof of claims for cash surrender values or other investment values in life insurance and annuities need not be filed unless the liquidator expressly so requires.

II. 
Excused Late Filings. For a good cause shown, the liquidator shall recommend and the court shall permit a claimant making a late filing to share in dividends, whether past or future, as if he were not late, to the extent that any such payment will not prejudice the orderly administration of the liquidation. Good cause includes but is not limited to the following:

(a) That existence of a claim was not known to the claimant and that he filed within 30 days after he learned of it;

(b) That a claim for cash surrender values or other investment values in life insurance or annuities which was not required to be filed was omitted from the liquidator's recommendations to the court under RSA 402-C:45, and that it was filed within 30 days after the claimant learned of the omission;

(c) That a transfer to creditor was avoided under RSA 402-C:30-32 or was voluntarily surrendered under RSA 402-C:33, and that the filing satisfies the conditions of RSA 402-C:33;

(d) That valuation under RSA 402-C:43 of security held by a secured creditor shows a deficiency, which is filed within 30 days after the valuation; and

(e) That a claim was contingent and became absolute, and was filed within 30 days after it became absolute.

III. 
Unexcused Late Filings. The liquidator may consider any claim filed late which is not covered by paragraph II, and permit it to receive dividends, other than the first dividend, which are subsequently declared on any claims of the same or lower priority if the payment does not prejudice the orderly administration of the liquidation. The late-filing claimant shall receive, at each distribution, the same percentage of the amount allowed on his claim as is then being paid to other claimants of the same priority plus the same percentage of the amount allowed on his claim as is then being paid to claimants of any lower priority. This shall continue until his claim has been paid in full.


Source. 1969, 272:1. 1975, 348:12, 13, eff. Aug. 6, 1975.

    402-C:38 Proof of Claim. 

I. 
Contents of Proof of Claim.

(a) Proof of claim shall consist of a verified statement that includes all of the following that are applicable:

1. The particulars of the claim, including the consideration given for it.

2. The identity and amount of the security on the claim.

3. The payments made on the debt, if any.

4. That the sum claimed is justly owing and that there is no setoff, counterclaim or defense to the claim.

5. Any right of priority of payment or other specific right asserted by the claimant.

6. A copy of any written instrument which is the foundation of the claim.

7. In the case of any third party claim based on a liability policy issued by the insurer, a conditional release of the insured pursuant to RSA 402-C:40, I.

8. The name and address of the claimant and the attorney who represents him, if any.

(b) No claim need be considered or allowed if it does not contain all the information under subparagraph (a) which may be applicable. The liquidator may require that a prescribed form be used and may require that other information and documents be included.

II. 
Supplementary Information. At any time the liquidator may request the claimant to present information or evidence supplementary to that required under paragraph I, and may take testimony under oath, require production of affidavits or depositions or otherwise obtain additional information or evidence.

III. 
Conclusiveness of Judgments. No judgment or order against an insured or the insurer entered after the filing of a successful petition for liquidation and no judgment or order against an insured or the insurer entered at any time by default or by collusion need be considered as evidence of liability or of quantum of damages. No judgment or order against an insured or the insurer entered within 4 months before the filing of the petition need be considered as evidence of liability or of the quantum of damages.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:39 Special Claims. 

I. 
Claims Contingent on Judgments. The claim of a third party which is contingent only on his first obtaining a judgment against the insured shall be considered and allowed as if there were no such contingency.

II. 
Claims Under Terminated Policies. Any claim that would have become absolute if there had been no termination of coverage under RSA 402-C:22, and which was not covered by insurance acquired to replace the terminated coverage, shall be allowed as if the coverage had remained in effect, unless at least 10 days before the insured event occurred either the claimant had actual notice of the termination or notice was mailed to the claimant as prescribed by RSA 402-C:26 or RSA 402-C:27, I. If allowed the claim shall share in distributions under RSA 402-C:44, II.

III. 
Other Contingent Claims. A claim may be allowed even if contingent, if it is filed in accordance with RSA 402-C:37, II. It may be allowed and may participate in all dividends declared after it is filed, to the extent that it does not prejudice the orderly administration of the liquidation.

IV. 
Immature Claims. Claims that are due except for the passage of time shall be treated as absolute claims are treated, except that where justice requires the court may order them discounted at the legal rate of interest.


Source. 1969, 272:1. 1998, 99:4, eff. July 19, 1998.

    402-C:4 Jurisdiction and Venue. 

I. 
Actions by Commissioner. Except as provided in paragraph II of this section and RSA 402-C:24, I, no delinquency proceeding shall be commenced under this chapter by anyone other than the commissioner of this state and no court shall have jurisdiction to entertain, hear or determine any proceeding commenced by any other person.

II. 
Actions by Judgment Creditors.

(a) The judgment creditors of 3 or more unrelated judgments may commence proceedings under the conditions and in the manner prescribed in this section, by serving notice upon the commissioner and the insurer of intention to file a petition for liquidation under RSA 402-C:20 or 53. Each of the judgments must:

(1) Have been rendered against the insurer by a court in this state having jurisdiction over the subject matter and the insurer;

(2) Have been entered more than 60 days before the service of notice;

(3) Not have been paid in full;

(4) Not be the subject of a valid contract between the insurer and any judgment creditor for payment of the judgment, unless the contract has been breached by the insurer; and

(5) Not be a judgment on which an appeal or review is pending.

(b) If any one of the judgments in favor of a petitioning creditor remains unpaid for 30 days after service of the notice, and the commissioner has not then filed a petition for liquidation, the creditor may file in the name of the commissioner a verified petition for liquidation of the insurer under RSA 402-C:20 or 53 alleging the conditions stated in this paragraph. The commissioner shall be served and joined in the action.

III. 
Exclusiveness of Proceedings. No court of this state shall have jurisdiction to entertain, hear or determine any complaint praying for the dissolution, liquidation, rehabilitation, sequestration, conservation or receivership of any insurer, or praying for an injunction or restraining order or other relief preliminary to, incidental to or relating to such proceedings other than in accordance with this chapter.

IV. 
Change of Venue. Venue for proceedings arising under this chapter shall be laid initially as specified in the sections providing for such proceedings. All other actions and proceedings initiated by the receiver may be commenced and tried where the delinquency proceedings are then pending or Merrimack county superior court. All other actions and proceedings against the receiver shall be commenced and tried in the county where the delinquency proceedings are pending. At any time upon motion of any party, venue may be changed by order of the court or the presiding judge thereof to any other superior court in this state, as the convenience of the parties and witnesses and the ends of justice may require. This paragraph relates only to venue and is not jurisdictional.

V. 
Personal Jurisdiction, Grounds for. In addition to other grounds for jurisdiction provided by the laws of this state, a court of this state having jurisdiction of the subject matter has jurisdiction over a person served in an action brought by the receiver of a domestic insurer or an alien insurer domiciled in this state:

(a) If the person served is an agent, broker, or other person who has at any time written policies of insurance for or has acted in any manner whatsoever on behalf of an insurer against which a delinquency proceeding has been instituted, in any action resulting from or incident to such a relationship with the insurer.

(b) If the person served is a reinsurer who has at any time entered into a contract of reinsurance with an insurer against which a delinquency proceeding has been instituted, or is an agent or broker of or for the reinsurer, in any action on or incident to the reinsurance contract.

(c) If the person served is or has been an officer, director, manager, trustee, organizer, promoter, or other person in a position of comparable authority or influence over an insurer against which a delinquency proceeding has been instituted, in any action resulting from or incident to such a relationship with the insurer.

(d) If the person served is or was at the time of the institution of the delinquency proceeding against the insurer holding assets in which the receiver claims an interest on behalf of the insurer, in any action concerning the assets.

(e) If the person served is obligated to the insurer in any way whatsoever, in any action on or incident to the obligation.

VI. 
Forum Non Conveniens. If the court on motion of any party finds that any action commenced under paragraph V should as a matter of substantial justice be tried in a forum outside this state, the court may enter an order to stay further proceedings on the action in this state.


Source. 1969, 272:1. 1991, 96:1, eff. Jan. 1, 1992.

    402-C:40 Special Provisions for Third Party Claims. 

I. 
Third Party's Claim. Whenever any third party asserts a cause of action against an insured of an insurer in liquidation, the third party may file a claim with the liquidator. The filing of the claim shall release the insured's liability to the third party on that cause of action in the amount of the applicable policy limit, but the liquidator shall also insert in any form used for the filing of third party claims appropriate language to constitute such a release. The release shall be void if the insurance coverage is avoided by the liquidator.

II. 
Insured's Claim. Whether or not the third party files a claim, the insured may file a claim on his own behalf in the liquidation. If the insured fails to file a claim by the date for filing claims specified in the order of liquidation or within 60 days after mailing of the notice required by subparagraph (b) of RSA 402-C:26, I, whichever is later, he is an unexcused late filer.

III. 
Procedure for Insured's Claim. The liquidator shall make his recommendations to the court under RSA 402-C:45 for the allowance of an insured's claim under paragraph II after consideration of the probable outcome of any pending action against the insured on which the claim is based, the probable damages recoverable in the action and the probable costs and expenses of defense. After allowance by the court, the liquidator shall withhold any dividends payable on the claim, pending the outcome of litigation and negotiation with the insured. Whenever it seems appropriate, he shall reconsider the claim on the basis of additional information and amend his recommendations to the court. The insured shall be afforded the same notice and opportunity to be heard on all changes in the recommendation as in its initial determination. The court may amend its allowance as it thinks appropriate. As claims against the insured are settled or barred, the insured shall be paid from the amount withheld the same percentage dividend as was paid on other claims of like priority, based on the lesser of a) the amount actually recovered from the insured by action or paid by agreement plus the reasonable costs and expenses of defense, or b) the amount allowed on the claims by the court. After all claims are settled or barred any sum remaining from the amount withheld shall revert to the undistributed assets of the insurer. Delay in final payment under this section shall not be a reason for unreasonable delay of final distribution and discharge of the liquidator.

IV. 
Multiple Claims. If several claims founded upon one policy are filed, whether by third parties or as claims by the insured under this section, and the aggregate allowed amount of the claims to which the same limit of liability in the policy is applicable exceeds that limit, each claim as allowed shall be reduced in the same proportion so that the total equals the policy limit. Claims by the insured shall be evaluated as in paragraph III. If any insured's claim is subsequently reduced under paragraph III, the amount thus freed shall be apportioned ratably among the claims which have been reduced under this section.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:41 Disputed Claims. 

I. 
Notice of Rejection and Request for Hearing. When a claim is denied in whole or in part by the liquidator, written notice of the determination shall be given to the claimant and his attorney by first class mail at the address shown in the proof of claim. Within 60 days from the mailing of the notice, the claimant may file his objections with the court. If no such filing is made, the claimant may not further object to the determination.

II. 
Notice of Hearing. Whenever objections are filed with the court, the liquidator shall ask the court for a hearing as soon as practicable and give notice of the hearing by first class mail to the claimant or his attorney and to any other persons directly affected, not less than 10 nor more than 20 days before the date of the hearing. The matter may be heard by the court or by a court-appointed referee.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:42 Claims of Surety. 

Whenever a creditor whose claim against an insurer is secured in whole or in part by the undertaking of another person fails to prove and file that claim, the other person may do so in the creditor's name, and shall be subrogated to the rights of the creditor, whether the claim has been filed by the creditor or by the other person in the creditor's name, to the extent that he discharges the undertaking. In the absence of an agreement with the creditor to the contrary, the other person shall not be entitled to any dividend until the amount paid to the creditor on the undertaking plus the dividends paid on the claim from the insurer's estate to creditor equals the amount of the entire claim of the creditor. Any excess received by the creditor shall be held by him in trust for such other person.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:43 Secured Creditors' Claims. 

I. The value of any security held by a secured creditor shall be determined in one of the following ways, as the court directs:

(a) By converting the same into money according to the terms of the agreement pursuant to which the security was delivered to such creditor;

(b) By agreement, arbitration, compromise or litigation between the creditor and the liquidator.

II. The determination shall be under the supervision and control of the court. The amount so determined shall be credited upon the secured claim, and any deficiency shall be treated as an unsecured claim. If the claimant surrenders his security to the liquidator, the entire claim shall be allowed as if unsecured.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:44 Order of Distribution. 

The order of distribution of claims from the insurer's estate shall be as stated in this section. The first $50 of the amount allowed on each claim in the classes under paragraphs II, V, and VI except claims of the guaranty associations as defined in RSA 404-B, 404-H, 404-D, and 408-B shall be deducted from the claim. Claims may not be cumulated by assignment to avoid application of the $50 deductible provision. Subject to the $50 deductible provision, every claim in each class shall be paid in full or adequate funds retained for the payment before the members of the next class receive any payment. No subclasses shall be established within any class.

I. 
Administration Costs. The costs and expenses of administration, including but not limited to the following: the actual and necessary costs of preserving or recovering the assets of the insurer; compensation for all services rendered in the liquidation; any necessary filing fees; the fees and mileage payable to witnesses; and reasonable attorney's fees.

II. 
Policy Related Claims. All claims by policyholders, including claims for unearned premiums in excess of $50, beneficiaries, and insureds arising from and within the coverage of and not in excess of the applicable limits of insurance policies and insurance contracts issued by the company, and liability claims against insureds which claims are within the coverage of and not in excess of the applicable limits of insurance policies and insurance contracts issued by the company and claims of the New Hampshire Insurance Guaranty Association, the New Hampshire Life and Health Insurance Guaranty Association and any similar organization in another state. All claims under life insurance and annuity policies, whether for death proceeds, annuity proceeds or investment values, shall be treated as loss claims. That portion of any loss for which indemnification is provided by other benefits or advantages recovered or recoverable by the claimant shall not be included in this class, other than benefits or advantages recovered or recoverable in discharge of familial obligations of support or by way of succession at death or as proceeds of life insurance, or as gratuities. No payment made by an employer to an employee shall be treated as a gratuity.

III. 
Claims of the Federal Government.

IV. 
Wages.

(a) Debts due to employees for services performed, not to exceed $1,000 to each employee which have been earned within one year before the filing of the petition for liquidation. Officers shall not be entitled to the benefit of this priority.

(b) Such priority shall be in lieu of any other similar priority authorized by law as to wages or compensation of employees.

V. 
Residual Classification. All other claims including claims of any state or local government, not falling within other classes under this section. Claims, including those of any non-federal governmental body, for a penalty or forfeiture, shall be allowed in this class only to the extent of the pecuniary loss sustained from the act, transaction or proceeding out of which the penalty or forfeiture arose with reasonable and actual costs occasioned thereby. The remainder of such claims shall be postponed to the class of claims under paragraph VIII.

VI. 
Judgments. Claims based solely on judgments. If a claimant files a claim and bases it both on the judgment and on the underlying facts, the claim shall be considered by the liquidator who shall give the judgment such weight as he deems appropriate. The claim as allowed shall receive the priority it would receive in the absence of the judgment. If the judgment is larger than the allowance on the underlying claim, the remaining portion of the judgment shall be treated as if it were a claim based solely on a judgment.

VII. 
Interest on Claims Already Paid. Interest at the legal rate compounded annually on all claims in the classes under paragraphs I through VI from the date of the petition for liquidation or the date on which the claim becomes due, whichever is later, until the date on which the dividend is declared. The liquidator, with the approval of the court, may make reasonable classifications of claims for purposes of computing interest, may make approximate computations and may ignore certain classifications and time periods as de minimis.

VIII. 
Miscellaneous Subordinated Claims. The remaining claims or portions of claims not already paid, with interest, as in paragraph VII:

(a) Claims under RSA 402-C:39, II;

(b) Claims subordinated by RSA 402-C:61;

(c) Claims filed late;

(d) Portions of claims subordinated under paragraph V;

(e) Claims or portions of claims payment of which is provided by other benefits or advantages recovered or recoverable by the claimant.

IX. 
Preferred Ownership Claims. Surplus or contribution notes, or similar obligations, and premium refunds on assessable policies. Interest at the legal rate shall be added to each claim, as in paragraphs VII and VIII.

X. 
Proprietary Claims. The claims of shareholders or other owners.


Source. 1969, 272:1. 1975, 348:14. 1977, 499:1. 1998, 99:1. 2005, 248:5, eff. Sept. 12, 2005.

    402-C:45 Liquidator's Recommendations to the Court. 

I. 
Recommended Claims. The liquidator shall review all claims duly filed in the liquidation and shall make such further investigation as he deems necessary. He may compound, compromise or in any other manner negotiate the amount for which claims will be recommended to the court. Unresolved disputes shall be determined under RSA 402-C:41. As often as practicable, he shall present to the court reports of claims against the insurer with his recommendations. The reports shall include the name and address of each claimant, the particulars of the claim and the amount of the claim finally recommended, if any. As soon as reasonably possible after the last day for filing claims, he shall present a list of all claims not already reported. If the insurer has issued annuities or life insurance policies, the liquidator shall report the persons to whom, according to the records of the insurer, amounts are owed as cash surrender values or other investment values and the amounts owed. If the insurer has issued policies on the advance premium plan, the liquidator shall report the persons to whom, according to the records of the insurer, unearned premiums are owed and the amounts owed.

II. 
Allowance of Claims. The court may approve, disapprove or modify any report on claims by the liquidator, except that the liquidator's agreements with other parties shall be final and binding on the court on claims settled for $500 or less. No claim under a policy of insurance shall be allowed for an amount in excess of the applicable policy limits.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:46 Distribution of Assets. 

I. 
Payments to Creditors. Under the direction of the court, the liquidator shall pay dividends in a manner that will assure the proper recognition of priorities and a reasonable balance between the expeditious completion of the liquidation and the protection of unliquidated and undetermined claims, including third party claims. Distribution of assets in kind may be made at valuations set by agreement between the liquidator and the creditor and approved by the court.

II. 
Excess Assets.

(a) Upon liquidation of a domestic mutual insurance company, any assets held in excess of its liabilities and the amounts which may be paid to its members as provided under subparagraph (b) shall be paid into the state treasury for the credit of the insurance department.

(b) The maximum amount payable upon liquidation to any member for and on account of his membership in a domestic mutual insurance company, in addition to the insurance benefits promised in the policy, shall be the total of all premium payments made by the member with interest at the legal rate compounded annually.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:47 Unclaimed and Withheld Funds. 

I. 
Unclaimed Funds. All unclaimed funds subject to distribution remaining in the liquidator's hands when he is ready to apply to the court for discharge, including the amount distributable to any creditor, shareholder, member or other person who is unknown or cannot be found or who is under disability with no person legally competent to receive his distributive share, shall be deposited with the state treasurer, and shall be paid over without interest except in accordance with RSA 402-C:44 to the person entitled thereto or his legal representative upon proof satisfactory to the state treasurer of his right thereto. Any amount on deposit not claimed within 6 years from the discharge of the liquidator is deemed abandoned and shall become the property of the state.

II. 
Withheld Funds. All funds withheld under RSA 402-C:40 and not distributed shall upon discharge of the liquidator be deposited with the state treasurer and paid by him in accordance with RSA 402-C:40. Any sums remaining which under RSA 402-C:40 would revert to the undistributed assets of the insurer shall be transferred to the state treasurer and become the property of the state under paragraph I, unless the commissioner petitions the court to reopen the liquidation under RSA 402-C:49.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:48 Termination of Proceedings. 

I. 
Liquidator's Application. When all assets justifying the expense of collection and distribution have been collected and distributed under this chapter, the liquidator shall apply to the court for discharge. The court may grant the discharge and make any other orders deemed appropriate, including an order to transfer to the state treasury for the credit of the insurance department any remaining funds that are uneconomic to distribute.

II. 
Application by Others. Any other person may apply to the court at any time for an order under paragraph I. If the application is denied, the applicant shall pay the costs and expenses of the liquidator in resisting the application, including a reasonable attorney's fee.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:49 Reopening Liquidation. 

After the liquidation proceeding has been terminated and the liquidator discharged, the commissioner or other interested party may at any time petition the court to reopen the proceedings for good cause, including the discovery of additional assets. If the court is satisfied that there is justification for reopening, it shall so order.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:5 Injunctions and Orders. 

I. 
Injunctions in This State. Any receiver appointed in a proceeding under this chapter may at any time apply for and any court of general jurisdiction in this state may grant, such restraining orders, temporary and permanent injunctions, and other orders as are deemed necessary and proper to prevent:

(a) The transaction of further business;

(b) The transfer of property;

(c) Interference with the receiver or with the proceedings;

(d) Waste of the insurer's assets;

(e) Dissipation and transfer of bank accounts;

(f) The institution or further prosecution of any actions or proceedings;

(g) The obtaining of preferences, judgments, attachments, garnishments or liens against the insurer or its assets;

(h) The levying of execution against the insurer or its assets;

(i) The making of any sale or deed for nonpayment of taxes or assessments that would lessen the value of the assets of the insurer;

(j) The withholding from the receiver of books, accounts, documents or other records relating to the business of the insurer; or

(k) Any other threatened or contemplated action that might lessen the value of the insurer's assets or prejudice the rights of policyholders, creditors or shareholders, or the administration of the proceeding.

II. 
Injunctions Elsewhere. The receiver may apply to any court outside of this state for the relief described in paragraph I.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:50 Disposition of Records During and After Termination of Liquidation. 

Whenever it appears to the commissioner that the records of any insurer in process of liquidation or completely liquidated are no longer useful, he or she may recommend to the court what records should be retained for future reference and what should be disposed of. The court shall enter an order thereon. Until further order of the court, the commissioner shall keep all records the court orders preserved and shall destroy the remainder whether or not the records have been photographed or otherwise reproduced.


Source. 1969, 272:1. 2003, 144:3, eff. Jan. 1, 2004.

    402-C:51 External Audit of Receiver's Books. 

The court in which the proceeding is pending may, as it deems desirable, cause audits to be made of the books of the commissioner relating to any receivership established under this chapter, and a report of each audit shall be filed with the commissioner and with the court. The books, records and other documents of the receivership shall be made available to the auditor at any time without notice. The expense of each audit shall be considered a cost of administration of the receivership.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:52 Conservation of Property of Foreign or Alien Insurers Found in This State. 

I. 
Grounds for Petition. If a domiciliary liquidator has not been appointed, the commissioner may apply to the superior court for Merrimack county by verified petition for an order directing him to conserve the property of an alien insurer not domiciled in this state or a foreign insurer on any one or more of the following grounds:

(a) Any of the grounds in RSA 402-C:15;

(b) Any of the grounds in RSA 402-C:20;

(c) That any of its property has been sequestered by official action in its domiciliary state, or in any other state;

(d) That enough of its property has been sequestered in a foreign country to give reasonable cause to fear that the insurer is or may become insolvent;

(e) That 1) its certificate of authority to do business in this state has been revoked or that none was ever issued, and 2) there are residents of this state with outstanding claims or outstanding policies.

II. 
Terms of Order. The court may issue the order in whatever terms it deems appropriate. The filing or recording of the order with any register of deeds in this state imparts the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that register of deeds.

III. 
Transformation to Liquidation or Ancillary Receivership. The conservator may at any time petition for and the court may grant an order under RSA 402-C:53 to liquidate the assets of a foreign or alien insurer under conservation or, if appropriate, for an order under RSA 402-C:55 to be appointed ancillary receiver.

IV. 
Order to Return to Company. The conservator may at any time petition the court for an order, terminating conservation of an insurer. If the court finds that the conservation is no longer necessary, it shall order that the insurer be restored to possession of its property and the control of its business. The court may also make such finding and issue such order at any time upon its own motion.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:53 Liquidation of Property of Foreign or Alien Insurers Found in This State. 

I. 
Grounds for Petition. If no domiciliary receiver has been appointed, the commissioner may apply to the superior court for Merrimack county by verified petition for an order directing him to liquidate the assets found in this state of a foreign insurer or an alien insurer not domiciled in this state, on any of the following grounds:

(a) Any of the grounds in RSA 402-C:15;

(b) Any of the grounds in RSA 402-C:20;

(c) Any of the grounds in RSA 402-C:52.

II. 
Terms of Order. If it appears to the court that the best interests of creditors, policyholders and the public so require, the court may issue an order to liquidate in whatever terms it deems appropriate. The filing or recording of the order with any register of deeds in this state imparts the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that register of deeds.

III. 
Conversion to Ancillary Proceeding. If a domiciliary liquidator is appointed in a reciprocal state while a liquidation is proceeding under this section, the liquidator under this section shall thereafter act as ancillary receiver under RSA 402-C:55. If a domiciliary liquidator is appointed in a nonreciprocal state while a liquidation is proceeding under this section, the liquidator under this section may petition the court for permission to act as ancillary receiver under RSA 402-C:55.

IV. 
Federal Receivership. On the same grounds as are specified in paragraph I, the commissioner may petition any appropriate federal district court to be appointed receiver to liquidate that portion of the insurer's assets and business over which the court will exercise jurisdiction, or any lesser part thereof that the commissioner deems desirable for the protection of the policyholders and creditors in this state. The commissioner may accept appointment as federal receiver if another person files a petition.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:54 Foreign Domiciliary Receivers in Other States. 

I. 
Property Rights and Title: Reciprocal State. The domiciliary liquidator of an insurer domiciled in a reciprocal state shall be vested by operation of law with the title to all of the property, contracts and rights of action, and all of the books, accounts and other records of the insurer located in this state. The date of vesting shall be the date of the filing of the petition, if that date is specified by the domiciliary law for the vesting of property in the domiciliary state; otherwise, the date of vesting shall be the date of entry of the order directing possession to be taken. The domiciliary liquidator shall have the immediate right to recover balances due from agents and to obtain possession of the books, accounts and other records of the insurer located in this state. He also shall have the right to recover the other assets of the insurer located in this state, subject to RSA 402-C:55, II.

II. 
Property Rights and Title: State Not a Reciprocal State. If a domiciliary liquidator is appointed for an insurer not domiciled in a reciprocal state, the commissioner of this state shall be vested by operation of law with the title to all of the property, contracts and rights of action, and all of the books, accounts and other records of the insurer located in this state, at the same time that the domiciliary liquidator is vested with title in the domicile. The commissioner of this state may petition for a conservation or liquidation order under RSA 402-C:52 or 53, or for an ancillary receivership under RSA 402-C:55, or after approval by the superior court for Merrimack county may transfer title to the domiciliary liquidator, as the interests of justice and the equitable distribution of the assets require.

III. 
Filing Claims. Claimants residing in this state may file claims with the liquidator or ancillary receiver, if any, in this state or with the domiciliary liquidator, if the domiciliary law permits. The claims must be filed on or before the last date fixed for the filing of claims in the domiciliary liquidation proceedings.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:55 Ancillary Formal Proceedings. 

I. 
Appointment of Ancillary Receiver in This State. If a domiciliary liquidator has been appointed for an insurer not domiciled in this state, the commissioner shall file a petition with the superior court for Merrimack county requesting appointment as ancillary receiver in this state:

(a) If he finds that there are sufficient assets of the insurer located in this state to justify the appointment of an ancillary receiver;

(b) If 10 or more persons resident in this state having claims against the insurer file a petition with the commissioner requesting appointment of an ancillary receiver; or

(c) If the protection of creditors or policyholders in this state so requires.

II. 
Terms of Order. The court may issue an order appointing an ancillary receiver in whatever terms it deems appropriate. The filing or recording of the order with any register of deeds in this state imparts the same notice as a deed, bill of sale or other evidence of title duly filed or recorded with that register of deeds.

III. 
Property Rights and Title: Ancillary Receivers in This State. When a domiciliary liquidator has been appointed in a reciprocal state, the ancillary receiver appointed in this state under paragraph I shall have the sole right to recover all the assets of the insurer in this state not already recovered by the domiciliary liquidator, except that the domiciliary liquidator shall be entitled to and have the sole right to recover balances due from agents and the books, accounts and other records of the insurer. The ancillary receiver shall have the right to recover balances due from agents and books, accounts and other records of the insurer, if such action is necessary to protect the assets because of inaction by the domiciliary liquidator. The ancillary receiver shall, as soon as practicable, liquidate from their respective securities those special deposit claims and secured claims which are proved and allowed in the ancillary proceedings in this state, and shall pay the necessary expenses of the proceedings. He shall promptly transfer all remaining assets to the domiciliary liquidator. Subject to this section, the ancillary receiver and his deputies shall have the same powers and be subject to the same duties with respect to the administration of assets as a liquidator of an insurer domiciled in this state.

IV. 
Property Rights and Title: Foreign Ancillary Receivers. When a domiciliary liquidator has been appointed in this state, ancillary receivers appointed in reciprocal states shall have, as to assets and books, accounts and other records located in their respective states, corresponding rights and powers to those prescribed in paragraph III for ancillary receivers appointed in this state.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:56 Ancillary Summary Proceedings. 

The commissioner in his sole discretion may institute proceedings under RSA 402-C:11-13 at the request of the commissioner or other appropriate official of the domiciliary state of any foreign or alien insurer having property located in this state.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:57 Claims of Nonresidents Against Insurers Domiciled in This State. 

I. 
Filing Claims. In a liquidation proceeding begun in this state against an insurer domiciled in this state, claimants residing in foreign countries or in states not reciprocal states must file claims in this state, and claimants residing in reciprocal states may file claims either with the ancillary receiver, if any, in their respective states, or with the domiciliary liquidator. Claims must be filed on or before the last dates fixed for the filing of claims in the domiciliary liquidation proceeding.

II. 
Proving Claims. Claims belonging to claimants residing in reciprocal states may be proved either in the liquidation proceeding in this state as provided in this chapter, or in ancillary proceedings, if any, in the reciprocal states. If notice of the claim and opportunity to appear and be heard is afforded the domiciliary liquidator of this state as provided in RSA 402-C:58 with respect to ancillary proceedings in this state, the final allowance of claims by the courts in ancillary proceedings in reciprocal states shall be conclusive as to amount and as to priority against special deposits or other security located in the ancillary states, but shall not be conclusive with respect to priorities against general assets under RSA 402-C:44.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:58 Claims of Residents Against Insurers Domiciled in Reciprocal States. 

I. 
Filing Claims. In a liquidation proceeding in a reciprocal state against an insurer domiciled in that state, claimants against the insurer who reside within this state may file claims either with the ancillary receiver, if any, in this state, or with the domiciliary liquidator. Claims must be filed on or before the last dates fixed for the filing of claims in the domiciliary liquidation proceeding.

II. 
Proving Claims. Claims belonging to claimants residing in this state may be proved either in the domiciliary state under the law of that state or in ancillary proceedings, if any, in this state. If a claimant elects to prove his claim in this state, he shall file his claim with the court in the manner provided in RSA 402-C:37 and 38. The ancillary receiver shall make his recommendation to the court as under RSA 402-C:45. He also shall arrange a date for hearing if necessary under RSA 402-C:41 and shall give notice to the liquidator in the domiciliary state, either by registered mail or by personal service at least 40 days prior to the date set for hearing. If the domiciliary liquidator, within 30 days after the giving of such notice, gives notice in writing to the ancillary receiver and to the claimant, either by registered mail or by personal service, of his intention to contest the claim, he shall be entitled to appear or to be represented in any proceeding in this state involving the adjudication of the claim. The final allowance of the claim by the courts of this state shall be accepted as conclusive as to amount and as to priority against special deposits or other security located in this state.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:59 Attachment, Garnishment and Levy of Execution. 

During the pendency in this or any other state of a liquidation proceeding, whether called by that name or not, no action or proceeding in the nature of an attachment, garnishment or levy of execution shall be commenced or maintained in this state or elsewhere against the delinquent insurer or its assets.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:6 Costs and Expenses of Litigation. 

In any proceeding under this chapter, the court may award such costs and other expenses of litigation as justice requires, without regard to the limitations otherwise prescribed by law. If costs and expenses are taxed against the commissioner, they shall be paid pursuant to RSA 402-C:44, I.


Source. 1969, 272:1. 1997, 221:2, eff. July 1, 1997.

    402-C:60 Interstate Priorities. 

I. 
Priorities. In a liquidation proceeding in this state involving one or more reciprocal states, the order of distribution of the domiciliary state shall control as to all claims of residents of this and reciprocal states. All claims of residents of reciprocal states shall be given equal priority of payment from general assets regardless of where such assets are located.

II. 
Priority of Special Deposit Claims. The owners of special deposit claims against an insurer for which a liquidator is appointed in this or any other state shall be given priority against the special deposits in accordance with the statutes governing the creation and maintenance of the deposits. If there is a deficiency in any deposit so that the claims secured by it are not fully discharged from it, the claimants may share in the general assets, but the sharing shall be deferred until general creditors, and also claimants against other special deposits who have received smaller percentages from their respective special deposits, have been paid percentages of their claims equal to the percentage paid from the special deposit.

III. 
Priority of Secured Claims. The owner of a secured claim against an insurer for which a liquidator has been appointed in this or any other state may surrender his security and file his claim as a general creditor, or the claim may be discharged by resort to the security in accordance with RSA 402-C:43, in which case the deficiency, if any, shall be treated as a claim against the general assets of the insurer on the same basis as claims of unsecured creditors.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:61 Subordination of Claims for Noncooperation. 

If an ancillary receiver in another state or foreign country, whether called by that name or not, fails to transfer to the domiciliary liquidator in this state any assets within his control other than special deposits, diminished only by the expenses of the ancillary receivership, if any, the claims filed in the ancillary receivership, other than special deposit claims or secured claims, shall be placed in the class of claims under RSA 402-C:44, VIII.


Source. 1969, 272:1. 1998, 99:5, eff. July 19, 1998.

    402-C:7 Cooperation of Officers and Employees. 

I. 
Duty to Cooperate. Any officer, manager, trustee or general agent of any insurer and any other person with executive authority over or in charge of any segment of the insurer's affairs shall cooperate with the commissioner in any proceeding under this chapter or any investigation preliminary or incidental to the proceeding. "To cooperate" includes, but is not limited to the following:

(a) To reply promptly in writing to any inquiry from the commissioner requesting such a reply; and

(b) To make available and deliver to the commissioner any books, accounts, documents or other records, or information or property of or pertaining to the insurer and in his possession, custody or control.

II. 
Duty Not to Obstruct. No person shall obstruct or interfere with the commissioner in the conduct of any delinquency proceeding or any investigation preliminary or incidental thereto.

III. 
Right to Defend. This section shall not render it illegal to resist by legal proceedings the petition for liquidation or other delinquency proceedings, or other orders.

IV. 
Sanction. Any person included within RSA 402-C:7, I who fails to cooperate with the commissioner, or any person who obstructs or interferes with the commissioner in the conduct of any delinquency proceeding or any investigation preliminary or incidental thereto, shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person.


Source. 1969, 272:1. 1973, 528:278, eff. at 11:59 p.m., Oct. 31, 1973.

    402-C:8 Bonds. 

In any proceeding under this chapter the commissioner and his deputies shall be responsible on their official bonds for the faithful performance of their duties. If the court deems it desirable for the protection of the assets, it may at any time require an additional bond from the commissioner or his deputies.


Source. 1969, 272:1, eff. June 23, 1969.

    402-C:9 Commissioner's Reports. 

I. 
General Report of Proceedings. The commissioner shall include in his annual report:

(a) 
Formal Proceedings. The names of the insurers proceeded against under RSA 402-C:15, 20, 24, 52, 53, and 55 and such other facts as indicate in reasonable detail his formal proceedings under this chapter; and

(b) 
Informal Proceedings. Such facts as generally indicate the utilization and effectiveness of proceedings under RSA 402-C:11, 12 and 13.

II. 
Special Reports.

(a) 
Causes of Delinquency. The commissioner shall include in the annual report, not later than the second annual report following the initiation of any formal proceedings under this chapter, a detailed analysis of the basic causes and the contributing factors making the initiation of formal proceedings necessary, and shall make recommendations for remedial legislation. For this purpose the commissioner may appoint a special assistant qualified in insurance, finance and accounting to conduct the study and prepare the analysis, and may determine the special assistant's compensation, which shall be paid pursuant to RSA 402-C:44, I.

(b) 
Final Study. The commissioner shall include in the annual report, not later than the second annual report following discharge of the receiver, a detailed study of the delinquency proceeding for each insurer subjected to a formal proceeding, with an analysis of the problems faced and their solutions. The commissioner shall also suggest alternative solutions, as well as other material of interest, for the purpose of assisting and guiding liquidators or rehabilitators in the future. For this purpose the commissioner may appoint a special assistant qualified to conduct the study and prepare the analysis, and may determine the special assistant's compensation, which shall be paid pursuant to RSA 402-C:44, I.

III. 
Reports on Insurers Subject to Proceedings. The commissioner as receiver shall make and file annual reports and any other required reports for the companies proceeded against under RSA 402-C:15, 20, 24, 52, 53 and 55 in the manner and form and within the time required by law of insurers authorized to do business in this state, and under the same penalties for failure to do so.


Source. 1969, 272:1. 1997, 221:3, eff. July 1, 1997.

    402-D:1 Purpose and Scope. 

This chapter governs the qualifications and procedures for the licensing of public adjusters. It specifies the duties of and restrictions on public adjusters, which include limiting their licensure to assisting insureds in first party claims.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:10 License Denial, Nonrenewal, or Revocation. 

I. The commissioner may place on probation, suspend, revoke, or refuse to issue or renew a public adjuster's license or may impose an administrative fine in the amount of $2,500 per violation, or impose any combination of actions, after notice and hearing, for any one or more of the following causes:

(a) Providing incorrect, misleading, incomplete, or materially untrue information in the license application.

(b) Violating any insurance laws, or violating any rule, subpoena, or order of the commissioner or of another state's insurance commissioner.

(c) Obtaining or attempting to obtain a license through misrepresentation or fraud.

(d) Improperly withholding, misappropriating, or converting any moneys or properties received in the course of doing insurance business.

(e) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance.

(f) Having been convicted of a felony.

(g) Having admitted or been found to have committed any insurance unfair trade practice or insurance fraud.

(h) Using fraudulent, coercive, or dishonest practices; or demonstrating incompetence, untrustworthiness, or financial irresponsibility in the conduct of business in this state or elsewhere.

(i) Having an insurance license, or its equivalent, denied, suspended, or revoked in any other state, province, district, or territory.

(j) Forging another's name to an application for insurance or to any document related to an insurance transaction.

(k) Cheating, including improperly using notes or any other reference material, to complete an examination for an insurance license.

(l) Knowingly accepting insurance business from a person who is not licensed but who is required to be licensed by the commissioner.

(m) Failing to comply with an administrative or court order imposing a child support obligation.

(n) Paying a commission, service fee, brokerage, or other valuable consideration to a person for investigating or settling claims in this state if that person is required to be licensed under this chapter and is not so licensed.

(o) Failing to maintain evidence of financial responsibility as required by RSA 402-D:11.

II. A public adjuster may pay or assign commission, service fees, brokerages, or other valuable consideration to persons who do not investigate or settle claims in this state, unless the payment would violate the provisions of RSA 417. A person shall not accept a commission, service fee, brokerage, or other valuable consideration for investigating or settling claims in this state if that person is required to be licensed under this chapter and is not so licensed.

III. In the event that the action by the commissioner is to deny an application for or nonrenew a license, the commissioner shall notify the applicant or licensee and advise, in writing, the applicant or licensee of the reason for the non-renewal or denial of the applicant's or licensee's license. The applicant or licensee may make written demand upon the commissioner pursuant to RSA 400-A:17 for a hearing before the commissioner to determine the reasonableness of the commissioner's action. The hearing shall be held pursuant to the provisions of RSA 400-A:17.

IV. The commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and title XXXVII against any person who is under investigation for or charged with a violation of this chapter or title XXXVII even if the person's license or registration has been surrendered or has lapsed by operation of law.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:11 Bond or Letter of Credit. 

I. Prior to issuance of a license as a public adjuster, the applicant shall maintain in force evidence of financial responsibility through one of the following:

(a) A surety bond executed and issued by an insurer authorized to issue surety bonds in this state, which bond:

(1) Shall be in the amount of at least $20,000;

(2) Shall be in favor of this state and shall specifically authorize recovery by the commissioner on behalf of any person in this state who sustained damages as the result of erroneous acts, failure to act, conviction of fraud, or conviction of unfair practices in his or her capacity as a public adjuster; and

(3) Shall not be terminated unless at least 30 days prior written notice has been filed with the commissioner and given to the licensee.

(b) An irrevocable letter of credit issued by a qualified financial institution, which letter of credit:

(1) Shall be in the sum of at least $20,000; and

(2) Shall be to an account to the commissioner and subject to lawful levy of execution by any person to whom the public adjuster has been found to be legally liable as the result of erroneous acts, failure to act, fraudulent acts, or unfair practices in his or her capacity as a public adjuster.

II. The issuer of such evidence of financial responsibility shall notify the commissioner upon termination of such policy, bond or letter of credit, unless the public adjuster replaces this evidence of financial responsibility and has presented the evidence of such replacement to the existing issue or such instrument.

III. The commissioner may ask for the evidence of such financial responsibility at any time the commissioner deems relevant.

IV. The authority to act as a public adjuster shall automatically terminate if the evidence of financial responsibility terminates or becomes impaired.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:12 Continuing Education. 

I. A person, who holds a public adjuster license and who is not exempt under paragraph III, shall satisfactorily complete a minimum of 15 hours of continuing education courses, including a minimum of 3 hours of ethics, specifically designed to increase the knowledge of public adjusting duties and responsibilities during each continuing education biennium.

II. Every 2 years, at least 60 days prior to the renewal date of their license, persons holding a public adjusters license shall be certified by the insurance department as having completed 15 hours of continuing education.

III. This section shall not apply to:

(a) Licensees not licensed for one full year prior to the end of the applicable continuing education biennium; and

(b) Licensees holding nonresident public adjuster licenses who have met the continuing education requirements of their home state and whose home state gives credit to residents of this state on the same basis.

IV. Only continuing education courses approved by the commissioner shall be used to satisfy the continuing education requirement of paragraph I.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:13 Contract Between Public Adjuster and Insured. 

I. The agreement between the public adjuster and the insured shall be in writing and contain the following:

(a) Title of "Public Adjuster Contract."

(b) Name, business name, telephone number, and business street address of the public adjuster.

(c) Name and address of the insured.

(d) Description of the loss and its location, if applicable.

(e) Name of the insurer and the policy number.

(f) Full salary, fee, commission, or other consideration the public adjuster is to receive for services under the contract.

(g) Description of services to be provided to the insured.

(h) Signatures of the public adjuster and the insured.

(i) Date the contract was signed by the public adjuster and date the contract was signed by the insured.

(j) Complete identification as to the means by which the public adjuster satisfied RSA 402-D:11.

(k) A statement printed in not less than bold, 12-point type, which shall state, in substance: "You have the right, at your option, to rescind this contract at any time within 3 business days after the end of the day you sign it. Should you wish to discuss this matter with the New Hampshire insurance department, it can be reached, toll-free, by dialing 1-800-852-3416."

II. A public adjuster contract may not contain any contract term that:

(a) Allows the public adjuster's fee to be collected when money is due from an insurance company, but not paid, or that allows a public adjuster to collect the entire fee from the first check issued by an insurance company, rather than as a percentage of each check issued by an insurance company.

(b) Requires the insured to authorize an insurance company to issue a check only in the name of the public adjuster.

(c) Imposes late fees or collection costs on the insured.

III. Prior to the signing of the contract the public adjuster shall provide the insured with a separate disclosure document that states:

(a) The insured is not required to hire a public adjuster.

(b) The insured has the right to communicate directly with the insured's attorney, the insurer, the insurer's adjuster, and the insurer's attorney, or any other person regarding the settlement of the insured's claim.

(c) The public adjuster is not a representative or employee of the insurer.

(d) The salary, fee, commission, or other consideration is to be paid by the insured, not by the insurer.

(e) Complete identification as to the means by which the public adjuster satisfied RSA 402-D:11.

IV. The contracts shall be executed in triplicate to provide an original contract to the public adjuster, the insurer, and the insured. The public adjuster's original contract shall be available at all times for inspection without notice by the commissioner.

V. The public adjuster shall give the insured written notice of the insured's rights, as follows:

(a) The insured has the right to rescind the contract within 3 working days after the date the contract was signed.

(b) If the insured exercises the right to rescind the contract, the rescission must be in writing and mailed or delivered to the public adjuster at the address in the contract.

(c) If the insured exercises the right to rescind the contract, anything of value given by the insured under the contract will be returned to the insured within 15 business days following the receipt by the public adjuster of the cancellation notice.

VI. After the time to rescind has elapsed and within 6 working days after the date the contract is signed, the public adjuster shall give written notice to the insurer, its adjuster, or its attorney that the public adjuster has entered into a written contract with the insured.


Source. 2006, 9:1. 2012, 100:2, eff. July 28, 2012.

    402-D:14 Approval of Forms. 

I. No contract in writing for the adjustment or appraisal for any loss shall be made until a copy of the form of such contract has been on file for 30 days with the commissioner, unless before the expiration of that period the commissioner shall have approved the form in writing, provided that the commissioner may disapprove the form within the 30-day period.

II. Contracts not containing all of the information required by RSA 402-D:13, I shall be automatically deemed disapproved. Any disapproved contract that is used by a public adjuster in violation of this paragraph shall be voidable by the consumer who signed the contract.

III. In the event of disapproval of the form, the commissioner shall notify the public adjuster and shall specify the reasons for the disapproval. The decision to disapprove the form may be appealed in accordance with RSA 541.


Source. 2006, 9:1. 2014, 31:4, eff. July 26, 2014.

    402-D:15 Escrow or Trust Accounts. 

I. A public adjuster who receives, accepts, or holds any moneys on behalf of an insured, towards the settlement of a claim for loss or damage, shall deposit the moneys in an interest bearing escrow or trust account in a financial institution which is insured by an agency of the federal government in their home state.

II. All funds held in an escrow or trust account and interest accruing thereon shall be the property of the insured and shall be held pursuant to a written agreement signed by the insured and the public adjuster.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:16 Record Retention. 

I. A public adjuster shall maintain a complete record of each transaction as a public adjuster. The records required by this section shall include, at a minimum, the following:

(a) Name of the insured.

(b) Date, location, and amount of the loss.

(c) Copy of the contract between the public adjuster and the insured.

(d) Name of the insurer, and the amount, expiration date and number of each policy carried with respect to the loss.

(e) An itemized statement of the insured's recoveries.

(f) An itemized statement of all compensation received by the public adjuster, from any source whatsoever, in connection with the loss.

(g) A register of all moneys received, deposited, disbursed, or withdrawn in connection with a transaction with an insured, including fee transfers and disbursements from a trust account and all transactions concerning all interest bearing accounts.

(h) Name of the public adjuster who executed the contract.

(i) Name of the attorney representing the insured, if applicable, and the name of the claims representative of the insurance company.

(j) Evidence that the requirements of RSA 402-D:11 have been satisfied.

II. Records shall be maintained for at least 5 years after the termination of the transaction with an insured and shall be open to examination by the commissioner at all times.

III. Records submitted to the commissioner in accordance with this section that contain personal identifying information, shall be treated as confidential by the commissioner and shall not be subject to RSA 91-A. However, in order to assist in the performance of the commissioner's duties, the commissioner may share documents, materials, or other information, including the confidential documents, materials, or other information with other state, federal and international regulatory agencies, with the National Association of Insurance Commissioners (NAIC) and its affiliates and subsidiaries, and with state, federal and international law enforcement authorities; provided, that the recipient agrees to maintain the confidentiality of the information provided. Such parties shall agree in writing prior to receiving the information to provide to it the same confidential treatment as required by this paragraph, unless the prior written consent of the person to which it pertains has been obtained.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:17 Standards of Conduct of Public Adjuster. 

I. A public adjuster shall be honest and fair in all communications with the insured, the insurer, and the public.

II. A public adjuster shall not solicit, or attempt to solicit, an insured during the progress of a loss-producing occurrence, as defined in the insured's insurance contract.

III. A public adjuster shall not permit an unlicensed employee or representative of the public adjuster to advertise, engage insureds, furnish reports, or present bills to insureds, or in any manner whatsoever to conduct business for which a license is required under this chapter.

IV. A public adjuster shall not have a direct or indirect financial interest in any aspect of the claim, other than the salary, fee, commission, or other consideration established in the written contract with the insured.

V. A public adjuster shall not require any interest in salvage of property subject to the contract with the insured unless the public adjuster obtains written permission from the insured after settlement of the claim with the insurer.

VI. The public adjuster shall abstain from referring or directing the insured to get needed repairs or services in connection with a loss from any person:

(a) With whom the public adjuster has a financial interest; or

(b) From whom the public adjuster may receive direct or indirect compensation for the referral.

VII. A public adjuster shall not enter into a contract with an insured where the public adjuster knows or should know that the insured will obtain full recovery without the services of an adjuster.

VIII. No public adjuster shall have any interest in any construction firm, salvage firm, building appraisal firm, motor vehicle repair shop or any other firm which performs any work in conjunction with damages caused by an insured loss. The word "firm" shall include any corporation, partnership, association, joint stock company, or person.

IX. Any compensation or anything of value received by a public adjuster shall be disclosed by such adjuster to the insured in writing including the source and amount of such.

X. No public adjuster may employ, be employed by, or be in partnership with or receive or pay any remuneration whatsoever to or from any licensed insurance producer, insurer, or employee of an insurer arising out of the activities as a public adjuster.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:18 Reporting of Actions. 

I. The public adjuster shall report to the commissioner any administrative action taken against the public adjuster in another jurisdiction or by another governmental agency in this state within 30 days of the final disposition of the matter. This report shall include a copy of the order, consent to order, or other relevant legal documents.

II. Within 30 days of the initial pretrial hearing date, the public adjuster shall report to the commissioner any criminal prosecution of the public adjuster taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:19 Additional Penalty. 

In addition to any of the penalties provided in this chapter, any person who shall act within this state as a public adjuster without being licensed as provided in this chapter shall be guilty of a class A misdemeanor. Any licensee who in the course of his or her work as a public adjuster shall misrepresent his or her identity or the identity of his or her principal or employer, or who shall wrongfully divulge information obtained by him or her in his or her capacity as a public adjuster may be subject to an administrative fine not to exceed $2,500. Additionally, the commissioner may order a refund of any moneys gained or obtained, or restitution of any valuable consideration received.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

I-a. "
Home state
" means the District of Columbia and any state or territory of the United States in which a licensee maintains his or her principal place of residence or principal place of business and is licensed to act as a public adjuster.

II. "
Person
" means a natural person.

III. "
Public adjuster
" means any person who, on behalf of an insured:

(a) Directly or indirectly solicits from the insured or his or her representative the authority to act for the insured to settle or negotiate settlement or appraisal of a loss under a fire insurance or homeowner's insurance policy and who so acts for a fee or compensation from a person other than an insurer;

(b) Acts or aids, solely in relation to first party claims arising under a fire insurance or homeowner's insurance policy, on behalf of an insured person or business entity in negotiating for, or effecting the settlement of, a claim for loss or damage covered by an insurance contract;

(c) Advertises for employment as a public adjuster of insurance claims or solicits business or represents himself or herself to the public as a public adjuster of first party insurance claims for losses or damages arising out of fire insurance or homeowner's insurance policies; or

(d) Directly or indirectly solicits business, investigates or adjusts losses, or advises an insured about first party claims for losses or damages arising out of policies of fire or homeowner's insurance for another person engaged in the business of adjusting losses or damages covered by an insurance policy.

IV. "
Uniform individual application
" means the current version of the National Association of Insurance Commissioners (NAIC) Uniform Individual Application for resident and nonresident persons.


Source. 2006, 9:1. 2008, 18:10, eff. July 11, 2008.

    402-D:20 Rulemaking Authority. 

The commissioner may adopt rules, pursuant to RSA 541-A, as are necessary or proper to carry out the purposes of this chapter.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:21 Severability. 

If any provision of this chapter, or the application thereof to any person or circumstances, 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 severable.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:3 License Required. 

I. A person shall not act or hold himself or herself out as a public adjuster in this state unless the person is licensed as a public adjuster in accordance with this chapter.

II. A person licensed as a public adjuster shall not represent or act as an adjuster licensed pursuant to RSA 402-B and representing an insurer in any capacity, including acting as an employee of the insurer or as an insurance claims adjuster.

III. A license as a public adjuster shall not be required of the following:

(a) An attorney-at-law admitted to practice in this state, when acting in his or her professional capacity as an attorney;

(b) A person employed only for the purpose of obtaining facts surrounding a loss or furnishing technical assistance to a licensed public adjuster, including photographers, estimators, private investigators, engineers, and handwriting experts;

(c) A licensed health care provider, or employee of a licensed health care provider, who prepares or files a health claim form on behalf of a patient; or

(d) A person who settles subrogation claims between insurers.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:4 Application for License. 

I. A person applying for a public adjuster license shall make application to the commissioner on the appropriate uniform application or other application prescribed by the commissioner.

II. The applicant shall declare under penalty of perjury and under penalty of refusal, suspension, or revocation of the license that the statements made in the application are true, correct, and complete to the best of the applicant's knowledge and belief.

III. The commissioner shall review each application and may conduct an investigation on each applicant in accordance with this chapter.

IV. The commissioner is authorized to request and receive, in connection with an application for a license hereunder, criminal history record information from the department of safety, division of state police or the department of justice, and the Federal Bureau of Investigation.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:5 Resident License. 

I. Before issuing a public adjuster license to an applicant under this section, the commissioner shall find that the applicant:

(a) Is eligible to designate this state as his or her home state or is a nonresident who is not eligible for a license under RSA 402-D:8.

(b) Has not committed any act that is a ground for denial, suspension, or revocation of license set forth in RSA 402-D:10.

(c) Is trustworthy, reliable, and of good reputation, evidence of which may be determined by the commissioner.

(d) Is financially responsible to exercise the license and has provided proof of financial responsibility as required in RSA 402-D:11.

(e) Has paid the fees set forth in RSA 400-A:29.

(f) Maintains an office in this state with public access during regular business hours.

(g) Is at least 18 years of age.

(h) Has successfully passed the public adjuster examination.

(i) Possesses a minimum of 5 years experience in the insurance business, with some of that experience involving claims adjusting, or other experience considered sufficient by the commissioner.

II. The commissioner may require any documents reasonably necessary to verify the information contained in the application.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:6 Examination. 

I. A person applying for a public adjuster license, pursuant to RSA 402-D:4, shall pass a written examination unless exempt pursuant to RSA 402-D:7. The examination shall test the knowledge of the person concerning the duties and responsibilities of an adjuster and the insurance laws and rules of this state.

II. The commissioner may make arrangements, including contracting with an outside testing service, for administering examinations.

III. An person who fails to appear for the examination as scheduled or fails to pass the examination, shall reapply for an examination and remit all required fees and forms before being rescheduled for another examination.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:7 Exemptions From Examination. 

I. A person who applies for a public adjuster license in this state who was previously licensed as a public adjuster in another state based on a public adjuster examination shall not be required to complete any prelicensing examination. This exemption is only available if the person is currently licensed in that state or if the application is received within 12 months of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in the state or the state's producer database records, maintained by the NAIC, its affiliates, or subsidiaries, indicates that the public adjuster is or was licensed in good standing.

II. A person licensed as a public adjuster in another state based on a public adjuster examination who moves to this state shall make application within 90 days of establishing legal residence to become a resident licensee pursuant to RSA 402-D:4 and RSA 402-D:5. No prelicensing examination shall be required of that person to obtain a public adjuster license.

III. A person who applies for a public adjuster license in this state who was previously licensed as a public adjuster in this state shall not be required to complete any prelicensing examination. This exemption is only available if the application is received within 12 months of the cancellation of the applicant's previous license in this state and if, at the time of cancellation, the applicant was in good standing in this state.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:8 Nonresident License;  Reciprocity. 

I. Unless denied licensure pursuant to RSA 402-D:10, a nonresident person shall receive a nonresident public adjuster license if:

(a) The person is currently licensed as a resident public adjuster and in good standing in his or her home state;

(b) The person has submitted the proper request for licensure, has paid the fees required by RSA 400-A:29, and has provided proof of financial responsibility as required in RSA 402-D:11;

(c) The person has submitted or transmitted to the commissioner the appropriate completed application for licensure; and

(d) The person's home state awards non-resident public adjuster licenses to residents of this state on the same basis.

II. The commissioner may verify the public adjuster's licensing status through the producer database maintained by the National Association of Insurance Commissioners (NAIC), its affiliates, or subsidiaries.

III. As a condition to continuation of a public adjuster license issued under this section, the licensee shall maintain a resident public adjuster license in his or her home state. The non-resident public adjuster license issued under this section shall terminate and be surrendered immediately to the commissioner if the home state public adjuster license terminates for any reason.


Source. 2006, 9:1, eff. May 2, 2006.

    402-D:9 License. 

I. Unless denied licensure pursuant to RSA 402-D:10, persons who have met the requirements of RSA 402-D:5 or RSA 402-D:8 shall be issued a public adjuster license.

II. A public adjuster license shall remain in effect unless revoked, terminated, or suspended as long as the request for renewal and fee set forth in RSA 400-A:29 is paid and any other requirements for license renewal are met by the due date.

III. The licensee shall inform the commissioner by any means acceptable to the commissioner of a change of address, change of legal name, or change of information submitted on the application within 30 days of the change.

IV. A licensed public adjuster shall be subject to RSA 417.

V. A public adjuster who allows his or her license to lapse may, within 12 months from the due date of the renewal, be issued a new public adjuster license upon the commissioner's receipt of the request for renewal. However, a penalty in the amount of double the unpaid renewal fee shall be required for the issue of the new public adjuster license. The new public adjuster license shall be effective the date the commissioner receives the request or renewal and the late payment penalty.

VI. A licensed public adjuster who is unable to comply with license renewal procedures due to military service, a long-term medical disability, or some other extenuating circumstance, may request a waiver of those procedures. The public adjuster may also request a waiver of any examination requirement, fine, or other sanction imposed for failure to comply with renewal procedures.

VII. The license shall contain the licensee's name, business street address, mailing address, personal identification number, the date of issuance, the expiration date, and any other information the commissioner deems necessary. Licensees shall inform the commissioner by any means acceptable to the commissioner of a change of address within 30 days of the change. Failure to timely inform the commissioner of a change in address shall result in an additional fee pursuant to RSA 400-A:29.

VIII. In order to assist in the performance of the commissioner's duties, the commissioner may contract with non-governmental entities, including the NAIC or any affiliates or subsidiaries that the NAIC oversees, to perform any ministerial functions, including the collection of fees and data, related to licensing that the commissioner may deem appropriate.

IX. Unless revoked by the commissioner, the license and any renewal thereof shall expire on October 1 of the second calendar year after its issue.


Source. 2006, 9:1, eff. May 2, 2006.

    402-E:1 Definitions. 

In this chapter:

I. "Actuary" means a person who is a member in good standing of the American Academy of Actuaries.

II. "Insurer" means any person, firm, association or corporation duly licensed in this state as an insurance company pursuant to title XXXVII.

III. (a) "Managing general agent" (MGA) means any person, firm, association or corporation who negotiates and binds ceding reinsurance contracts on behalf of an insurer or manages all or part of the insurance business of an insurer, including the management of a separate division, department or underwriting office, and acts as an agent for such insurer whether known as a managing general agent, manager or other similar term, who, with or without the authority, either separately or together with affiliates, produces, directly or indirectly, and underwrites an amount of gross direct written premiums equal to or more than 5 percent of the policyholder surplus as reported in the last annual statement of the insurer in any one quarter or year together with one or more of the following:

(1) Adjusts or pays claims in excess of $200,000; or

(2) Negotiates reinsurance on behalf of the insurer.

(b) Notwithstanding subparagraph (a), the following persons shall not be considered as MGAs for the purposes of this chapter:

(1) An employee of the insurer.

(2) A U.S. manager of the United States branch of an alien insurer.

(3) An underwriting manager which, pursuant to contract, manages all insurance operations of the insurer other than those managed by the insurer itself, is under common control with the insurer, subject to RSA 401-B, the holding company regulatory act, and whose compensation is not based on the volume of premiums written.

(4) The attorney-in-fact authorized by and acting for the subscribers of a reciprocal insurer or inter-insurance exchange under powers of attorney.

IV. "Underwrite" means the authority to accept or reject risk on behalf of the insurer.


Source. 1991, 95:1. 2003, 144:4, eff. Jan. 1, 2004.

    402-E:2 Licensure. 

I. No person, firm, association, corporation, or other entity shall act as an MGA until an MGA license has been issued by the commissioner. The license shall be renewed annually thereafter so long as the MGA complies with applicable law and rules and upon remittance of the renewal fee.

II. No person, firm, association, or corporation shall act in the capacity of an MGA with respect to risks located in this state for an insurer licensed in this state, unless such person is a licensed producer in this state.

III. No person, firm, association, or corporation shall act in the capacity of an MGA representing an insurer domiciled in this state with respect to risks located outside this state unless such person is licensed as a producer in this state, pursuant to the provisions of this chapter. Such license may be a nonresident license.

IV. The commissioner may require a bond in an amount acceptable to the commissioner for the protection of the insurer.

V. The commissioner may require the MGA to maintain an errors and omissions policy.

VI. The commissioner may require financial and other data in form and context satisfactory to the commissioner as part of the license application process.


Source. 1991, 95:1. 1997, 284:2, eff. Jan. 1, 1998.

    402-E:3 Required Contract Provisions. 

No person, firm, association or corporation acting in the capacity of an MGA shall place business with an insurer unless there is in force a written contract between the parties which sets forth the responsibilities of each party and where both parties share responsibility for a particular function, specifies the division of such responsibilities, and contains the following minimum provisions:

I. The insurer may terminate the contract for cause upon written notice to the MGA. The insurer may suspend the underwriting authority of the MGA during the pendency of any dispute regarding the cause for termination.

II. The MGA will render accounts to the insurer detailing all transactions and remit all funds due under the contract to the insurer on not less than a monthly basis.

III. All funds collected for the account of an insurer shall be held by the MGA in a fiduciary capacity in a bank which is a member of the Federal Reserve System. This account shall be used for all payments on behalf of the insurer. The MGA may retain no more than 3 months' estimated claims payments and allocated loss adjustment expenses.

IV. Separate records of business written by the MGA shall be maintained. The insurer shall have access and rights to copy all accounts and records related to its business in a form usable by the insurer, and the commissioner shall have access to all books, bank accounts and records of the MGA in a form usable to the commissioner.

V. The contract shall not be assigned in whole or part by the MGA.

VI. Appropriate underwriting guidelines, including:

(a) The maximum annual premium volume;

(b) The basis of the rates to be charged;

(c) The types of risks which may be written;

(d) Maximum limits of liability;

(e) Applicable exclusions;

(f) Territorial limitations;

(g) Policy cancellation provisions; and

(h) The maximum policy period.

The insurer may cancel or non-renew any policy of insurance subject to the applicable laws and rules concerning the cancellation and nonrenewal of insurance policies.

VII. If the contract permits the MGA to settle claims on behalf of the insurer:

(a) All claims shall be reported to the company in a timely manner.

(b) A copy of the claim file shall be sent to the insurer at its request or as soon as it becomes known that the claim:

(1) Has the potential to exceed an amount determined by the commissioner or exceeds the limit set by the company, whichever is less.

(2) Involves a coverage dispute.

(3) May exceed the MGA's claims settlement authority.

(4) Is open for more than 6 months.

(5) Is closed by payment of an amount set by the commissioner or an amount set by the company, whichever is less.

(c) All claim files shall be the joint property of the insurer and MGA. However, upon an order of liquidation of the insurer such files shall become the sole property of the insurer or its estate; the MGA shall have reasonable access to and the right to copy the files on a timely basis.

(d) Any settlement authority granted to the MGA may be terminated for cause upon the insurer's written notice to the MGA or upon the termination of the contract. The insurer may suspend the settlement authority during the pendency of any dispute regarding the cause for termination.

(e) Any person who, in any manner or capacity other than purely clerical, handles, services or adjusts claims for or on behalf of an MGA shall be licensed as required by RSA 402-B.

VIII. Where electronic claims files are in existence, the contract shall address the timely transmission of the data.

IX. If the contract provides for a sharing of interim profits by the MGA, and the MGA has the authority to determine the amount of the interim profits by establishing loss reserves or controlling claim payments, or in any other manner, interim profits shall not be paid to the MGA until one year after they are earned for property insurance business and 5 years after they are earned on casualty business and not until the profits have been verified pursuant to RSA 402-E:4.

X. The MGA shall not:

(a) Bind reinsurance or retrocessions on behalf of the insurer, except that the MGA may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the insurer contains reinsurance underwriting guidelines including, for both reinsurance assumed and ceded, a list of reinsurers with which such automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured and commission schedules.

(b) Commit the insurer to participate in insurance or reinsurance syndicates.

(c) Appoint any producer without assuring that the producer is lawfully licensed to transact the type of insurance for which he is appointed.

(d) Without prior approval of the insurer, pay or commit the insurer to pay a claim over a specified amount, net of reinsurance, which shall not exceed one percent of the insurer's policyholders' surplus as of December 31 of the last completed calendar year.

(e) Collect any payment from a reinsurer or commit the insurer to any claim settlement with a reinsurer, without prior approval of the insurer. If prior approval is given, a report shall be promptly forwarded to the insurer.

(f) Permit its subproducer to serve on the insurer's board of directors.

(g) Jointly employ an individual who is employed with the insurer.

(h) Appoint a sub-MGA.


Source. 1991, 95:1. 1997, 284:3, eff. Jan. 1, 1998.

    402-E:4 Duties of Insurers. 

I. The insurer shall have on file an independent financial examination, in a form acceptable to the commissioner, of each MGA with which it has done business.

II. If an MGA establishes loss reserves, the insurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the MGA. This is in addition to any other required loss reserve certification.

III. The insurer, at least 2 times each year, shall conduct an on-site review of the underwriting and claims processing operations of the MGA.

IV. Binding authority for all reinsurance contracts or participation in insurance or reinsurance syndicates shall rest with an officer of the insurer, who shall not be affiliated with the MGA.

V. Within 30 days of entering into or termination of a contract with an MGA, the insurer shall provide written notification of such appointment or termination to the commissioner. Notices of appointment of an MGA shall include a statement of duties which the applicant is expected to perform on behalf of the insurer, the lines of insurance for which the applicant is to be authorized to act, and any other information the commissioner may request.

VI. An insurer shall review its books and records each quarter to determine if any producer has become an MGA. If the insurer determines that a producer has become an MGA, the insurer shall promptly notify the producer and the commissioner of such determination, and the insurer and producer shall fully comply with the provisions of this chapter within 30 days.

VII. An insurer shall not appoint to its board of directors an officer, director, employee, subproducer, or controlling shareholder of its MGAs. This paragraph shall not apply to relationships governed by RSA 401-B.


Source. 1991, 95:1, eff. Jan. 1, 1992.

    402-E:5 Examination Authority. 

I. The acts of the MGA are considered to be the acts of the insurer on whose behalf it is acting. An MGA may be examined as if it were the insurer.

II. The commissioner may designate examiners or consultants, as appropriate, to perform an audit of an MGA when the commissioner considers an audit necessary. The audit shall be conducted at the expense of the MGA. MGA's shall make all records and books of account available to the examiners or consultants, and shall otherwise facilitate the performance of the audit.


Source. 1991, 95:1. 1997, 284:4, eff. Jan. 1, 1998.

    402-E:6 Penalties and Liabilities. 

I. If the commissioner finds after notice and hearing that any person has violated any provision of this chapter, or rules adopted pursuant to this chapter, the commissioner may order:

(a) For each separate violation, a penalty in an amount of $2,500.

(b) Revocation or suspension of the producer's license.

(c) The MGA to reimburse the insurer, the rehabilitator or liquidator of the insurer for any losses incurred by the insurer caused by a violation of this chapter committed by the MGA.

(d) Any other applicable penalty provided for in the insurance law.

I-a. Any person who shall practice or attempt to practice as an MGA in this state without a license shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person.

II. Nothing contained in this chapter is intended to or shall in any manner limit or restrict the rights of policyholders, claimants and auditors.


Source. 1991, 95:1. 1997, 284:5. 2005, 206:4, eff. Jan. 1, 2006.

    402-E:7 Rulemaking. 

The commissioner of the insurance department may adopt rules, under RSA 541-A, necessary for the implementation and administration of this chapter.


Source. 1991, 95:1. 2002, 207:45, eff. July 15, 2002.

    402-E:8 Other Applicable Provisions. 

The provisions of title XXXVII apply to managing general agents.


Source. 1997, 284:6, eff. Jan. 1, 1998.

    402-F:1 Definitions. 

In this chapter:

I. "Actuary" means a person who is a member in good standing of the American Academy of Actuaries.

II. "Controlling person" means any person, firm, association or corporation who directly or indirectly has the power to direct or cause to be directed, the management, control or activities of the reinsurance intermediary.

III. "Insurer" means any person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of the insurance laws as an insurer.

IV. "Licensed producer" means an agent, broker or reinsurance intermediary licensed pursuant to the applicable provisions of the insurance laws.

V. "Reinsurance intermediary" means a reinsurance intermediary-broker or a reinsurance intermediary-manager.

VI. "Reinsurance intermediary-broker" or "
RB
" means a person, other than an officer or employee of the ceding insurer, firm, association or corporation who solicits, negotiates or places reinsurance cessions or retrocessions on behalf of a ceding insurer without acting as a reinsurance intermediary-manager (RM) on behalf of such insurer.

VII. "Reinsurance intermediary-manager" or "
RM
" means a person, firm, association or corporation, whether known as an RM, manager, or other similar term, who has authority to bind or manages all or part of the assumed reinsurance business of a reinsurer, including the management of a separate division, department or underwriting office, and acts as an agent for such reinsurer , except the following:

(a) An employee of the reinsurer.

(b) A United States manager of the U.S. branch of an alien reinsurer.

(c) An underwriting manager that, pursuant to contract, manages all or part of the reinsurance operations of the reinsurer, is under common control with the reinsurer, subject to RSA 401-B, and that is not compensated on the volume of premiums written.

(d) The manager of a group, association, pool or organization of insurers which engage in joint underwriting or joint reinsurance but only if the group, association, pool, or organization of insurers , as distinguished from its members, is subject to examination by the insurance commissioner of the state in which the manager's principal business office is located.

VIII. "
Reinsurer
" means a person, firm, association or corporation duly licensed in this state pursuant to the applicable provisions of the insurance law as an insurer with the authority to assume reinsurance.

IX. "To be in violation" means that the reinsurance intermediary, insurer or reinsurer for whom the reinsurance intermediary was acting failed to substantially comply with the provisions of this chapter.

X. "Qualified U.S. financial institution" means an institution that:

(a) Is organized or, in the case of a U.S. office of a foreign banking organization, licensed, under the laws of the United States or any state thereof;

(b) Is regulated, supervised and examined by U.S. federal or state authorities having regulatory authority over banks and trust companies; and

(c) Has been determined by either the commissioner, or the Securities Valuation Office of the National Association of Insurance Commissioners, to meet such standards of financial condition and standing as are considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit shall be acceptable to the commissioner.


Source. 1991, 200:1. 1993, 254:6. 2007, 255:1, eff. Jan. 1, 2008.

    402-F:10-a Reciprocity. 

I. The insurance commissioner shall waive any requirements for a nonresident license application with a valid license from the applicant's home state, except the requirements imposed by RSA 402-F:2, if the applicant's home state awards nonresident licenses to residents of this state on the same basis.

II. A nonresident reinsurance intermediary's satisfaction of any applicable home state continuing education requirements, if any, for licenses as insurance producers or reinsurance intermediaries shall constitute satisfaction of the state's continuing education requirements if the nonresident producer's home state recognizes the satisfaction of its continuing education requirements imposed upon producers or reinsurance intermediaries from this state on the same basis.


Source. 2007, 255:5, eff. Jan. 1, 2008.

    402-F:10-b Service of Process. 

A reinsurance intermediary, by accepting licensure in this state, is deemed to have consented to the jurisdiction of the commissioner and the courts of this state with respect to all activities conducted under the license, and to have designated the commissioner as its agent for service of process. Each licensed reinsurance intermediary shall furnish the commissioner with the name and address of a designated contact resident of this state to whom notices or orders of the commissioner or process affecting the reinsurance intermediary may be forwarded. The licensee shall promptly notify the commissioner in writing of every change in this designated contact for service of process, and such changes shall not become effective until acknowledged by the commissioner.


Source. 2007, 255:5, eff. Jan. 1, 2008.

    402-F:10 Penalties and Liabilities. 

I. If the commissioner determines that the reinsurance intermediary or any other person has not materially complied with this chapter, or any rule or order adopted under this chapter, after notice and opportunity to be heard, the commissioner may order:

(a) For each separate violation, a civil penalty in an amount not exceeding $5,000.

(b) Revocation or suspension of the reinsurance intermediary's license; and

(c) If it was found that because of such material non-compliance that the insurer or reinsurer has suffered any loss or damage, the commissioner may maintain a civil action brought by or on behalf of the reinsurer or insurer and its policyholders and creditors for recovery of compensatory damages for the benefit of the reinsurer or insurer and its policyholders and creditors or seek other appropriate relief.

II. If an order of rehabilitation or liquidation of the insurer has been entered pursuant to RSA 402-C, and the receiver appointed under that order determines that the reinsurance intermediary or any other person has not materially complied with this chapter, or any rule or order promulgated under this chapter, and the insurer suffered any loss or damage therefrom, the receiver may maintain a civil action for recovery of damages or other appropriate sanctions for the benefit of the insurer.

III. Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided in the insurance laws.

IV. Nothing contained in this chapter shall in any manner limit or restrict the rights of policyholders, claimants, creditors, or other third parties or confer any rights to such persons.


Source. 1991, 200:1. 1997, 284:10. 2005, 206:5. 2007, 255:4, eff. Jan. 1, 2008.

    402-F:11 Rulemaking. 

The commissioner may adopt rules, under RSA 541-A which are reasonable and necessary for the implementation and administration of this chapter, relative to:

I. Qualifications and application review procedures for licensure under RSA 402-F:2.

II. License suspension and revocation procedures.

III. Procedures for inspecting books, accounts, and records, under RSA 402-F:9.

IV. Hearings, appeals, and enforcement procedures.

V. [Repealed.]


Source. 1991, 200:1. 2002, 207:29. 2012, 171:26, XIX, eff. Aug. 10, 2012.

    402-F:12 Other Applicable Provisions. 

The provisions of title XXXVII apply to reinsurance intermediaries.


Source. 1997, 284:11, eff. Jan. 1, 1998.

    402-F:2 Licensure. 

I. No person, firm, association or corporation shall act as an RB in this state if the RB maintains an office either directly or as a member or employee of a firm or association, or an officer, director or employee of a corporation:

(a) In this state, unless the RB is a licensed producer or reinsurance intermediary in this state; or

(b) In another state, unless the RB is a licensed producer or reinsurance intermediary in this state or another state having a law substantially similar to this law.

II. No person, firm, association or corporation shall act as an RM:

(a) For a reinsurer domiciled in this state, unless the RM is a licensed producer or reinsurance intermediary in this state.

(b) In this state, if the RM maintains an office either directly or as a member or employee of a firm or association, or an officer, director or employee of a corporation in this state, unless the RM is a licensed producer or reinsurance intermediary in this state.

III. The commissioner may require a resident RM subject to paragraph II to:

(a) File a bond in an amount from an insurer acceptable to the commissioner for the protection of the reinsurer; and

(b) Maintain an errors and omissions policy in an amount acceptable to the commissioner.

IV. The commissioner may issue a reinsurance intermediary license to any person, firm, association or corporation who has complied with the requirements of this chapter. A license issued to a firm or association will authorize all the members of such firm or association and any designated employees to act as reinsurance intermediaries under the license, and all such persons shall be named in the application and any supplements to the application. A license issued to a corporation shall authorize all of the officers, and any designated employees and directors of the corporation, to act as reinsurance intermediaries on behalf of the corporation, and all such persons shall be named in the application and any supplements to the application.

V. The commissioner shall issue a nonresident reinsurance intermediary license if:

(a) The person is currently licensed as a resident reinsurance intermediary or insurance producer and in good standing in his or her home state.

(b) The person has submitted the proper request for licensure and has paid the fees required by RSA 400-A:29.

(c) The person has submitted or transmitted to the insurance commissioner the application for licensure that the person submitted to his or her home state, or in lieu of that application, a completed application deemed appropriate by the commissioner.

(d) The person's home state awards nonresident licenses to residents of this state on the same basis.

VI. The commissioner may refuse to issue a reinsurance intermediary license if, in his or her judgment, the applicant, anyone named on the application, or any member, principal, officer or director of the applicant, is not trustworthy, or that any controlling person of such applicant is not trustworthy to act as a reinsurance intermediary, or that any of the foregoing has given cause for revocation or suspension of such license, or has failed to comply with any prerequisite for the issuance of such license. Upon written request, the commissioner shall furnish a summary of the basis for refusal to issue a license, which document shall be privileged and not subject to RSA 91-A.

VII. Licensed attorneys at law of this state when acting in their professional capacity as such shall be exempt from this section.


Source. 1991, 200:1. 1993, 254:7. 1997, 284:7. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:3 Required Contract Provisions;  Reinsurance Intermediary-Brokers. 

Transactions between an RB and the insurer it represents in such capacity shall only be entered into pursuant to a written authorization, specifying the responsibilities of each party. The authorization shall, at a minimum, provide that:

I. The insurer may terminate the RB's authority at any time.

II. The RB shall render accounts to the insurer accurately detailing all material transactions, including information necessary to support all commissions, charges and other fees received by, or owing, to the RB, and remit all funds due to the insurer within 30 days of receipt.

III. All funds collected for the insurer's account shall be held by the RB in a fiduciary capacity in a bank that is a qualified U.S. financial institution, as defined in RSA 402-F:1, X.

IV. The RB shall comply with the written standards established by the insurer for the cession or retrocession of all risks.

V. The RB shall disclose to the insurer any relationship with any reinsurer to which business will be ceded or retroceded.

VI. The RB shall comply with RSA 402-F:4.


Source. 1991, 200:1. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:4 Books and Records;  Reinsurance Intermediary-Brokers. 

I. For at least 10 years after expiration of each contract of reinsurance transacted by the RB, the RB shall keep a complete record for each transaction showing:

(a) The type of contract, limits, underwriting restrictions, classes or risks and territory.

(b) Period of coverage, including effective and expiration dates, cancellation provisions and notice required of cancellation.

(c) Reporting and settlement requirements of balances.

(d) Rates used to compute the reinsurance premium.

(e) Names and addresses of assuming reinsurers.

(f) Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the RB.

(g) Related correspondence and memoranda.

(h) Proof of placement.

(i) Details regarding retrocessions handled by the RB, including the identity of retrocessionaires and percentage of each contract assumed or ceded.

(j) Financial records, including but not limited to, premium and loss accounts.

(k) When the RB procures a reinsurance contract on behalf of a licensed ceding insurer:

(1) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or

(2) If placed through a representative of the assuming reinsurer, other than an employee, written evidence that such reinsurer has delegated binding authority to the representative.

II. The insurer shall have access and the right to copy and audit all accounts and records maintained by the RB related to its business in a form usable by the insurer.


Source. 1991, 200:1. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:5 Duties of Insurers Utilizing the Services of a Reinsurance Intermediary-Broker. 

I. An insurer shall not engage the services of any person, firm, association or corporation to act as an RB on its behalf, unless the person is licensed as required by RSA 402-F:2, I.

II. An insurer may not employ an individual who is employed by an RB with which it transacts business, unless the RB is under common control with the insurer and subject to RSA 401-B.

III. The insurer shall annually obtain a copy of statements of the financial condition of each RB with which it transacts business.


Source. 1991, 200:1. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:6 Required Contract Provisions;  Reinsurance Intermediary-Managers. 

Transactions between an RM and the reinsurer it represents in such capacity shall only be entered into pursuant to a written contract, specifying the responsibilities of each party, which shall be approved by the reinsurer's board of directors. At least 30 days before such reinsurer assumes or cedes business through the producer, a true copy of the approved contract shall be filed with the commissioner for approval. The contract shall, at a minimum, provide that:

I. The reinsurer may terminate the contract for cause upon written notice to the RM. The reinsurer may immediately suspend the authority of the RM to assume or cede business during the pendency of any dispute regarding the cause for termination.

II. The RM shall render accounts to the reinsurer accurately detailing all material transactions, including information necessary to support all commissions, charges and other fees received by, or owing to the RM, and remit all funds due under the contract to the reinsurer on not less than a monthly basis.

III. All funds collected for the reinsurer's account shall be held by the RM in a fiduciary capacity in a bank that is a qualified U.S. financial institution, as defined in RSA 402-F:1, X. The RM may retain no more than 3 months' estimated claims payments and allocated loss adjustment expenses. The RM shall maintain a separate bank account for each reinsurer that it represents.

IV. For at least 10 years after expiration of each contract of reinsurance transacted by the RM, the RM shall keep a complete record for each transaction showing:

(a) The type of contract, limits, underwriting restrictions, classes or risks and territory.

(b) Period of coverage, including effective and expiration dates, cancellation provisions and notices required of cancellation, and disposition of outstanding reserves on covered risks.

(c) Reporting and settlement requirements of balances.

(d) Rates used to compute the reinsurance premium.

(e) Names and addresses of reinsurers.

(f) Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the RM.

(g) Related correspondence and memoranda.

(h) Proof of placement.

(i) Details regarding retrocessions handled by the RM, as permitted by RSA 402-F:8, IV, including the identity of retrocessionaires and percentage of each contract assumed or ceded.

(j) Financial records, including but not limited to, premium and loss accounts.

(k) When the RM places a reinsurance contract on behalf of a ceding insurer:

(1) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or

(2) If placed through a representative of the assuming reinsurer, other than an employee, written evidence that such reinsurer has delegated binding authority to the representative.

V. The reinsurer shall have access and the right to copy all accounts and records maintained by the RM related to its business in a form usable by the reinsurer.

VI. The contract cannot be assigned in whole or in part by the RM.

VII. The RM shall comply with the written underwriting and rating standards established by the insurer for the acceptance, rejection or cession of all risks.

VIII. Rates, terms and purposes of commissions, charges and other fees which the RM may levy against the reinsurer as are set forth.

IX. If the contract permits the RM to settle claims on behalf of the reinsurer:

(a) All claims shall be reported to the reinsurer in a timely manner.

(b) A copy of the claim file shall be sent to the reinsurer at its request or as soon as it becomes known that the claim:

(1) Has the potential to exceed the lesser of an amount determined by the commissioner or the limit set by the reinsurer;

(2) Involves a coverage dispute;

(3) May exceed the RM's claims settlement authority;

(4) Is open for more than 6 months; or

(5) Is closed by payment of the lesser of an amount set by the commissioner or an amount set by the reinsurer.

(c) All claim files shall be the joint property of the reinsurer and the RM. However, upon an order of liquidation of the reinsurer such files shall become the sole property of the reinsurer or its estate, and the RM shall have reasonable access to and the right to copy the files on a timely basis.

(d) Any settlement authority granted to the RM may be terminated for cause upon the reinsurer's written notice to the RM or upon the termination of the contract. The reinsurer may suspend the settlement authority during the pendency of the dispute regarding the cause of termination.

X. If the contract provides for a sharing of interim profits by the RM, interim profits shall not be paid until one year after the end of each underwriting period for property business and 5 years after the end of each underwriting period for casualty business, or a later period set by the commissioner for specified lines of insurance, and not until the adequacy of reserves on remaining claims has been verified pursuant to RSA 402-F:8, III.

XI. The RM shall annually provide the reinsurer with a statement of its financial condition prepared by an independent certified accountant.

XII. The reinsurer shall periodically, at least semi-annually, conduct an on-site review of the underwriting and claims processing operation of the RM.

XIII. The RM shall disclose to the reinsurer any relationship it has with any insurer prior to ceding or assuming any business with such insurer pursuant to this contract.

XIV. Within the scope of its actual or apparent authority, the acts of the RM shall be deemed to be the acts of the reinsurer on whose behalf it is acting.


Source. 1991, 200:1. 1997, 284:8. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:7 Prohibited Acts. 

The RM shall not:

I. Cede retrocessions on behalf of the reinsurer, except that the RM may cede facultative retrocessions pursuant to obligatory facultative agreements if the contract with the reinsurer contains reinsurance underwriting guidelines for such retrocession. The guidelines shall include a list of reinsurers with which such automatic agreements are in effect, and for each such reinsurer, the coverages and amounts or percentages that may be reinsured, and commission schedules.

II. Commit the reinsurer to participate in reinsurance syndicates.

III. Appoint any producer without assuring that the producer is lawfully licensed to transact the type of reinsurance for which he or she is appointed.

IV. Without prior approval of the reinsurer, pay or commit the reinsurer to pay a claim, net of retrocessions, that exceeds the lesser of an amount specified by the reinsurer or one percent of the reinsurer's policyholders' surplus as of December 31 of the last complete calendar year.

V. Collect any payment from a retrocessionaire or commit the reinsurer to any claim settlement with a retrocessionaire, without prior approval of the reinsurer. If prior approval is given, a report must be promptly forwarded to the reinsurer.

VI. Jointly employ an individual who is employed by the reinsurer unless such RM is under common control with the reinsurer subject to RSA 401-B.

VII. Appoint a sub-RM.


Source. 1991, 200:1. 1993, 254:8. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:8 Duties of Reinsurers Utilizing the Services of an RM. 

I. A reinsurer shall not engage the services of any person, firm, association or corporation to act as an RM on its behalf unless the person is licensed as required by RSA 402-F:2.

II. The reinsurer shall annually obtain a copy of statements of the financial condition of each RM which such reinsurer has engaged prepared by an independent certified accountant in a form acceptable to the commissioner.

III. If an RM establishes loss reserves, the reinsurer shall annually obtain the opinion of an actuary attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the RM. This opinion shall be in addition to any other required loss reserve certification.

IV. Binding authority for all retrocessional contracts or participation in reinsurance syndicates shall rest with an officer of the reinsurer who shall not be affiliated with the RM.

V. Within 30 days of termination of a contract with an RM, the reinsurer shall provide written notification of termination to the commissioner.

VI. A reinsurer shall not appoint to its board of directors any officer, director, employee, controlling shareholder or subproducer of its RM. This paragraph shall not apply to relationships governed by RSA 401-B.


Source. 1991, 200:1. 2007, 255:2, eff. Jan. 1, 2008.

    402-F:9-a Compliance With Orders. 

I. An RB or RM shall comply with any order of a court of competent jurisdiction or a duly constituted arbitration panel requiring the production of non-privileged documents by the RB or RM, or the testimony of an employee or other individual otherwise under the control of the RB or RM with respect to any reinsurance transaction for which it acted as an RB or RM.

II. Compliance shall be subject to the right of the RB or RM, and the parties to the reinsurance transaction, to object to the court or arbitration panel concerning the nature or scope of the documents or testimony or the time within which it must comply with the order. Failure to comply with the order shall be deemed to be a material non-compliance with this chapter. However, in no event shall this section be construed to require more than one appearance by the same witness in a single action or arbitration.


Source. 2007, 255:3, eff. Jan. 1, 2008.

    402-F:9 Examination Authority. 

I. A reinsurance intermediary shall be subject to examination by the commissioner. The commissioner shall have access to all books, bank accounts and records of the reinsurance intermediary in a form usable to the commissioner.

II. An RM may be examined as if it were the reinsurer.


Source. 1991, 200:1. 1993, 254:9. 1997, 284:9. 2007, 255:2, eff. Jan. 1, 2008.

    402-G:1 Definitions. 

In this chapter:

I. "Accredited state" means a state in which the insurance department or regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established from time to time by the National Association of Insurance Commissioners (NAIC).

II. "Control" or "controlled" means "control" as defined in RSA 401-B:1, III.

III. "Controlled insurer" means a licensed insurer which is controlled, directly or indirectly, by a producer.

IV. "Controlling producer" means a producer who, directly or indirectly, controls an insurer.

V. "Licensed insurer" or "insurer" means any person, firm, association, or corporation duly licensed to transact a property/casualty insurance business in this state. The following, among others, are not licensed insurers for the purposes of this chapter:

(a) All risk retention groups as defined in the Superfund Amendments Reauthorization Act of 1986, Pub. L. No. 99-499, 100 Stat. 1613 (1986) and the Risk Retention Act, 15 U.S.C. section 3901 et seq. (1982 __ampersand__ Supp. 1986) and RSA 405-A;

(b) All residual market pools and joint underwriting authorities or associations; and

(c) All captive insurers which, for the purposes of this chapter, are insurance companies owned by another organization whose exclusive purpose is to insure risks of the parent organization and affiliated companies or, in the case of groups and associations, insurance organizations owned by the insureds whose exclusive purpose is to insure risks to member organizations or group members, or both, and their affiliates.

VI. "Producer" means an insurance broker or brokers or any other person, firm, association or corporation, when, for any compensation, commission or other thing of value, such person, firm, association or corporation acts or aids in any manner in soliciting, negotiating, or procuring the making of any insurance contract on behalf of an insured other than the person, firm, association, or corporation.


Source. 1992, 288:15. 1993, 254:10, eff. Jan. 1, 1994.

    402-G:2 Applicability. 

This chapter shall apply to licensed insurers, as defined in RSA 402-G:1, V, either domiciled in this state or domiciled in a state that is not an accredited state having in effect a substantially similar law. All provisions of RSA 401-B, to the extent they are not superseded by this chapter, shall continue to apply to all parties within holding company systems subject to the chapter.


Source. 1992, 288:15, eff. Jan. 1, 1993.

    402-G:3 Minimum Standards;  Required Contract Provisions. 

I. Applicability of section:

(a) The provisions of this section shall apply if, in any calendar year, the aggregate amount of gross written premium on business placed with a controlled insurer by a controlling producer is equal to or greater than 5 percent of the admitted assets of the controlled insurer, as reported in the controlled insurer's quarterly statement filed as of September 30 of the prior year.

(b) Notwithstanding subparagraph I(a), the provisions of this section shall not apply if:

(1) The controlling producer:

(A) Places insurance only with the controlled insurer, or only with the controlled insurer and a member or members of the controlled insurer's holding company system, or the controlled insurer's parent, affiliate, or subsidiary and receives no compensation based upon the amount of premiums written in connection with such insurance; and

(B) Accepts insurance placements only from non-affiliated subproducers, and not directly from insureds; and

(2) The controlled insurer, except for insurance business written through a residual market facility, accepts insurance business only from a controlling producer, a producer controlled by the controlled insurer, or a producer that is a subsidiary of the controlled insurer.

II. A controlled insurer shall not accept business from a controlling producer and a controlling producer shall not place business with a controlled insurer unless there is a written contract between the controlling producer and the insurer specifying the responsibilities of each party, which contract has been approved by the board of directors of the insurer and contains the following minimum provisions:

(a) The controlled insurer may terminate the contract for cause, upon written notice to the controlling producer. The controlled insurer shall suspend the authority of the controlling producer to write business during the pendency of any dispute regarding the cause for the termination.

(b) The controlling producer shall render accounts to the controlled insurer detailing all material transactions, including information necessary to support all commissions, charges and other fees received by, or owing to, the controlling producer.

(c) The controlling producer shall remit all funds due under the terms of the contract to the controlled insurer on at least a monthly basis. The due date shall be fixed so that premiums or installments thereof collected shall be remitted no later than 90 days after the effective date of any policy placed with the controlled insurer under this contract.

(d) All funds collected for the controlled insurer's account shall be held by the controlling producer in a fiduciary capacity, in one or more appropriately identified bank accounts in banks that are members of the Federal Reserve System, in accordance with the provisions of the insurance law as applicable. However, funds of a controlling producer not required to be licensed in this state shall be maintained in compliance with the requirements of the controlling producer's domiciliary jurisdiction.

(e) The controlling producer shall maintain separately identifiable records of business written for the controlled insurer.

(f) The contract shall not be assigned in whole or in part by the controlling producer.

(g) The controlled insurer shall provide the controlling producer with its underwriting standards, rules and procedures, manuals setting forth the rates to be charged, and the conditions for the acceptance or rejection of risks. The controlling producer shall adhere to the standards, rules, procedures, rates, and conditions. The standards, rules, procedures, rates, and conditions shall be the same as those applicable to comparable business placed with the controlled insurer by a producer other than the controlling producer.

(h) The rates and terms of the controlling producer's commissions, charges, or other fees and the purposes for those charges or fees. The rates of the commissions, charges, and other fees shall be no greater than those applicable to comparable business placed with the controlled insurer by producers other than controlling producers. For purposes of this subparagraph and subparagraph II(a) of this section, examples of "comparable business" includes the same lines of insurance, same kinds of insurance, same kinds of risks, similar policy limits, and similar quality of business.

(i) If the contract provides that the controlling producer, on insurance business placed with the insurer, is to be compensated contingent upon the insurer's profits on that business, then such compensation shall not be determined and paid until at least 5 years after the premiums on liability insurance are earned and at least 1 year after the premiums are earned on any other insurance. In no event shall the commissions be paid until the adequacy of the controlled insurer's reserves on remaining claims has been independently verified pursuant to paragraph IV of this section.

(j) A limit on the controlling producer's writings in relation to the controlled insurer's surplus and total writings. The insurer may establish a different limit for each line or sub-line of business. The controlled insurer shall notify the controlling producer when the applicable limit is approached and shall not accept business from the controlling producer if the limit is reached. The controlling producer shall not place business with the controlled insurer if it has been notified by the controlled insurer that the limit has been reached.

(k) The controlling producer may negotiate but shall not bind reinsurance on behalf of the controlled insurer on business the controlling producer places with the controlled insurer, except that the controlling producer may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the controlled insurer contains underwriting guidelines including, for both reinsurance assumed, and ceded, a list of reinsurers with which such automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured and commission schedules.

III. Every controlled insurer shall have an audit committee of the board of directors composed of independent directors. The audit committee shall annually meet with management, the insurer's independent certified public accountants, and an independent casualty actuary or other independent loss reserve specialist acceptable to the commissioner to review the adequacy of the insurer's loss reserves.

IV. Reporting requirements are as follows:

(a) In addition to any other required loss reserve certification, the controlled insurer shall file annually, on April 1 of each year, with the commissioner an opinion of an independent casualty actuary, or such other independent loss reserve specialist acceptable to the commissioner, reporting loss ratios for each line of business written and attesting to the adequacy of loss reserves established for losses incurred and outstanding as of year-end, including incurred but not reported, on business placed by the producer; and

(b) The controlled insurer shall annually report to the commissioner the amount of commissions paid to the producer, the percentage such amount represents of the net premiums written, and comparable amounts and percentage paid to noncontrolling producers for placements of the same kinds of insurance.


Source. 1992, 288:15, eff. Jan. 1, 1993.

    402-G:4 Disclosure. 

The producer, prior to the effective date of the policy, shall deliver written notice to the prospective insured disclosing the relationship between the producer and the controlled insurer, except that, if the business is placed through a subproducer who is not a controlling producer, the controlling producer shall retain in his records a signed commitment from the subproducer that the subproducer is aware of the relationship between the insurer and the producer and that the subproducer has or will notify the insured.


Source. 1992, 288:15, eff. Jan. 1, 1993.

    402-G:5 Penalties. 

I. (a) If the commissioner believes that the controlling producer or any other person has not materially complied with this chapter, or any rule adopted or order issued under this chapter, after notice and opportunity to be heard, the commissioner may order the controlling producer to cease placing business with the controlled insurer; and

(b) If it was found that because of such material non-compliance that the controlled insurer or any policyholder thereof has suffered any loss or damage, the commissioner may maintain a civil action or intervene in an action brought by or on behalf of the insurer or policyholder for recovery of compensatory damages for the benefit of the insurer or policyholder or other appropriate relief.

II. If an order for liquidation or rehabilitation of the controlled insurer has been entered pursuant to RSA 402-C, and the receiver appointed under that order believes that the controlling producer or any other person has not materially complied with this chapter, or any rule adopted or order issued under this chapter, and the insurer suffered any loss or damage therefrom, the receiver may maintain a civil action for recovery of damages or other appropriate sanctions for the benefit of the insurer.

III. Nothing contained in this section shall affect the right of the commissioner to impose any other penalties provided for in the insurance laws.

IV. Nothing contained in this section is intended to or shall in any manner alter or affect the rights of policyholders, claimants, creditors or other third parties.


Source. 1992, 288:15, eff. Jan. 1, 1993.

    402-H:1 Definitions. 

I. "
Administrator
" or "
third party administrator
" or "
TPA
" means a person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, in connection with life, annuity, or health coverage or property and casualty insurance, except any of the following:

(a) An employer, or a wholly owned direct or indirect subsidiary of an employer, on behalf of its employees or the employees of one or more subsidiaries or affiliated corporations of such employer.

(b) A union on behalf of its members.

(c) An insurer that is authorized to transact insurance in this state pursuant to RSA 401 or a subsidiary or affiliated corporation of such insurer if the insurer and the subsidiary or affiliated corporation have overlapping directorates.

(d) An insurance producer licensed to sell life, annuities, or health coverage or property and casualty insurance in this state, whose activities are limited exclusively to the sale of insurance.

(e) A creditor on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors.

(f) A trust and its trustees, agents, and employees acting pursuant to such trust established in conformity with 29 U.S.C. section 186.

(g) A trust exempt from taxation under section 501(a) of the Internal Revenue Code, its trustees and employees acting pursuant to such trust, or a custodian and the custodian's agents or employees acting pursuant to a custodian account which meets the requirements of section 401(f) of the Internal Revenue Code.

(h) A credit union or a financial institution that is subject to supervision or examination by federal or state banking authorities, or a mortgage lender, to the extent they collect and remit premiums to licensed insurance producers or to limited line producers or authorized insurers in connection with loan payments.

(i) A credit card issuing company that advances for and collects insurance premiums or charges from its credit card holders who have authorized collection.

(j) A person who adjusts or settles claims in the normal course of that person's practice or employment as an attorney at law and who does not collect charges or premiums in connection with life, annuity, or health coverage or property and casualty insurance.

(k) An adjuster licensed by this state whose activities are limited to adjustment of claims.

(l) A person licensed as a managing general agent in this state, pursuant to RSA 402-E, whose activities are limited exclusively to the scope of activities conveyed under such license.

(m) An administrator who is affiliated with an insurer and who only performs the contractual duties, between the administrator and the insurer, of an administrator for the direct and assumed insurance business of the affiliated insurer. The insurer is responsible for the acts of the administrator and is responsible for providing all of the administrator's books and records to the insurance commissioner, upon request from the insurance commissioner. For purposes of this subparagraph, "
insurer
" means a licensed insurance company, prepaid hospital or medical care plan, or a health maintenance organization.

II. "
Affiliate
" or "
affiliated
" means any entity or person who directly, or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person.

III. "
Commissioner
" means the commissioner of insurance.

IV. "
Control
" means "control" as defined in RSA 401-B:1, III.

V. "
GAAP
" means United States generally accepted accounting principles consistently applied.

VI. "
Insurance producer
" means a person who sells, solicits, or negotiates a contract of insurance as those terms are defined in this chapter.

VII. "
Insurer
" means, for the purposes of this chapter only and except as provided in RSA 402-H:6, a person undertaking to provide life, annuity, or health coverage or property and casualty insurance or self-funded coverage under a multiple employer welfare arrangement or a church plan in this state. For the purposes of this chapter, "
insurer
" may include an employer, a licensed insurance company, a prepaid hospital or medical care plan, or a health maintenance organization.

VIII. "
Negotiate
" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract; provided, that the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers.

IX. "
Overlapping directorates
" as applied to insurers and subsidiaries or affiliated corporations means that an insurer and a subsidiary or affiliated corporation of such insurer share a majority of their board of directors and officers.

X. "
Person
" means an individual or a business entity.

XI. "
Sell
" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

XII. "
Solicit
" means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company.

XIII. "
Underwrites
" or "
underwriting
" means, but is not limited to, the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer or self-funded plan for the overall planning and coordinating of a benefits program.


Source. 1993, 253:1. 1995, 161:2, 4. 1998, 159:1. 2006, 271:1, eff. Aug. 8, 2006. 2021, 50:3, 4, eff. July 24, 2021.

    402-H:10 Delivery of Materials to Covered Individuals. 

Any policies, certificates, booklets, termination notices or other written communications delivered by the insurer to the administrator for delivery to insured parties or covered individuals shall be delivered by the administrator promptly after receipt of instructions from the insurer to deliver them.


Source. 1993, 253:1, eff. Jan. 1, 1994.

    402-H:11-a Registration Requirement. 

A person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, and who is not otherwise required to obtain a certificate of authority or license in connection with life, annuity, or health coverage provided by a self-funded plan shall register with the commissioner by March 1 of each year, verifying its status as herein described. The registration requirement shall not apply to those persons or entities that are specifically exempted by RSA 402-H:1, I. Registrants under this section shall not be required to hold a certificate of authority as an administrator in this state or to meet the other requirements of this chapter.


Source. 2006, 271:9, eff. Aug. 8, 2006.

    402-H:11-b Exemption. 

An association administering a pooled risk management program operated pursuant to RSA 5-B or conducting business that is exempt from taxation under the Internal Revenue Code, section 115 shall not be required to obtain a certificate of authority or to meet the other requirements of this chapter for services provided in connection with the administration of its pooled risk management plans or its section 115 business, but shall be required to register with the commissioner pursuant to RSA 402-H:11-a. Pooled risk management program registration may be accomplished by providing the commissioner a copy of the informational filing required to be filed with the department of state pursuant to RSA 5-B:4.


Source. 2006, 271:9, eff. Aug. 8, 2006.

    402-H:11 Certificate of Authority Required. 

I. No person shall act as, or offer to act as, or hold himself or herself out to be an administrator in this state without a valid certificate of authority as an administrator issued by the commissioner.

II. Applicants to be an administrator shall make an application to the commissioner upon a form to be furnished by the commissioner and fee paid pursuant to RSA 400-A:29, I(a). The application shall include or be accompanied by the following information and documents:

(a) All basic organizational documents of the administrator, including any articles of incorporation, articles of association, partnership agreement, trade name certificate, trust agreement, shareholder agreement and other applicable documents and all amendments to such documents.

(b) The bylaws, rules, regulations or similar documents regulating the internal affairs of the administrator.

(c) NAIC biographical affidavit for the individuals who are responsible for the conduct of affairs of the administrator; including all members of the board of directors, board of trustees, executive committee or other governing board or committee; the principal officers in the case of a corporation or the partners or members in the case of a partnership, association or limited liability company; any shareholder or member holding directly or indirectly 10 percent or more of the voting stock, voting securities, or voting interest of the administrator; and any other person who exercise control or influence over the affairs of the administrator.

(1) Audited financial statements or reports for the 2 most recent fiscal years that prove that the administrator has a positive net worth. If the administrator has been in existence for less than 2 fiscal years, the application shall include financial statements or reports, certified by an officer of the administrator and prepared in accordance with GAAP, for any completed fiscal years, and for any month during the current fiscal year for which such financial statements or reports have been completed. An audited financial/annual report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:

(A) Amounts shown on the consolidated audited financial report shall be shown on the worksheet.

(B) Amounts for each entity shall be stated separately.

(C) Explanations of consolidating and eliminating entries shall be included.

(2) The administrator shall also include such other information as the commissioner may require in order to review the current financial condition of the applicant.

(e) A statement describing the business plan, including information of staffing levels and activities proposed in this state and nationwide. The plan shall provide details setting forth the administrator's capability for providing a sufficient number of experienced and qualified personnel in the areas of claims processing, recordkeeping and underwriting.

(f) An administrator that intends to directly solicit insurance contracts or to otherwise act as an insurance producer shall provide proof that it has a license as a producer in this state.

(g) Contact information for a designated agent in this state for service of process.

(h) Such other pertinent information as may be required by the commissioner.

III. An administrator licensed or applying for licensure under this section shall make available for inspection by the commissioner copies of all contracts with insurers or other persons utilizing the services of the administrator.

IV. An administrator licensed or applying for licensure under this section shall produce its accounts, records, and files for examination, and make its officers available to give information with respect to its affairs, as often as reasonably required by the commissioner.

V. The commissioner may refuse to issue a certificate of authority or license if the commissioner determines that the administrator, or any individual responsible for the conduct of affairs of the administrator, is not competent, trustworthy, financially responsible or of good personal and business reputation, or has had an insurance or an administrator certificate of authority or license denied or revoked for cause by any jurisdiction, or if the commissioner determines that any of the grounds set forth in RSA 402-H:14 exists with respect to the administrator.

VI. A certificate of authority issued under this section shall remain valid, unless surrendered, suspended or revoked by the commissioner until June 14 of each year. On June 14 of each year such certificate of authority may be renewed upon the filing of a renewal application together with the renewal fee under RSA 400-A: 29, and so long as the administrator continues in business in this state and remains in compliance with this chapter.

VII. An administrator licensed or applying for licensure under this section shall immediately notify the commissioner of any material change in its ownership, control, or other fact or circumstance affecting its qualification for a certificate of authority or license in this state. The commissioner shall record any such changes in the department's records.

VIII. An administrator licensed or applying for a certificate of authority that administers or will administer benefit plans that are fully insured by an insurer that is not licensed in this state, multiple employer welfare arrangements, or church self-insured plans shall maintain a surety bond for the use and benefit of the commissioner that covers individuals and persons in New Hampshire who have remitted premiums or insurance charges or other moneys to the administrator in the course of the administrator's business in the greater of $100,000 or 10 percent of the administrator's average daily client account balance during the preceding calendar year. However, in no event shall the bond be more than $1,000,000. If an administrator cannot obtain a bond, then another security, including, but not limited to, cash or negotiable securities in an amount equal to the amount of the required surety bond shall be set aside in one or more trusteed bank accounts in the state of New Hampshire under trust terms that require the commissioner's signature for any account activity, except the accumulation of interest or other funds into the account, and that allows the commissioner, by order, to disburse the trust funds for the satisfaction of policyholder or customer claims.


Source. 1993, 253:1. 2006, 271:8, eff. Aug. 8, 2006. 2022, 42:5, eff. July 2, 2022.

    402-H:12 Annual Report and Filing Fee. 

I. (a) Each licensed administrator shall file an annual report for the preceding calendar year with the commissioner on or before June 1 of each year, or within such extension of time as the commissioner for good cause may grant. The annual report shall include an audited financial statement performed by an independent certified public accountant. An audited financial/annual report prepared on a consolidated basis shall include a columnar consolidating or combining worksheet that shall be filed with the report and include the following:

(1) Amounts shown on the consolidated audited financial report shall be shown on the worksheet;

(2) Amounts for each entity shall be stated separately; and

(3) Explanations of consolidating and eliminating entries shall be included.

(b) The report shall be in the form and contain such matters as the commissioner prescribes and shall be verified by at least 2 officers of the administrator.

II. The annual report shall include the complete names and addresses of all insurers with which the administrator had agreements during the preceding fiscal year.

III. At the time of filing its annual report, the administrator shall pay a filing fee pursuant to RSA 400-A:29, III.


Source. 1993, 253:1. 2006, 271:10, eff. Aug. 8, 2006.

    402-H:13 Examination and Audits. 

The acts of the administrator are considered to be the acts of the insurer on whose behalf it is acting. An administrator may be examined as if it were the insurer. The commissioner may designate examiners or consultants, as appropriate, to perform an audit of an administrator when the commissioner considers an audit necessary. The audit shall be conducted at the expense of the administrator. Administrators shall make all records and books of account available to the examiners or consultants, and shall otherwise facilitate the performance of the audit. All claims information respecting the identities of individual claimants shall be kept confidential.


Source. 1993, 253:1. 1997, 284:13. 2006, 271:11, eff. Aug. 8, 2006.

    402-H:14 Grounds for Denial, Suspension, or Revocation of Certificate of Authority. 

I. The certificate of authority or license of an administrator shall be denied, suspended, or revoked if the commissioner finds that the administrator:

(a) Is in an unsound financial condition.

(b) Is using such methods or practices in the conduct of its business so as to render its further transaction of business in this state hazardous or injurious to insured persons or the public.

(c) Has failed to pay any judgment rendered against it in this state within 60 days after the judgment has become final.

II. The commissioner may deny, suspend, or revoke the certificate of authority or license of an administrator if the commissioner finds that the administrator:

(a) Has violated any lawful rule or order of the commissioner or any provision of the insurance laws of this state.

(b) Has refused to be examined or to produce its accounts, records and files for examination, or if any individual responsible for the conduct of affairs of the administrator, including members of the board of directors, board of trustees, executive committee, or other governing board or committee; the principal officers in the case of a corporation or the partners or members in the case of a partnership, association, or limited liability company; any shareholder or member holding directly or indirectly 10 percent or more of the voting stock, voting securities, or voting interest of the administrator; and any other person who exercises control or influence over the affairs of the administrator; has refused to give information with respect to its affairs or has refused to perform any other legal obligation as to such examination, when required by the commissioner.

(c) Has, without just cause, refused to pay proper claims or perform services arising under its contracts or has, without just cause, caused covered individuals to accept less than the amount due them or caused covered individuals to employ attorneys or bring suit against the administrator to secure full payment or settlement of such claims.

(d) At any time fails to meet any qualification for which issuance of the certificate could have been refused had such failure then existed and been known to the commissioner.

(e) Or any of the individuals responsible for the conduct of its affairs, including members of the board of directors, board of trustees, executive committee, or other governing board or committee; the principal officers in the case of a corporation or the partners or members in the case of a partnership, association, or limited liability company; any shareholder or member holding directly or indirectly 10 percent or more of its voting stock, voting securities, or voting interest; and any other person who exercises control or influence over its affairs; has been convicted of, or has entered a plea of guilty or nolo contendere to, a felony without regard to whether adjudication was withheld.

(f) Is under suspension or revocation in another state.

(g) Has failed to timely file its annual report.

III. The commissioner may, without advance notice or hearing, immediately suspend the certificate of authority or license of an administrator if the commissioner finds that one or more of the following circumstances exist:

(a) The administrator is insolvent or impaired.

(b) A proceeding for receivership, conservatorship, rehabilitation, or other delinquency proceeding regarding the administrator has been commenced in any state.

(c) The financial condition or business practices of the administrator otherwise pose an imminent threat to the public health, safety or welfare of the residents of this state.

IV. If the commissioner finds that one or more grounds exist for the suspension or revocation of a certificate of authority issued under this section, the commissioner may, in lieu of suspension or revocation, impose a fine upon the administrator.


Source. 1993, 253:1. 2006, 271:12, eff. Aug. 8, 2006.

    402-H:15 Rulemaking Authority. 

The insurance commissioner shall adopt rules under RSA 541-A as may be necessary to properly administer this chapter.


Source. 1993, 253:1, eff. Jan. 1, 1994.

    402-H:16 Penalties. 

An administrator who violates or fails to comply with the provisions of this chapter or rules adopted pursuant to this chapter shall be subject to suspension or revocation of its certificate of authority or an administrative penalty not to exceed $2,500 for each violation.


Source. 1993, 253:1. 1997, 284:14, eff. Jan. 1, 1998.

    402-H:17 Repealed by 2006, 271:14 eff. Aug. 8, 2006. 

    402-H:2 Written Agreement Necessary. 

I. No administrator shall act as such without a written agreement between the administrator and the insurer and the written agreement shall be retained as part of the official records of both the insurer and the administrator for the duration of the agreement and for 5 years thereafter. The agreement shall contain all provisions required by this chapter, except insofar as those requirements do not apply to the functions performed by the administrator.

II. The written agreement shall include a statement of duties that the administrator is expected to perform on behalf of the insurer and the lines, classes or types of insurance which the administrator is to be authorized to administer. The agreement shall make provision with respect to underwriting or other standards pertaining to the business underwritten by the insurer.

III. The insurer or administrator may, with written notice, terminate the written agreement for cause as provided in the agreement. The insurer may suspend the underwriting authority of the administrator during the pendency of any dispute regarding the cause for termination of the written agreement. The insurer shall fulfill any lawful obligations with respect to policies affected by the written agreement, regardless of any dispute between the insurer and the administrator.


Source. 1993, 253:1. 2006, 271:2, eff. Aug. 8, 2006.

    402-H:3 Payment to Administrator. 

If an insurer utilizes the services of an administrator, the payment to the administrator of any premiums or charges for insurance by or on behalf of the insured party shall be deemed to have been received by the insurer, and the payment of return premiums or claim payments forwarded by the insurer to the administrator shall not be deemed to have been paid to the insured party or claimant until such payments are received by the insured party or claimant. Nothing in this section limits any right of the insurer against the administrator resulting from the failure of the administrator to make payments to the insurer, insured parties, or claimants.


Source. 1993, 253:1, eff. Jan. 1, 1994.

    402-H:4 Maintenance of Information. 

I. An administrator shall maintain and make available to the insurer complete books and records of all transactions performed on behalf of the insurer. The books and records shall be maintained in accordance with prudent standards of insurance recordkeeping and shall be maintained for a period of not less than 5 years from the date of their creation.

II. The commissioner shall have access to books and records maintained by an administrator for the purposes of examination, audit and inspection. Any documents, materials or other information in the possession or control of the commissioner that are furnished by an administrator, insurer, insurance producer or an employee or agent thereof acting on behalf of the administrator, insurer or insurance producer, or obtained by the commissioner in an investigation shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena and shall not be subject to discovery or admission in evidence in any private civil action. However, the commissioner may use such documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.

III. Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to paragraph II.

IV. In order to assist in the performance of his or her duties, the commissioner:

(a) May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to paragraph II, with other state, federal, and international regulatory agencies, with the National Association of Insurance Commissioners (NAIC), its affiliates or subsidiaries and with state, federal, and international law enforcement authorities, provided, that the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information. Such parties shall agree in writing prior to receiving the information to provide to it the same confidential treatment as required by this paragraph, unless the prior written consent of the company to which it pertains has been obtained;

(b) May receive documents, materials, or information, including otherwise confidential and privileged documents, materials, or information, from the NAIC, its affiliates or subsidiaries, and from regulatory and law enforcement officials or other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information; and

(c) May enter into agreements governing sharing and use of information consistent with this paragraph.

V. No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in paragraph IV.

VI. Nothing in this chapter shall prohibit the commissioner from releasing final, adjudicated actions including for cause terminations that are open to public inspection, pursuant to RSA 91-A, to a database or other clearinghouse service maintained by the NAIC, its affiliates or subsidiaries.

VII. The insurer shall own the records generated by the administrator pertaining to the insurer; however, the administrator shall retain the right to continuing access to books and records to permit the administrator to fulfill all of its contractual obligations to insured parties, claimants, and the insurer.

VIII. If the insurer and the administrator cancel their agreement, notwithstanding the provisions of RSA 402-H:4, I, the administrator may, by written agreement with the insurer, transfer all records to a new administrator rather than retain them for 5 years. In such cases, the new administrator shall acknowledge, in writing, that it is responsible for retaining the records of the prior administrator as required in RSA 402-H:4, I.


Source. 1993, 253:1. 2006, 271:3, eff. Aug. 8, 2006.

    402-H:5 Approval of Advertising. 

An administrator may use only advertising pertaining to the business underwritten by an insurer that has been approved in writing by the insurer in advance of its use.


Source. 1993, 253:1. 2006, 271:4, eff. Aug. 8, 2006.

    402-H:6 Responsibilities of the Insurer. 

I. If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims payment procedures applicable to the coverage and for securing reinsurance, if any. The rules pertaining to these matters shall be provided, in writing, by the insurer to the administrator. The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer.

II. It is the sole responsibility of the insurer to provide for competent administration of its programs.

III. In cases in which an administrator administers benefits for more than 100 certificate holders on behalf of an insurer, the insurer shall, at least semi-annually, conduct a review of the operations of the administrator. At least one such review shall be an on-site audit of the operations of the administrator.

IV. For purposes of this section, "
insurer
" means a licensed insurance company, prepaid hospital or medical care plan, or a health maintenance organization.


Source. 1993, 253:1. 2006, 271:5, eff. Aug. 8, 2006.

    402-H:7 Premium Collection and Payment of Claims. 

I. All insurance charges or premiums collected by an administrator on behalf of or for an insurer, and the return of premiums received from the insurer, shall be held by the administrator in a fiduciary capacity. The funds shall be immediately remitted to the person entitled to them or shall be deposited promptly in a fiduciary account established and maintained by the administrator in a federally or state insured financial institution. The written agreement between the administrator and the insurer shall provide for the administrator to periodically render an accounting to the insurer detailing all transactions performed by the administrator pertaining to the business underwritten by the insurer.

II. If charges or premiums deposited in a fiduciary account have been collected on behalf of or for one or more insurers, the administrator shall keep records clearly recording the deposits in and withdrawals from the account on behalf of each insurer. The administrator shall keep copies of all the records and, upon request of an insurer, shall furnish the insurer with copies of the records pertaining to such deposits and withdrawals.

III. The administrator shall not pay any claim by withdrawals from a fiduciary account in which premiums or charges are deposited. Withdrawals from the account shall be made as provided in the written agreement between the administrator and the insurer. The written agreement shall address, but not be limited to, the following:

(a) Remittance to an insurer entitled to remittance.

(b) Deposit in an account maintained in the name of the insurer.

(c) Transfer to and deposit in a claims-paying account, with claims to be paid as provided for in RSA 402-H:7, IV.

(d) Payment to a group policyholder for remittance to the insurer entitled to such remittance.

(e) Payment to the administrator of its commissions, fees or charges.

(f) Remittance of a return premium to the person or persons entitled to such return premium.

IV. All claims paid by the administrator from funds collected on behalf of or for an insurer shall be paid only on drafts or checks of and as authorized by the insurer, provided however that property and casualty claims may also be paid other than by draft or check, pursuant to rules adopted in accordance with RSA 281-A and RSA 417.


Source. 1993, 253:1. 1997, 284:12. 2006, 271:6. 2014, 31:5, eff. July 26, 2014.

    402-H:8 Compensation to the Administrator. 

I. An administrator shall not enter into any agreement or understanding with an insurer in which the effect is to make the amount of the administrator's commissions, fees, or charges contingent upon savings effected in the adjustment, settlement and payment of losses covered by the insurer's obligations. This provision shall not prohibit an administrator from receiving performance-based compensation for providing hospital or other auditing services.

II. This section shall not prevent the compensation of an administrator from being based on premiums or charges collected or the number of claims paid or processed.


Source. 1993, 253:1, eff. Jan. 1, 1994.

    402-H:9 Notice to Covered Individuals;  Disclosure of Charges and Fees. 

I. When the services of an administrator are utilized, the administrator shall provide a written notice approved by the insurer to covered individuals advising them of the identity of, and relationship among, the administrator, the policyholder and the insurer.

II. When an administrator collects funds, the reason for collection of each item shall be identified to the insured party and each item shall be shown separately from any premium. Additional charges may not be made for services to the extent the services have been paid for by the insurer.

III. The administrator shall disclose to the insurer all charges, fees and commissions received from all services in connection with the provision of administrative services for the insurer, including any fees or commissions paid by the insurers providing reinsurance.


Source. 1993, 253:1. 2006, 271:7, eff. Aug. 8, 2006.

    402-J:1 Purpose and Scope. 

I. This chapter governs the qualifications and procedures for the licensing of insurance producers. It simplifies and organizes some statutory language to improve efficiency and reduce costs associated with issuing and renewing insurance licenses.


[Paragraph II effective until January 1, 2023; see also paragraph II set out below.]



II. This chapter applies to all persons required to be a licensed producer pursuant to the provisions of RSA 402:15; RSA 405:15; RSA 405:24; RSA 405:44-a; RSA 405:44-b; RSA 406-C:3; RSA 407-C:3; RSA 408:42; RSA 416-A:15; RSA 418:31; RSA 420-A:7; RSA 420-B:18; RSA 420-F:3; and New Hampshire code of administrative rules Ins 2501.03.


[Paragraph II effective January 1, 2023; see also paragraph II set out above.]



II. This chapter applies to all persons required to be a licensed producer pursuant to the provisions of RSA 402:15; RSA 405:15; RSA 405:24; RSA 405:44-a; RSA 405:44-b; RSA 406-C:3; RSA 407-C:3; RSA 416-A:15; RSA 418:31; RSA 420-A:7; RSA 420-B:18; RSA 420-F:3; and New Hampshire code of administrative rules Ins 2501.03.

III. [Repealed.]


Source. 2000, 315:1. 2001, 95:1. 2005, 206:11. 2008, 18:1, II, eff. July 11, 2008. 2022, 144:6, eff. Jan. 1, 2023.

    402-J:10 Assumed Names. 

An insurance producer doing business under any name other than the producer's legal name is required to notify and obtain approval of the commissioner prior to using the assumed name.


Source. 2000, 315:1.

    402-J:11 Temporary Licensing. 

I. The commissioner may issue a temporary insurance producer license for a period not to exceed 180 days without requiring an examination if the commissioner deems that the temporary license is necessary for the servicing of an insurance business in the following cases:

(a) To a member or employee of a business entity licensed as an insurance producer, upon the death or disability of an individual designated in the business entity application or the license.

(b) To the designee of a licensed insurance producer entering active service in the armed forces of the United States of America.

(c) In any other circumstance where the commissioner deems that the public interest will best be served by the issuance of a license.

II. The commissioner may by order limit the authority of any temporary licensee in any way deemed necessary to protect insureds and the public. The commissioner may require the temporary licensee to have a suitable sponsor who is a licensed producer or insurer and who assumes responsibility for all acts of the temporary licensee and may impose other similar requirements designed to protect insureds and the public. The commissioner may by order revoke a temporary license if the interest of insureds or the public are endangered. A temporary license may not continue after the owner or the personal representative disposes of the business.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:12 License Denial, Nonrenewal, or Revocation. 

I. The commissioner may place on probation, suspend, revoke, or refuse to issue or renew an insurance producer's license, or may levy an administrative fine not to exceed $2,500 per violation, in accordance with RSA 400-A:15, III or any combination of actions for any one or more of the following causes:

(a) Providing incorrect, misleading, incomplete, or materially untrue information in the license application.

(b) Violating any insurance laws, or violating any rule, regulation, subpoena, or order of the commissioner or of another state's insurance commissioner.

(c) Obtaining or attempting to obtain a license through misrepresentation or fraud.

(d) Improperly withholding, misappropriating, or converting any moneys or properties in the course of doing insurance business.

(e) Intentionally misrepresenting the terms of an actual or proposed insurance contract or application for insurance.

(f) Having been convicted of a felony.

(g) Having admitted or been found to have committed any insurance unfair trade practice or fraud.

(h) Using fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness or financial irresponsibility in the conduct of business in this state or elsewhere.

(i) Having an insurance producer license, or its equivalent, denied, suspended, or revoked in any other state, province, district, or territory.

(j) Forging another's name to an application for insurance or to any document related to an insurance transaction.

(k) Improperly using notes or any other reference material to complete an examination for an insurance license.

(l) Knowingly accepting insurance business from an individual who is not licensed.

(m) Failing to comply with an administrative or court order imposing a child support obligation.

II. In the event that the action by the commissioner is to nonrenew or to deny an application for a license, the commissioner shall notify the applicant or licensee and advise, in writing, the applicant or licensee of the reason for the denial or nonrenewal of the applicant's or licensee's license. The applicant or licensee may make written demand upon the commissioner for a hearing before the commissioner to determine the reasonableness of the commissioner's action pursuant to RSA 400-A:17.

III. The license of a business entity may be suspended, revoked, or refused if the commissioner finds, after hearing, that an individual licensee's violation was known or should have been known by one or more of the partners, officers, or managers acting on behalf of the partnership or corporation and the violation was neither reported to the commissioner nor had any corrective action taken.

IV. In addition to or in lieu of any applicable denial, suspension, or revocation of a license, a person may, after hearing, be subject to an administrative fine pursuant to RSA 400-A:15, III.

V. The commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and title XXXVII against any person who is under investigation for or charged with a violation of this chapter or title XXXVII even if such person's license or registration has been surrendered or has lapsed by operation of law.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001. 2020, 37:48, eff. Sept. 27, 2020.

    402-J:13 Commissions. 

I. An insurance company or insurance producer shall not pay a commission, service fee, brokerage or other valuable consideration to a person for selling, soliciting, or negotiating insurance in this state if that person is required to be licensed under this chapter and is not so licensed.

II. A person shall not accept a commission, service fee, brokerage or other valuable consideration for selling, soliciting, or negotiating insurance in this state if that person is required to be licensed under this chapter and is not so licensed.

III. Renewal or other deferred commission may be paid to a person for selling, soliciting or negotiating insurance in this state if the person was required to be licensed under this chapter at the time of the sale, solicitation, or negotiation and was so licensed at that time.

IV. An insurer or insurance producer may pay or assign commissions, service fees, brokerages, or other valuable consideration to an insurance agency or to persons who do not sell, solicit, or negotiate insurance in this state, unless the payment would violate RSA 417:4, IX.


Source. 2000, 315:1.

    402-J:14 Appointments and Authority. 

I. An insurance producer shall not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed.

II. To appoint a producer as its agent, the appointing insurer shall file, in a format approved by the commissioner, a notice of appointment within 15 days from the date the agency contract is executed or the first insurance application is submitted. An insurer may also elect to appoint a producer to all or some insurers within the insurer's holding company system or group by the filing of a single appointment request.

III. An insurer shall pay an appointment fee, in the amount and method of payment set forth in RSA 400-A:29 for each insurance producer appointed by the insurer.

IV. While such producer's appointment remains in force, an insurer shall be bound by the acts of the person named therein within his or her apparent authority as its acknowledged producer.

V. No such company shall issue a policy or other evidence of insurance through an unlicensed producer or other unlicensed person. Any violation of this provision shall, after hearing, subject the insurer to an administrative fine, pursuant to RSA 400-A:15, III, and, upon repeated violations, the commissioner may suspend or revoke the license of the company.


Source. 2000, 315:1. 2001, 95:1. 2003, 144:5, eff. Jan. 1, 2004.

    402-J:15 Notification to Commissioner of Termination;  Confidentiality;  Penalties. 

I. An insurer or authorized representative of the insurer that terminates the appointment, employment, contract or other insurance business relationship with a producer shall notify the commissioner within 15 days following the effective date of the termination under RSA 402:15-c, using a format prescribed by the commissioner, if the reason for termination is one of the reasons set forth in RSA 402-J:12 or the insurer has knowledge the producer was found by a court, government body, or self-regulatory organization authorized by law, to have engaged in any of the activities in RSA 402-J:12. Upon the written request of the commissioner, the insurer shall provide additional information, documents, records, or other data pertaining to the termination or activity of the producer.

II. An insurer or authorized representative of the insurer that terminates the appointment, employment, or contract with a producer for any reason not set forth in RSA 402-J:12, shall notify the commissioner within 15 days following the effective date of the termination, using a format prescribed by the commissioner. Upon written request of the commissioner, the insurer shall provide additional information, documents, records, or other data pertaining to the termination.

III. The insurer or the authorized representative of the insurer shall promptly notify the commissioner in a format acceptable to the commissioner if, upon further review or investigation, the insurer discovers additional information that would have been reportable to the commissioner in accordance with paragraph I had the insurer then known of its existence.

IV. (a) Within 15 days after making the notification required by paragraphs I, II, and III, the insurer shall mail a copy of the notification to the producer at his or her last known address. If the producer is terminated for cause for any of the reasons listed in RSA 402-J:12, the insurer shall provide a copy of the notification to the producer at his or her last known address by certified mail, return receipt requested, postage prepaid or by overnight delivery using a nationally recognized carrier.

(b) Within 30 days after the producer has received the original or additional notification, the producer may file written comments concerning the substance of the notification with the commissioner. The producer shall, by the same means, simultaneously send a copy of the comments to the reporting insurer, and the comments shall become a part of the commissioner's file and accompany every copy of a report distributed or disclosed for any reason about the producer as permitted under RSA 402-J:15, VII.

V. (a) In the absence of actual malice, an insurer, the authorized representative of the insurer, a producer, the commissioner, or an organization of which the commissioner is a member and that compiles the information and makes it available to other insurance commissioners, or regulatory or law enforcement agencies shall not be subject to civil liability, and a civil cause of action of any nature shall not arise against these entities or their respective agents or employees, as a result of any statement or information required by or provided pursuant to this section or any information relating to any statement that may be requested in writing by the commissioner, from an insurer or producer; or a statement by a terminating insurer or producer to an insurer or producer limited solely and exclusively to whether a termination for cause under paragraph I was reported to the commissioner, provided that the propriety of any termination for cause under paragraph I is certified in writing by an officer or authorized representative of the insurer or producer terminating the relationship.

(b) In any action brought against a person that may have immunity under subparagraph V(a) for making any statement required by this section or providing any information relating to any statement that may be requested by the commissioner, the party bringing the action shall plead specifically in any allegation that subparagraph V(a) does not apply because the person making the statement or providing the information did so with actual malice.

(c) Subparagraphs V(a) and (b) shall not abrogate or modify any existing statutory or common law privileges or immunities.

VI. (a) Any documents, materials, or other information in the control or possession of the insurance department that is furnished by an insurer, producer, or an employee or agent thereof acting on behalf of the insurer or producer, or obtained by the commissioner in an investigation pursuant to this chapter shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use such documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's duties.

(b) Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to subparagraph VI(a).

(c) In order to assist in the performance of the commissioner's duties under this chapter, the commissioner may:

(1) Share documents, materials, or other information, including the confidential and privileged documents, materials, or information under subparagraph VI(a), with other state, federal, and international regulatory agencies, with the National Association of Insurance Commissioners, its affiliates or subsidiaries, and with state, federal, and international law enforcement authorities, provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material, or other information.

(2) Receive documents, materials, or information, including otherwise confidential and privileged documents, materials, or information, from the National Association of Insurance Commissioners, its affiliates or subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice of the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information; and may enter into agreements governing sharing and use of information consistent with this subparagraph.

(3) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized herein.

(d) Nothing in this chapter shall prohibit the commissioner from releasing final, adjudicated actions including for cause terminations that are open to public inspection pursuant to RSA 91-A to a database or other clearinghouse service maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries.

VII. An insurer, the authorized representative of the insurer, or producer that fails to report as required under the provisions of RSA 402-J:15 or that is found to have reported with actual malice by a court of competent jurisdiction may, after notice and hearing, have its license or certificate of authority suspended or revoked and may be fined in accordance with RSA 400-A:15, III.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:16 Reciprocity. 

I. The commissioner shall waive any requirements for a nonresident license applicant with a valid license from his or her home state except the requirements imposed by RSA 402-J:8, if the applicant's home state awards nonresident licenses to residents of this state on the same basis.

II. A nonresident producer's satisfaction of his or her home state's continuing education requirements for licensed producers shall constitute satisfaction of this state's continuing education requirements if the nonresident producer's home state recognizes the satisfaction of its continuing education requirements imposed upon producers from this state on the same basis.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:17 Reporting of Actions. 

I. A producer shall report to the commissioner any administrative action taken against the producer in another jurisdiction or by another governmental agency in this state within 30 days of the final disposition of the matter. This report shall include a copy of the order, consent to order, or other relevant legal documents.

II. Within 30 days of the initial pretrial hearing date, a producer shall report to the commissioner any criminal prosecution of the producer taken in any jurisdiction. The report shall include a copy of the initial complaint filed, the order resulting from the hearing, and any other relevant legal documents.


Source. 2000, 315:1. 2001, 95:1. 2005, 248:6, eff. Sept. 12, 2005.

    402-J:18 Rules. 

The commissioner may, in accordance with RSA 541-A, adopt reasonable rules as are necessary or proper to carry out the purpose of this chapter.


Source. 2000, 315:1.

    402-J:19 Severability. 

If any provisions of this chapter, or the application of a provision to any person or circumstances, shall be held invalid, the remainder of the chapter, and the application of the provision to persons or circumstances other than those to which it is held invalid, shall not be affected.


Source. 2000, 315:1.

    402-J:2 Definitions. 

In this chapter:

I. "
Business entity
" means a corporation, association, partnership, limited liability company or partnership, or other legal entity.

II. "
Commissioner
" means the insurance commissioner of the state of New Hampshire.

III. "
Home state
" means the District of Columbia and any state or territory of the United States in which an insurance producer maintains his or her principal place of residence or principal place of business and is licensed to act as an insurance producer.

IV. "
Insurance
" means any of the lines of authority in RSA 401:1 and RSA 401:1-a.

V. "
Insurance producer
" means a person required to be licensed under the laws of this state to sell, solicit, or negotiate insurance.

VI. "
License
" means a document issued by the commissioner authorizing a person to act as an insurance producer for the lines of authority specified in the document. The license itself does not create any authority, actual, apparent, or inherent, in the holder to represent or commit an insurance carrier.

VII. "
Limited line credit insurance
" includes credit life, credit disability, credit property, credit unemployment, involuntary unemployment, mortgage life, mortgage guaranty, mortgage disability, guaranteed automobile protection gap insurance, and any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing that credit obligation that the commissioner determines should be designated a form of limited line credit insurance.

VIII. "
Limited line credit insurance producer
" means a person who sells, solicits or negotiates one or more forms of limited line credit insurance coverage to individuals through a master, corporate, group, or individual policy.

IX. "
Limited lines insurance
" means those lines of insurance that the commissioner deems necessary to recognize for the purpose of complying with RSA 402-J:8.

X. "
Limited lines producer
" means a person authorized by the commissioner to sell, solicit, or negotiate limited lines insurance.

XI. "
Negotiate
" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms, or conditions of such contract, provided that the person engaged in that act either sells insurance, or obtains insurance from insurers for purchasers.

XII. "
Person
" means an individual or business entity.

XIII. "
Sell
" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

XIV. "
Solicit
" means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company.

XV. "
Terminate
" means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance.

XVI. "
Uniform application
" means the current version of the NAIC uniform application for resident and nonresident producer licensing.

XVII. "
Uniform business entity application
" means the current version of the NAIC uniform business entity application for resident and nonresident business entities.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:3 License Required. 

I. A person shall not sell, solicit, or negotiate insurance in this state for any class or classes of insurance unless the person is licensed for that line of authority in accordance with this chapter.

II. Any person who shall practice or attempt to practice as an insurance producer in this state without a license shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person.


Source. 2000, 315:1. 2005, 206:6, eff. Jan. 1, 2006.

    402-J:4 Exceptions to Licensing. 

I. Nothing in this chapter shall be construed to require an insurer to obtain an insurance producer license. For the purposes of this section "
insurer
" does not include an insurer's officers, directors, employees, subsidiaries, or affiliates.

II. A license as an insurance producer shall not be required of the following:

(a) An officer, director, or employee of an insurer or of an insurance producer, provided that the officer, director, or employee does not receive any commission on policies written or sold to insure risks residing, located or to be performed in this state and:

(1) The officer, director, or employee's activities are executive, administrative, managerial, clerical, or a combination of these and are only indirectly related to the sale, solicitation, or negotiations of insurance;

(2) The officer, director, or employee's function relates to underwriting, loss control, inspection or the processing, adjusting, investigating, or settling of a claim on a contract of insurance; or

(3) The officer, director, or employee is acting in the capacity of a special agent or agency supervisor assisting insurance producers where the person's activities are limited to providing technical advice and assistance to licensed insurance producers and do not include the sale, solicitation, or negotiation of insurance.

(b) A person who secures and furnishes information for the purpose of group life insurance, group property and casualty insurance, group annuities, group or blanket accident and health insurance; or for the purpose of enrolling individuals under plans; issuing certificates under plans or otherwise assisting in administering plans or performs administrative services related to mass marketed property and casualty insurance; where no commission is paid to the person for the service.

(c) An employer or association or its officers, directors, employees, or the trustees of an employee trust plan, to the extent that the employers, officers, employees, director, or trustees are engaged in the administration or operation of a program of employee benefits for the employer's or association's own employees or the employees of its subsidiaries or affiliates, which program involves the use of insurance issued by an insurer, as long as the employers, associations, officers, directors, employees, or trustees are not in any manner compensated, directly or indirectly, by the company issuing the contracts.

(d) Employees of insurers or organizations employed by insurers who are engaging in the inspection, rating or classification of risks, or in the supervision of the training of insurance producers and who are not individually engaged in the sale, solicitation, or negotiation of insurance.

(e) A person whose activities in this state are limited to advertising without the intent to solicit insurance in this state through communications in printed publications or other forms of electronic mass media whose distribution is not limited to residents of the state, provided that the person does not sell, solicit, or negotiate insurance that would insure risks residing, located, or to be performed in this state.

(f) A person who is not a resident of this state who sells, solicits, or negotiates a contract of insurance for commercial property and casualty risks to an insured with risks located in more than one state insured under that contract, provided that that person is otherwise licensed as an insurance producer to sell, solicit, or negotiate that insurance in the state where the insured maintains its principal place of business and the contract of insurance insures risks located in that state.

(g) A salaried full-time employee who counsels or advises his or her employer relative to the insurance interests of the employer or of the subsidiaries or business affiliates of the employer provided that the employee does not sell or solicit insurance or receive a commission.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:5 Application for Examination. 

I. A resident individual applying for an insurance producer license shall pass a written examination unless exempt pursuant to RSA 402-J:9. The examination shall test the knowledge of the individual concerning the lines of authority for which application is made, the duties and responsibilities of an insurance producer and the insurance laws and regulations of this state. Examinations required by this section shall be developed and conducted under title XXXVII and rules adopted by the commissioner.

II. The commissioner may make arrangements, including contracting with an outside testing service, for administering examinations and collecting the nonrefundable fee set forth in RSA 400-A:29.

III. Each individual applying for an examination shall remit a nonrefundable fee as prescribed by the commissioner as set forth in RSA 400-A:29.

IV. An individual who fails to appear for the examination as scheduled or fails to pass the examination, shall reapply for an examination and remit all required fees and forms before being rescheduled for another examination.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-J:6 Application for License. 

I. A person applying for a resident insurance producer license shall make application to the commissioner on the uniform application and declare under penalty of refusal, suspension, or revocation of the license that the statements made in the application are true, correct, and complete to the best of the individual's knowledge and belief. Before approving the application, the commissioner shall find that the individual:

(a) Is at least 18 years of age.

(b) Has not committed any act that is a ground for denial, suspension, or revocation set forth in RSA 402-J:12.

(c) [Repealed.]

(d) Has paid the fees set forth in RSA 400-A:29.

(e) Has successfully passed the examinations for the line or lines of authority for which the person has applied.

II. A business entity acting as an insurance producer is required to obtain an insurance producer license. Application shall be made using the uniform business entity application. Before approving the application the commissioner shall find that:

(a) The business entity has paid the fees set forth in RSA 400-A:29; and

(b) The business entity has designated a licensed producer responsible for the business entity's compliance with the insurance laws, rules, and regulations of this state. With the exception of RSA 402-L:3, V, the licensed person or persons designated by the business entity for its compliance shall be licensed to produce all of the lines of insurance that the entity is licensed to produce.

III. The commissioner may require any documents reasonably necessary to verify the information contained in an application.

IV. Each insurer that sells, solicits or negotiates any form of limited line credit insurance shall provide to each individual whose duties will include selling, soliciting or negotiating limited line credit insurance a program of instruction that may be approved by the commissioner.


Source. 2000, 315:1. 2001, 95:1. 2008, 18:1, III, eff. July 11, 2008. 2022, 223:7, eff. Aug. 16, 2022.

    402-J:7-a Continuing Education. 

Every 2 years, at least 60 days prior to the renewal date of their license, persons holding a producers license shall be certified by the insurance department as having completed 24 hours of continuing education instruction. Of the 24 continuing education hours required, at least 3 hours, but no more than 10 hours, shall consist of courses approved for ethics credit. Such continuing education instruction shall be approved by the insurance department. If a nonresident has complied with the continuing education requirements of his or her state of residence, he or she shall not be required to comply with requirements of this section.


Source. 2016, 109:2, eff. July 19, 2016.

    402-J:7 License. 

I. Unless denied licensure pursuant to RSA 402-J:12, persons who have met the requirements of RSA 402-J:5 and RSA 402-J:6 shall be issued an insurance producer license. An insurance producer may receive qualification for a license in one or more of the following lines of authority:

(a) Life: Insurance coverage on human lives including benefits of endowment, and annuities, and may include benefits in the event of death or dismemberment by accident and benefits for disability income.

(b) Accident and health or sickness: Insurance coverage for sickness, bodily injury, or accidental death and may include benefits for disability income.

(c) Property: Insurance coverage for the direct or consequential loss or damage to property of every kind.

(d) Casualty: Insurance coverage against legal liability, including that for death, injury, or disability or damage to real or personal property.

(e) Variable life and variable annuity products: Insurance coverage provided under variable life insurance contracts and variable annuities.

(f) Personal lines property and casualty: Insurance coverage sold to individuals and families for primarily noncommercial purposes.

(g) Credit-limited line credit insurance.

(h) Any other line of insurance permitted under state law or rules.

II. An insurance producer license shall remain in effect unless revoked or suspended as long as the fee set forth in RSA 400-A:29 is paid and educational requirements for resident individual producers are met by the due date.

III. An individual insurance producer who allows his or her license to lapse may, within 24 months from the due date of the renewal fee, reinstate the same license without the necessity of passing a written examination. However, a penalty in the amount of double the unpaid renewal fee shall be required for any renewal fee received after the due date.

IV. A licensed insurance producer who is unable to comply with license renewal procedures due to military service or some other extenuating circumstance may request a waiver of renewal procedures. The producer may also request a waiver of any examination requirement or any other fine or sanction imposed for failure to comply with renewal procedures.

V. The license shall contain the licensee's name, address, personal identification number, and the date of issuance, the lines of authority, the expiration date, and any other information the commissioner deems necessary.

VI. Licensees shall inform the commissioner by any means acceptable to the commissioner of a change of address within 30 days of the change. Change of address shall be accompanied by the fee required pursuant to RSA 400-A:29.

VII. In order to assist in the performance of the commissioner's duties, the commissioner may contract with non-governmental entities, including the National Association of Insurance Commissioners (NAIC) or any affiliates or subsidiaries that the NAIC oversees, to perform any ministerial functions, including the collection of fees, related to producer licensing that the insurance commissioner and the non-governmental entity may deem appropriate.


Source. 2000, 315:1. 2001, 95:1. 2008, 18:11, eff. July 11, 2008.

    402-J:8 Nonresident Licensing. 

I. Unless denied licensure pursuant to RSA 402-J:12, a nonresident shall receive a nonresident producer license if:

(a) The person is currently licensed as a resident and in good standing in his or her home state.

(b) The person has submitted the proper request for licensure and has paid the fees required by RSA 400-A:29.

(c) The person has submitted or transmitted to the commissioner the application for licensure that the person submitted to his or her home state, or in lieu of same, a completed uniform application.

(d) The person's home state awards nonresident producer licenses to residents of this state on the same basis.

II. A nonresident producer who moves from one state to another state or a resident producer who moves from this state to another state shall file a change of address and provide certification from the new resident state within 30 days of the change of legal residence. No license application or license fee is required.

III. The commissioner may verify the producer's licensing status through the producer database maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries.

IV. Notwithstanding any other provision of this chapter, a person licensed as a surplus lines producer in his or her home state shall receive a nonresident surplus lines producer license pursuant to paragraph I of this section. Except as provided in paragraph I, nothing in this section otherwise amends or supersedes any provision of RSA 405:24 through RSA 405:31.

V. Notwithstanding any other provision of this chapter, a person licensed as a limited line credit insurance or other type of limited lines producer in his or her home state shall receive a nonresident limited lines producer license, pursuant to paragraph I of this section, granting the same scope of authority as granted under the license issued by the producer's home state. For the purposes of this paragraph, limited line insurance is any authority granted by the home state which restricts the authority of the license to less than the total authority prescribed in the associated major lines pursuant to RSA 402-J:7, I(a)-(g).

VI. A nonresident insurance producer license shall remain in effect unless revoked or suspended as long as the fee set forth in RSA 400-A:29 is paid and the nonresident's insurance producer license remains in good standing in his or her home state. Termination of the producer's resident license shall be deemed termination of the New Hampshire nonresident producer license unless the producer timely files a change of address pursuant to paragraph II.


Source. 2000, 315:1. 2001, 95:1. 2008, 18:12, eff. July 11, 2008. 2019, 112:8, eff. Jan. 1, 2020.

    402-J:9 Exemption and Examination. 

I. An individual who applies for an insurance producer license in this state who was previously licensed for the same lines of authority in another state shall not be required to complete any prelicensing education or examination. This exemption is only available if the person is currently licensed in that state, or if the application is received within 90 days of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in that state or the state's Producer Database records, maintained by the NAIC, its affiliates or subsidiaries indicate that the producer is or was licensed in good standing for the line of authority requested.

II. A person licensed as an insurance producer in another state who moves to this state shall make application within 90 days of establishing legal residence to become a resident licensee pursuant to RSA 402-J:6. No prelicensing education or examination shall be required of that person to obtain any line of authority previously held in the prior state, except where the commissioner determines otherwise by regulation.


Source. 2000, 315:1. 2001, 95:1, eff. Aug. 20, 2001.

    402-K:1 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Customer
" means a person who purchases portable electronics or services.

III. "
Enrolled customer
" means a customer who elects coverage under a portable electronics insurance policy issued to a vendor of portable electronics.

IV. "
Location
" means any physical location in the state of New Hampshire or any Internet website, call center site, or similar location directed to residents of the state of New Hampshire.

V. "
Portable electronics
" means electronic devices that are portable in nature, their accessories and services related to the use of the device.

VI. "
Portable electronics insurance
" means insurance providing coverage for the repair or replacement of portable electronics which may provide coverage for portable electronics against any one or more of the following causes of loss: loss, theft, inoperability due to mechanical failure, malfunction, damage, or other similar causes of loss. "Portable electronics insurance" does not include:

(a) A service contract governed by RSA 415-C;

(b) A service contract or extended warranty providing coverage limited to the repair, replacement, or maintenance of property for the operational or structural failure of property due to a defect in materials, workmanship, accidental damage from handling, power surges, or normal wear and tear;

(c) A policy of insurance covering a seller's or a manufacturer's obligations under a warranty; or

(d) A homeowner's, renter's, motor vehicle, commercial multi-peril, or similar policy.

VII. "
Portable electronics transaction
" means:

(a) The sale or lease of portable electronics by a vendor to a customer; or

(b) The sale of a service related to the use of portable electronics by a vendor to a customer.

VIII. "
Supervising entity
" means a business entity that is a licensed insurer or insurance producer that is appointed or authorized by an insurer to supervise the administration of a portable electronics insurance program.

IX. "
Vendor
" means a person in the business of engaging in portable electronics transactions directly or indirectly.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:2 Licensure of Vendors. 

I. A vendor shall hold a limited lines license to sell or offer coverage under a policy of portable electronics insurance.

II. A limited lines license issued under this chapter shall authorize any employee or authorized representative of the vendor to sell or offer coverage under a policy of portable electronics insurance to a customer at each location at which the vendor engages in portable electronics transactions.

III. The supervising entity shall maintain a registry of vendor locations which are authorized to sell or solicit portable electronics insurance coverage in this state. Upon request by the commissioner and within 10 working days notice to the supervising entity, the registry shall be open to inspection and examination by the commissioner during regular business hours of the supervising entity.

IV. Notwithstanding any other provision of law, a license issued pursuant to this chapter shall authorize the licensee and its employees or authorized representatives to engage in those activities that are permitted in this chapter.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:3 Marketing Requirements for Sale of Portable Electronics Insurance. 

I. At every location where portable electronics insurance is offered to customers, brochures or other written materials shall be made available to a prospective customer which:

(a) Disclose that portable electronics insurance may provide a duplication of coverage already provided by a customer's homeowner's insurance policy, renter's insurance policy, motor vehicle insurance policy, or other source of coverage.

(b) State that the enrollment by the customer in a portable electronics insurance program is not required in order to purchase or lease portable electronics or services.

(c) Summarize the material terms of the insurance coverage, including:

(1) The identity of the insurer;

(2) The identity of the supervising entity;

(3) The amount of any applicable deductible and how it is to be paid;

(4) Benefits of the coverage; and

(5) Key terms and conditions of coverage such as whether portable electronics may be repaired or replaced with similar make and model reconditioned or non-original manufacturer parts or equipment.

(d) Provide a toll-free number and a summary of the process for filing a claim, including a description of how to return portable electronics and the maximum fee applicable in the event the customer fails to comply with any equipment return requirements.

(e) State that an enrolled customer may cancel enrollment for coverage under a portable electronics insurance policy at any time and the person paying the premium shall receive a refund of any applicable unearned premium.

II. Portable electronics insurance may be offered on a month-to-month or other periodic basis as a group or master commercial inland marine policy issued to a vendor of portable electronics for its enrolled customers.

III. Eligibility and underwriting standards for customers electing to enroll in coverage shall be established for each portable electronics insurance program in compliance with RSA 417:4, VIII(e) and RSA 417-B:2-a.

IV. A certificate, endorsement, brochure, or other evidence setting forth the terms and conditions of the portable electronics insurance policy shall be provided to each enrolled customer.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:4 Authority of Vendors of Portable Electronics. 

I. The employees and authorized representatives of vendors may sell or offer portable electronics insurance to customers and shall not be subject to licensure as an insurance producer under this chapter provided that:

(a) The vendor obtains a limited lines license to authorize its employees or authorized representatives to sell or offer portable electronics insurance pursuant to this section.

(b) The insurer issuing the portable electronics insurance either directly supervises or appoints a supervising entity to supervise the administration of the program, including development of a training program for employees and authorized representatives of the vendors. The training required by this section shall comply with the following:

(1) The training shall be delivered to employees and authorized representatives of vendors who are directly engaged in the activity of selling or offering portable electronics insurance.

(2) The training may be provided in electronic form. However, if conducted in an electronic form the supervising entity shall implement a supplemental education program regarding the portable electronics insurance product that is conducted and overseen by employees of the supervising entity who are licensed to sell, solicit, or negotiate portable electronics insurance to the extent required by RSA 402-J.

(3) Each employee and authorized representative shall receive basic instruction about the portable electronics insurance offered to customers and the disclosures required under RSA 402-K:3.

(c) No employee or authorized representative of a vendor of portable electronics shall advertise, represent, or otherwise hold himself or herself out as a non-limited lines licensed insurance producer.

II. The charges for portable electronics insurance coverage may be billed and collected by the vendor of portable electronics. Any charge to the enrolled customer for coverage that is not included in the cost associated with the purchase or lease of portable electronics or related services shall be separately itemized on the enrolled customer's bill. If the portable electronics insurance coverage is included with the purchase or lease of portable electronics or related services the vendor shall clearly and conspicuously disclose to the enrolled customer that the portable electronics insurance coverage is included with the portable electronics or related services. Vendors billing and collecting such charges shall not be required to maintain such funds in a segregated account provided that the vendor is authorized by the insurer to hold such funds in an alternative manner and remits such amounts to the supervising entity within 60 days of receipt. All funds received by a vendor from an enrolled customer for the sale of portable electronics insurance shall be considered funds held in trust by the vendor in a fiduciary capacity for the benefit of the insurer.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:5 Suspension or Revocation of License. 

If a vendor of portable electronics or its employee or authorized representative violates any provision of this chapter, the commissioner may:

I. After notice and hearing, impose fines not to exceed $500 per violation or $5,000 in the aggregate for such conduct;

II. After notice and hearing, impose other penalties that the commissioner deems necessary and reasonable to carry out the purpose of this article, including:

(a) Suspending the privilege of transacting portable electronics insurance pursuant to this section at specific business locations where violations have occurred; and

(b) Suspending or revoking the ability of individual employees or authorized representatives to act under the license.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:6 Termination of Portable Electronics Insurance. 

Notwithstanding RSA 417-B, RSA 417-C, or any other provision of law:

I. An insurer may terminate or otherwise change the terms and conditions of a policy of portable electronics insurance only upon providing the policyholder and enrolled customers with at least 30 days notice.

II. If the insurer changes the terms and conditions, then the insurer shall provide the vendor policyholder with a revised policy or endorsement and each enrolled customer with a revised certificate, endorsement, updated brochure, or other evidence indicating a change in the terms and conditions has occurred and a summary of material changes.

III. Notwithstanding paragraph I, an insurer may terminate an enrolled customer's enrollment under a portable electronics insurance policy upon 15 days notice for discovery of fraud or material misrepresentation in obtaining coverage or in the presentation of a claim thereunder.

IV. Notwithstanding paragraph I, an insurer may immediately terminate an enrolled customer's enrollment under a portable electronics insurance policy:

(a) For nonpayment of premium;

(b) If the enrolled customer ceases to have an active service with the vendor of portable electronics; or

(c) If an enrolled customer exhausts the aggregate limit of liability, if any, under the terms of the portable electronics insurance policy and the insurer sends notice of termination to the enrolled customer within 30 calendar days after exhaustion of the limit. However, if notice is not timely sent, enrollment shall continue notwithstanding the aggregate limit of liability until the insurer sends notice of termination to the enrolled customer.

V. Where a portable electronics insurance policy is terminated by a policyholder, the policyholder shall mail or deliver written notice to each enrolled customer advising the enrolled customer of the termination of the policy and the effective date of termination. The written notice shall be mailed or delivered to the enrolled customer at least 30 days prior to the termination.

VI. Whenever notice or correspondence with respect to a policy of portable electronics insurance is required pursuant to this section or is otherwise required by law, it shall be in writing and sent within the notice period, if any, specified within the statute or rule requiring the notice or correspondence. Notwithstanding any other provision of law, notices and correspondence may be sent either by mail or by electronic means as set forth in this paragraph. If the notice or correspondence is mailed, it shall be sent to the vendor of portable electronics at the vendor's mailing address specified for such purpose and to its affected enrolled customers' last known mailing addresses on file with the insurer. The insurer or vendor of portable electronics, as the case may be, shall maintain proof of mailing in a form authorized or accepted by the United States Postal Service or other commercial mail delivery service. If the notice or correspondence is sent by electronic means, it shall be sent to the vendor of portable electronics at the vendor's electronic mail address specified for such purpose and to its affected enrolled customers' last known electronic mail address as provided by each enrolled customer to the insurer or vendor of portable electronics, as the case may be. For the purposes of this paragraph, an enrolled customer's provision of an electronic mail address to the insurer or vendor of portable electronics, as the case may be, shall be deemed consent to receive notices and correspondence by electronic means. The insurer or vendor of portable electronics, as the case may be, shall maintain proof that the notice or correspondence was sent.

VII. Notice or correspondence required by this section or otherwise required by law may be sent on behalf of an insurer or vendor, as the case may be, by the supervising entity appointed by the insurer.


Source. 2012, 290:1, eff. Sept. 15, 2012.

    402-K:7 Application for License and Fees. 

I. A sworn application for a license under this chapter shall be made to and filed with the commissioner on forms prescribed and furnished by the commissioner.

II. The application shall provide:

(a) The name, residence address, and other information required by the commissioner for an employee or officer of the vendor that is designated by the applicant as the person responsible for the vendor's compliance with the requirements of this chapter. However, if the vendor derives more than 50 percent of its revenue from the sale of portable electronics insurance the information noted above shall be provided for all officers, directors, and shareholder of record having beneficial ownership of 10 percent or more of any class of securities registered under the federal securities law; and

(b) The location of the applicant's home office.

III. Any vendor engaging in portable electronics insurance transactions on or before the effective date of this chapter shall apply for licensure within 90 days of the application being made available by the commissioner. Any applicant commencing operations after the effective date of this chapter shall obtain a license prior to offering portable electronics insurance.

IV. Initial licenses issued pursuant to this chapter shall expire on the second May 31 from the date of issue. Renewed licenses shall be effective for 2 years, expiring on May 31.

V. Each vendor of portable electronics licensed under this chapter shall pay to the commissioner a fee as prescribed by the commissioner but in no event shall the fee exceed $1,000 for an initial portable electronics limited lines license and $500 for each renewal thereof. However, for a vendor that is engaged in portable electronics transactions at 10 or fewer locations in the state the fee shall not exceed $100 for an initial license and for each renewal thereof.

VI. A portable electronics license which is allowed to lapse may, within 24 months from the due date of the renewal, be reinstated with a penalty in the amount of double the unpaid renewal fee for any renewal received after the due date pursuant to paragraph V.


Source. 2012, 290:1, eff. Sept. 15, 2012. 2019, 112:9, 10, eff. Jan. 1, 2020.

    402-L:1 Short Title. 

This chapter shall be known as the travel insurance act.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:2 Definitions. 

In this chapter:

I. "
Aggregator site
" means an Internet website that provides access to information regarding insurance products from more than one insurer, including product and insurer information, for use in comparison shopping.

II. "
Blanket accident and health travel insurance
" means a policy issued to a travel agency or other organization that provides travel-related services, which agency or organization shall be deemed the policyholder and which provides accident and health coverage for all persons for whom travel-related services are provided in accordance with RSA 415:18, I-a.

III. "
Blanket personal inland marine travel insurance
" means a policy of travel insurance issued to any eligible group providing coverage for specific classes of persons defined in the policy with coverage provided to all members of the eligible group without a separate charge to individual members of the eligible group for personal loss that occurs incidental to travel.

IV. "
Cancellation fee waiver
" means a contractual agreement between a supplier of travel services and its customer to waive some or all of the non-refundable cancellation fee provisions of the supplier's underlying travel contract with or without regard to the reason for the cancellation or form of reimbursement. A cancellation fee waiver is not insurance.

V. "
Commissioner
" means the insurance commissioner.

VI. "
Designated responsible producer
" means an employee, who is a licensed individual producer, or the limited lines travel insurance producer who has designated the employee as responsible for the limited lines travel insurance producer's compliance with this chapter.

VII. "
Eligible group
" means 2 or more persons who are engaged in a common enterprise, or have an economic, educational, or social affinity or relationship, including, but not limited to, any of the following:

(a) An entity engaged in the business of providing travel or travel services, including, but not limited to, tour operators, lodging providers, vacation property owners, hotels and resorts, travel clubs, travel agencies, property managers, cultural exchange programs, and common carriers, or the operator, owner, or lessor of a means of transportation of passengers, including but not limited to airlines, cruise lines, railroads, steamship companies, and public bus carriers, where with regard to any particular travel or type of travel or travelers, all members or customers of the group have a common exposure to risk attendant to such travel.

(b) A college, school, or other institution of learning, covering students, teachers, employees, or volunteers.

(c) An employer covering any group of employees, volunteers, contractors, board of directors, dependents, or guests.

(d) A sports team, camp, or sponsor thereof, covering participants, members, campers, employees, officials, supervisors, or volunteers.

(e) A religious, charitable, recreational, educational, or civic organization, or branch thereof, covering any group of members, participants, or volunteers.

(f) A financial institution or financial institution vendor, or parent holding company, trustee, or agent of or designated by one or more financial institutions or financial institution vendors, including account holders, credit card holders, debtors, guarantors, or purchasers.

(g) An incorporated or unincorporated association, including labor unions, having a common interest, constitution, and bylaws, and organized and maintained in good faith for purposes other than obtaining insurance for members or participants of such association covering its members.

(h) A trust or the trustees of a fund established, created, or maintained for the benefit of and covering members, employees, or customers, subject to the commissioner's permitting the use of a trust of one or more associations meeting the requirements of subparagraph (g).

(i) An entertainment production company covering any group of participants, volunteers, audience members, contestants, or workers.

(j) A volunteer fire department, ambulance, rescue, police, court, or any first aid, civil defense, or other such volunteer group.

(k) Preschools, daycare institutions for children or adults, and senior citizen clubs.

(l) An automobile or truck rental or leasing company covering a group of individuals who may become renters, lessees, or passengers defined by their travel status on the rented or leased vehicles; provided that the common carrier, the operator, owner, or lessor of a means of transportation, or the automobile or truck rental or leasing company, is the policyholder under a policy.

(m) Any other group where the commissioner has determined that the members are engaged in a common enterprise, or have an economic, educational, or social affinity or relationship, and that issuance of the policy would not be contrary to the public interest.

VIII. "
Fulfillment materials
" means documentation sent to the purchaser of a travel protection plan confirming the purchase and providing the travel protection plan's coverage and assistance details.

IX. "
Group travel insurance
" means travel insurance issued to any eligible group.

X. "
Limited lines travel insurance producer
" means a:

(a) Licensed managing general underwriter;

(b) Licensed managing general agent or third party administrator;

(c) Licensed insurance producer, including a limited lines producer; or

(d) Travel administrator.

XI. "
Offer and disseminate
" means providing general information, including a description of the coverage and price, as well as processing the application, collecting premiums, and performing other non-licensable activities permitted by the state.

XII. "
Travel administrator
" means a person who directly or indirectly underwrites, collects charges, collateral, or premiums from, or adjusts or settles claims on residents of this state, in connection with travel insurance, except that a person shall not be considered a travel administrator if that person's only actions are as follows:

(a) A person working for a travel administrator to the extent that the person's activities are subject to the supervision and control of the travel administrator.

(b) An insurance producer selling insurance or engaged in administrative and claims related activities within the scope of the producer's license.

(c) A travel retailer offering and disseminating travel insurance and registered under the license of a limited lines travel insurance producer in accordance with this chapter.

(d) An individual adjusting or settling claims in the normal course of that individual's practice or employment as an attorney-at-law and who does not collect charges or premiums in connection with insurance coverage.

(e) A business entity that is affiliated with a licensed insurer while acting as a travel administrator for the direct and assumed insurance business of an affiliated insurer.

XIII. "
Travel assistance services
" means non-insurance services for which the consumer is not indemnified based on a fortuitous event, and if providing the service does not result in transfer or shifting of risk that would constitute the business of insurance. Travel assistance services include, but are not limited to: security advisories; destination information; vaccination and immunization information services; travel reservation services; entertainment; activity and event planning; translation assistance; emergency messaging; international legal and medical referrals; medical case monitoring; coordination of transportation arrangements; emergency cash transfer assistance; medical prescription replacement assistance; passport and travel document replacement assistance; lost luggage assistance; concierge services; and any other service that is furnished in connection with planned travel. Travel assistance services are not insurance and not related to insurance.

XIV. (a) "
Travel insurance
" means insurance coverage for personal risks incident to planned travel, including but not limited to:

(1) Interruption or cancellation of a trip or event;

(2) Loss of baggage or personal effects;

(3) Damages to accommodations or rental vehicles;

(4) Sickness, accident, disability, or death occurring during travel;

(5) Emergency evacuation;

(6) Repatriation of remains; or

(7) Any other contractual obligations to indemnify or pay a specified amount to the traveler upon determinable contingencies related to travel as approved by the commissioner.

(b) Travel insurance shall not include major medical plans, which provide comprehensive medical protection for travelers with trips lasting 12 months or longer, including those persons working or residing overseas as an expatriate, or any other product that requires a specific insurance producer license.

XV. "
Travel protection plans
" means plans that provide one or more of the following: travel insurance, travel assistance services, and cancellation fee waivers.

XVI. "
Travel retailer
" means a business entity that makes, arranges, or offers planned travel services and may offer and disseminate travel insurance as a service to its customers on behalf of and under the direction of a limited lines travel insurance producer.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:3 Requirements. 

I. Pursuant to the provisions of RSA 402-J, the commissioner may issue to an individual or business entity that has filed with the commissioner an application for such limited license, a limited lines travel insurance producer license, which authorizes the limited lines travel insurance producer to sell, solicit or negotiate travel insurance through a licensed insurer. No person shall act as a limited lines travel insurance producer or travel retailer unless properly licensed or registered, respectively.

II. (a) A travel retailer may offer and disseminate travel insurance on behalf of and under a limited lines travel insurance producer business entity license only if the following conditions are met:

(1) The limited lines travel insurance producer or travel retailer provides to purchasers of travel insurance:

(A) A description of the material terms or the actual material terms of the insurance coverage;

(B) A description of the process for filing a claim;

(C) A description of the review or cancellation process for the travel insurance policy; and

(D) The identity and contact information of the insurer and the limited lines travel insurance producer.

(2) At the time of licensure, the limited lines travel insurance producer establishes and maintains a register, on a form prescribed by the commissioner, listing each travel retailer that offers travel insurance on the limited lines travel insurance producer's behalf. The register shall be maintained and updated annually by the limited lines travel insurance producer and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The limited lines travel insurance producer shall submit such register to the insurance department upon request. The limited lines travel insurance producer shall also certify, upon request, that the registered travel retailer complies with 18 U.S.C. section 1033. The grounds for the suspension, revocation, and the penalties applicable to resident insurance producers under RSA 402 shall be applicable to the limited lines travel insurance producers and travel retailers.

(3) The designated responsible producer, president, secretary, treasurer, and any other officer or person who directs or controls the limited lines travel insurance producer's insurance operations has complied with the fingerprinting requirements applicable to insurance producers in the resident state of the limited lines travel insurance producer.

(4) The limited lines travel insurance producer has paid all applicable insurance producer licensing fees.

(5) The limited lines travel insurance producer requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which may be subject to review by the commissioner. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers.

(b) Limited lines travel insurance producers, and those registered under its license, are exempt from all examination requirements.

III. Any travel retailer offering or disseminating travel insurance shall make available to prospective purchasers, brochures or other written materials that have been approved by the travel insurer. Such materials shall include information which, at a minimum:

(a) Provides the identity and contact information of the insurer and the limited lines travel insurance producer;

(b) Explains that the purchase of travel insurance is not required in order to purchase any other product or service from the travel retailer; and

(c) Explains that an unlicensed travel retailer is permitted to provide general information about the insurance offered by the travel retailer, including a description of the coverage and price, but is not qualified or authorized to answer technical questions about the terms and conditions of the insurance offered by the travel retailer or to evaluate the adequacy of the customer's existing insurance coverage.

IV. A travel retailer's employee, or authorized representative, who is not licensed as an insurance producer shall not:

(a) Evaluate or interpret the technical terms, benefits, and conditions of the offered travel insurance coverage;

(b) Evaluate or provide advice concerning a prospective purchaser's existing insurance coverage; or

(c) Hold itself out as a licensed insurer, licensed producer, or insurance expert.

V. Any person licensed in a major line of authority as an insurance producer is authorized to sell, solicit, and negotiate travel insurance. A property and casualty insurance producer shall not be required to become appointed by an insurer in order to sell, solicit, or negotiate travel insurance.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:4 Registration;  Policy. 

I. Notwithstanding any provision of law to the contrary, a travel retailer whose insurance related activities, and those of its employees and authorized representative, are limited to offering and disseminating travel insurance on behalf of and under the direction of a limited lines travel insurance producer meeting the conditions stated under this chapter, is authorized to do so and receive related compensation, upon registration by the limited lines travel insurance producer as described in RSA 402-L:3, II(a)(2).

II. Travel insurance under this chapter may be provided under an individual policy or under a group or blanket policy.

III. Eligibility and underwriting standards for travel insurance may be developed and provided based on travel protection plans designed for individual or identified marketing or distribution channels, provided those standards also meet the state's applicable underwriting standards.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:5 Enforcement. 

I. The limited lines travel insurance producer and any travel retailer offering and disseminating travel insurance on behalf of the limited license travel insurance producer and under the limited lines travel insurance producers license shall be subject to RSA 417:4, VIII(e), RSA 402:J:12, and RSA 402-J:15.

II. The commissioner may adopt rules, pursuant to RSA 541-A, relative to the implementation of this chapter.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:6 Travel Protection Plans. 

Travel protection plans may be offered for one price for the combined features that the travel protection plan offers in this state if:

I. The travel protection plan clearly discloses to the consumer, at or prior to the time of purchase, that it includes travel insurance, travel assistance services, and cancellation fee waivers, as applicable, and provides information and an opportunity, at or prior to the time of purchase, for the consumer to obtain additional information regarding the features and pricing of each; and

II. The fulfillment materials:

(a) Describe and delineate the travel insurance, travel assistance services, and cancellation fee waivers in the travel protection plan; and

(b) Include the travel insurance disclosures and the contact information for persons providing travel assistance services, and cancellation fee waivers, as applicable.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:7 Sales Practices. 

I. All persons offering travel insurance to residents of this state are subject to RSA 417, except as otherwise provided in this section. In the event of a conflict between this chapter and other provisions of Title XXXVII regarding the sale and marketing of travel insurance and travel protection plans, the provisions of this chapter shall control.

II. Offering or selling a travel insurance policy that could never result in payment of any claims for any insured under the policy is an unfair trade practice under RSA 417.

III. (a) All documents provided to consumers prior to the purchase of travel insurance, including, but not limited to, sales materials, advertising materials, and marketing materials, shall be consistent with the travel insurance policy itself, including but not limited to, forms, endorsements, policies, rate filings, and certificates of insurance.

(b) For blanket personal inland marine travel insurance policies or certificates that contain pre-existing condition exclusions, information, and an opportunity to learn more about the pre-existing condition exclusions shall be provided any time prior to the time of purchase, and in the coverage's fulfillment materials.

(c)(1) The fulfillment materials and the information described in RSA 402-L:3, II(a)(1) shall be provided to a policyholder or certificate holder as soon as practicable, following the purchase of a travel protection plan. Unless the insured has either started a covered trip or filed a claim under the travel insurance coverage, a policyholder or certificate holder may cancel a policy or certificate for a full refund of the travel protection plan price from the date of purchase of a travel protection plan until at least:

(A) Fifteen days following the date of delivery of the travel protection plan's fulfillment materials by postal mail; or

(B) Ten days following the date of delivery of the travel protection plan's fulfillment materials by means other than postal mail.

(2) In this section, delivery means handing fulfillment materials to the policyholder or certificate holder or sending fulfillment materials by postal mail or electronic means to the policyholder or certificate holder.

(d) For blanket personal inland marine travel insurance policies or certificates, the company shall disclose in the policy documentation and fulfillment materials whether the travel insurance is primary or secondary to other applicable coverage.

(e) If travel insurance is marketed directly to a consumer through an insurer's Internet website or by others through an aggregator site, it shall not be an unfair trade practice or other violation of law where an accurate summary or short description of coverage is provided on the website page, if the consumer has access to the full provisions of the policy through electronic means.

IV. No person offering, soliciting, or negotiating travel insurance or travel protection plans on an individual or group basis may do so by using negative option or opt out, which would require a consumer to take an affirmative action to deselect coverage, such as unchecking a box on an electronic form, when the consumer purchases a trip.

V. It shall be an unfair trade practice to market blanket travel insurance coverage as free.

VI. When a consumer's destination jurisdiction requires insurance coverage, it shall not be an unfair trade practice to require that a consumer choose between the following options as a condition of purchasing a trip or travel package:

(a) Purchasing the coverage required by the destination jurisdiction through the travel retailer or limited lines travel insurance producer supplying the trip or travel package; or

(b) Agreeing to obtain and provide proof of coverage that meets the destination jurisdiction's requirements prior to departure.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:8 Travel Administrators. 

I. Notwithstanding any other provisions of Title XXXVII, no person shall act or represent itself as a travel administrator for travel insurance in this state unless that person:

(a) Is a licensed property and casualty insurance producer in this state for activities permitted under that producer license;

(b) Holds a valid managing general agent license in this state; or

(c) Holds a valid third-party administrator license in this state.

II. A travel administrator and its employees are exempt from the licensing requirements of RSA 402-B for travel insurance it administers.

III. An insurer is responsible for the acts of a travel administrator administering travel insurance underwritten by the insurer, and is responsible for ensuring that the travel administrator maintains all books and records relevant to the insurer to be made available by the travel administrator to the commissioner upon request.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-L:9 Scope and Purposes. 

I. The purpose of this chapter is to promote the public welfare by creating a comprehensive legal framework within which travel insurance may be sold in this state.

II. The requirements of this chapter shall apply to travel insurance that covers any resident of this state, and is sold, solicited, negotiated, or offered in this state, and policies and certificates are delivered or issued for delivery in this state. It shall not apply to cancellation fee waivers or travel assistance services, except as expressly provided in this chapter.

III. All other applicable provisions of this state's insurance laws shall continue to apply to travel insurance except that the specific provisions of this chapter shall supersede any general provisions of law that would otherwise be applicable to travel insurance.


Source. 2021, 119:2, Pt. I, Sec. 1, eff. Oct. 7, 2021.

    402-M:1 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Consent
" means agreement to administrative supervision by the insurer, including agreement to the terms of the supervision order.

III. "
Department
" means the insurance department.

IV. "
Insurer
" means and includes every entity or person licensed, authorized, or permitted by the commissioner to transact the business of insurance in this state, and for which the commissioner is granted authority to conduct an examination into its affairs, including all fraternal benefit societies as defined in RSA 418 and all providers of continuing care or life care contracts as defined in RSA 420-D; provided, however, that fraternal benefit societies and providers of continuing care or life care contracts shall not be construed to be "insurers" except for the limited purpose of administrative supervision under the provisions of this chapter.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:10 Other Laws;  Conflicts;  Meetings Between the Commissioner and the Supervisor. 

The commissioner may meet with a supervisor appointed under this chapter and with the attorney or other representative of the supervisor, without the presence of any other person, at the time of any proceeding or during the pendency of any proceeding held under authority of this chapter to carry out the commissioner's duties under this chapter or for the supervisor to carry out his or her duties under this chapter.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:11 Immunity. 

There shall be no liability on the part of, and no cause of action of any nature shall arise against, the commissioner or the department or their employees, agents, consultants, or counsel for any action taken by them that is within the scope of their powers and duties under this chapter and that is performed in good faith and not in a wanton or reckless manner.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:2 Applicability. 

The provisions of this chapter shall apply to:

I. All domestic insurers.

II. Any other insurer doing business in this state whose state of domicile has requested in writing that the commissioner apply the provisions of the chapter regarding such insurer.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:3 Notice to Comply with Written Requirements of Commissioner;  Noncompliance;  Administrative Supervision. 

I. An insurer may be subject to administrative supervision by the commissioner only if the insurer gives its consent.

II. Upon receiving consent of the insurer to the terms of the supervision order, the commissioner may issue an agreed supervision order which shall provide:

(a) A statement of the commissioner's grounds for seeking a supervision order;

(b) A date certain upon which the supervision order shall expire, ending the supervision period;

(c) A written list to the insurer of the requirements to abate the order prior to its expiration date; and

(d) A statement that the insurer is under the supervision of the commissioner and that the commissioner is applying and effectuating the provisions of this chapter.

III. The commissioner may employ staff personnel, outside counsel, and other consultants as necessary for the proper conduct of the administrative supervision. All reasonable costs of such outside counsel and other consultants, including the costs attributable to the use of staff personnel, shall be borne by the insurer under administrative supervision.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:4 Confidentiality of Certain Proceedings and Records. 

I. Except as set forth in this section, all administrative and judicial proceedings arising under this chapter shall be held privately unless a public hearing is requested by the insurer, and all proceedings, hearing, notices, correspondence, reports, orders, records, and other information in the possession of the commissioner or the department relating to the supervision of any insurer are confidential and shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner may use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.

II. The personnel of the department shall have access to these proceedings, hearings, notices, correspondence, reports, orders, records, or information as permitted by the commissioner. Neither the commissioner nor any person who receive documents, materials, or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to paragraph I.

III. The commissioner may share the notices, correspondence, reports, orders, records, or information with other state, federal, and international regulatory agencies, with the National Association of Insurance Commissioners (NAIC) and its affiliates and subsidiaries, and with state, federal, and international law enforcement authorities if the commissioner determines that the disclosure is necessary or proper for the enforcement of the laws of this or another state of the United States; provided, that the recipient agrees to maintain the confidentiality of the documents, material, or other information. No waiver of any applicable privilege or claim of confidentiality shall occur as a result of the sharing of documents, materials, or other information pursuant to this paragraph.

IV. This section shall not apply to proceedings under RSA 402-C or to hearings, notices, correspondence, reports, orders, records, or other information obtained upon the appointment of a receiver for the insurer by a court of competent jurisdiction.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:5 Authority of Administrative Supervisor. 

I. During the period of supervision, the commissioner, or designee, shall serve as the administrative supervisor. If the commissioner appoints a designee to serve as administrative supervisor, then such person shall have all of the powers of the commissioner granted under this section and shall be considered a state officer or official under RSA 99-D. The commissioner may impose operating restrictions or requirements on the insurer during the period of administrative supervision which are deemed necessary for the protection of policyholders or the general public. The commissioner may order the insurer to:

(a) Reduce the total amount of present and potential liability for policy benefits by reinsurance;

(b) Reduce, suspend, or limit the volume of business being accepted or renewed;

(c) Reduce general insurance and commission expenses by specified methods;

(d) Increase the insurer's capital and surplus;

(e) Suspend or limit the declaration and payment of dividends by an insurer to its stockholders or to its policyholders;

(f) File reports in a form acceptable to the commissioner concerning the market value of an insurer's assets;

(g) Limit or withdraw from certain investments or discontinue certain investment practices to the extent the commissioner deems necessary;

(h) Document the adequacy of premium rates in relation to the risks insured;

(i) File, in addition to regular annual statements, interim financial reports on the form adopted by the NAIC or in such format as adopted by the commissioner; or

(j) Cease from engaging in certain business practices which are illegal or which the administrative supervisor deems harmful to policyholders or the general public.

II. In addition to the provisions of paragraph I, the commissioner may prohibit the insurer from engaging in any of the following acts during the period of supervision without the prior approval of the administrative supervisor:

(a) Dispose of, convey, or encumber any of its assets or its business in force;

(b) Withdraw any funds from its bank accounts;

(c) Lend any of its funds;

(d) Invest any of its funds;

(e) Transfer any of its property;

(f) Incur any debt, obligation, or liability;

(g) Merge or consolidate with any company;

(h) Approve new premiums or renew any policies;

(i) Enter into any new reinsurance contract or treaty;

(j) Terminate, surrender, forfeit, convert, or lapse any insurance policy, certificate, or contract, except for nonpayment of premiums due;

(k) Release, pay, or refund premium deposits, accrued cash or loan values, unearned premiums, or other reserves on any insurance policy, certificate, or contract;

(l) Make any material change in management; or

(m) Increase salaries and benefits of officers or directors or the preferential payment of bonuses, dividends, or other payments deemed preferential.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:6 Extension of, or Early Release From, Supervision. 

I. If placed under administrative supervision by an order issued pursuant to RSA 402-M:3, the commissioner shall release the insurer from the supervision order prior to the end of the specified supervision period upon finding that the abatement requirements listed in the order have been met.

II. If the commissioner determines that the conditions giving rise to the supervision still exist at the end of the supervision period specified in the order, the commissioner may seek consent from the insurer to amend the agreed order extending the supervision period.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:7 Judicial Review. 

An insurer placed under administrative supervision by the commissioner may contest any action taken pursuant to the agreed supervision order at any time during the supervision by requesting review by the superior court for Merrimack county. The court shall review the action complained of in a closed hearing and render its decision at the earliest possible date thereafter. The court may stay any action of the commissioner, pending its review of such petition. Notwithstanding the foregoing, filing of a petition for review of such action shall not automatically stay the commissioner's action, or any of the provisions of the supervision order.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:8 Administrative Election of Proceedings. 

Nothing contained in this chapter shall preclude the commissioner from initiating any proceeding under RSA 402-C, including any judicial proceedings to place an insurer in conservation, rehabilitation, or liquidation proceedings or other delinquency proceedings, however designated under the laws of this state, regardless of whether the commissioner has previously initiated administrative supervision proceedings under this chapter against the insurer.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-M:9 Rules. 

The commissioner may adopt rules, pursuant to RSA 541-A, as necessary for the purposes of this chapter.


Source. 2016, 17:1, eff. Jan. 1, 2017.

    402-N:1 Definitions. 

In this chapter:

I. "
Claims processing services
" means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:

(a) Receiving payments for pharmacist services.

(b) Making payments to pharmacists or pharmacies for pharmacist services.

II. "
Commissioner
" means the commissioner of the insurance department.

III. "
Health carrier
" means "health carrier" as defined in RSA 420-J:3, XXIII.

IV. "
Health benefit plan
" means "health benefit plan" as defined in RSA 420-J:3, XIX.

V. "
Pharmacist
" means an individual licensed as a pharmacist by the pharmacy board.

VI. "
Pharmacist services
" means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy.

VII. "
Pharmacy
" means the place licensed by the pharmacy board in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail.

VIII. (a) "
Pharmacy benefits manager
" means a person, business, or other entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager, that, pursuant to a contract with a health carrier, manages the prescription drug coverage provided by the health carrier, including, but not limited to, providing claims processing services for prescription drugs, performing drug utilization review, processing drug prior authorization requests, adjudication of grievances or appeals related to prescription drug coverage, contracting with network pharmacies, and controlling the cost of covered prescription drugs.

(b) "Pharmacy benefits manager" shall not include any:

(1) Health care facility licensed in this state;

(2) Health care professional licensed in this state;

(3) Consultant who only provides advice as to the selection or performance of a pharmacy benefits manager;

(4) Service provided to the Centers for Medicare and Medicaid Services; or

(5) Health insurer licensed in this state if the health insurer or its subsidiary is providing pharmacy benefits management services exclusively to its own insureds.

IX. "
Rebate
" means a discount or price concession attributable to the utilization of a prescription drug that is paid by the pharmaceutical manufacturer of the drug directly to a pharmacy benefits manager or health carrier after the pharmacy benefits manager or health carrier processes a claim from a pharmacy for a prescription drug manufactured by such pharmaceutical manufacturer. "Rebate" shall not include bona fide service fees, administrative fees, or any other amount which does not qualify as a rebate under this paragraph.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:2 Registration to do Business;  Rulemaking;  Penalties. 

I. A person or organization shall not establish or operate as a pharmacy benefits manager in this state for health benefit plans without registering with the insurance commissioner under this chapter.

II. The commissioner shall adopt rules pursuant to RSA 541-A relative to:

(a) Prescribing the application format for registration as a pharmacy benefits manager, including a requirement to submit the registrant's corporate charter, articles of incorporation, or other formation documents.

(b) Establishing application fees and renewal fees, not to exceed $500 per year.

(c) Delineating procedures for handling consumer complaints and coordinating with the department's consumer services unit, including supplying designated contact information to enable the department to reach the pharmacy benefits manager regarding consumer complaints.

III. If the commissioner finds after notice and hearing that any person has violated any provision of this chapter, or rules adopted pursuant to this chapter, the commissioner may order:

(a) For each separate violation, a penalty in the amount of $2,500.

(b) Revocation or suspension of the pharmacy benefits manager registration.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:3 Provider Contract Standards for Pharmacy Benefit Managers. 

I. All contracts between a carrier or pharmacy benefit manager and a contracted pharmacy shall include:

(a) The sources used by the pharmacy benefit manager to calculate the drug product reimbursement paid for covered drugs available under the pharmacy health benefit plan administered by the carrier or pharmacy benefit manager.

(b) A process to appeal, investigate, and resolve disputes regarding the maximum allowable cost pricing. The process shall include the following provisions:

(1) A provision granting the contracted pharmacy or pharmacist at least 30 business days following the initial claim to file an appeal;

(2) A provision requiring the carrier or pharmacy benefit manager to investigate and resolve the appeal within 30 business days;

(3) A provision requiring that, if the appeal is denied, the carrier or pharmacy benefit manager shall:

(A) Provide the reason for the denial; and

(B) Identify the national drug code of a drug product that may be purchased by contracted pharmacies at a price at or below the maximum allowable cost; and

(4) A provision requiring that, if an appeal is granted, the carrier or pharmacy benefits manager shall within 30 business days after granting the appeal:

(A) Make the change in the maximum allowable cost; and

(B) Permit the challenging pharmacy or pharmacist to reverse and rebill the claim in question.

II. For every drug for which the pharmacy benefit manager establishes a maximum allowable cost to determine the drug product reimbursement, the pharmacy benefit manager shall:

(a) Include in the contract with the pharmacy information identifying the national drug pricing compendia or sources used to obtain the drug price data.

(b) Make available to a contracted pharmacy the actual maximum allowable cost for each drug.

(c) Review and make necessary adjustments to the maximum allowable cost for every drug for which the price has changed at least every 14 days.

III. [Repealed.]


Source. 2019, 320:2, eff. Jan. 1, 2020; 320:7, eff. June 30, 2020.

    402-N:4-a Prohibited Acts. 

A pharmacy benefit manager shall not, either directly or indirectly:

I. Prohibit an in-network retail pharmacy from:

(a) Mailing or delivering a prescription drug to an enrollee as an ancillary service of the in-network retail pharmacy provided that confirmation of delivery is obtained.

(b) Charging a shipping or handling surcharge to an enrollee who requests that the in-network retail pharmacy mail or deliver a prescription drug to the enrollee as an ancillary service provided the enrollee receives a disclosure from the in-network retail pharmacy regarding any surcharge to be charged to the patient for the delivery of a prescription drug, including that the surcharge may not be reimbursable by the plan sponsor or pharmacy benefit manager.

(c) Offering the ancillary services described in subparagraph I(a) to an enrollee.

II. Charge an enrollee who uses an in-network retail pharmacy that offers to mail or deliver a prescription drug to an enrollee as an ancillary service a surcharge for the delivery of a prescription drug or copayment that is higher than the surcharge or copayment the enrollee would pay if the enrollee used an in-network retail pharmacy that does not offer to mail or deliver a prescription drug to an enrollee as an ancillary service.

III. For purposes of this section, a retail pharmacy shall not include a "mail-order pharmacy" as defined in RSA 318:1, VII-b.


Source. 2021, 149:1, eff. Sept. 21, 2021.

    402-N:4 Prescription Drugs. 

I. A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy's usual and customary price of filling the prescription or the contracted copayment, whichever is less.

II. Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer shall pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:5 Complaints Relative to Pharmacy Benefit Managers. 

I. Consumers may file a complaint related to a registered pharmacy benefit manager pursuant to RSA 400-A:15-e.

II. The commissioner shall adopt rules, pursuant to RSA 541-A, to implement paragraph I. Such rules shall include procedures for addressing complaints, provisions for enforcement, the receipt of complaints referred to the insurance department under RSA 318:47-h, III(b), and for reporting to the board of pharmacy on the status of complaints referred.


Source. 2019, 320:2, eff. Jan. 1, 2020. 2021, 56:5, eff. July 24, 2021.

    402-N:6 Pharmacy Benefits Manager Reporting. 

I. Each pharmacy benefits manager shall submit an annual report to the commissioner containing a list of health benefit plans it administered, and the aggregate amount of all rebates it collected from pharmaceutical manufacturers that were attributable to patient utilization in the state of New Hampshire during the prior calendar year.

II. Information reported to the commissioner pursuant to this section shall be confidential and protected from disclosure under the commissioner's examination authority and shall not be considered a public record subject to disclosure under RSA 91-A. Based on this reporting, the commissioner shall make public aggregated data on the overall amount of rebates collected on behalf of covered persons in the state, but shall not release data that identifies a specific insurer or pharmacy benefit manager.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:7 Authority to Examine and Directly Bill Pharmacy Benefits Managers for Certain Examinations. 

The commissioner may examine and directly bill a pharmacy benefits manager required to be registered under this chapter for the costs of any examination pursuant to RSA 400-A:37 as necessary to determine and enforce compliance with this chapter. In addition, if the commissioner finds through an investigation or examination that a carrier has not received information required under RSA 420-J:7-b, XI from a pharmacy benefit manager, the commissioner may require that the pharmacy benefit manager provide the required information, and the commissioner may investigate or examine and directly bill the pharmacy benefit manager for the cost of any portion of the examination or investigation pertaining to obtaining the required information.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:8 Non-Exclusivity. 

Nothing in this chapter shall be interpreted to invalidate or render inapplicable any other provision of Title XXXVII 
 that is otherwise applicable to an entity that qualifies as a pharmacy benefit manager under this chapter.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-N:9 Severability. 

If any provision of this chapter or the application of this chapter to any person or circumstance is held invalid, the invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provisions or application, and to this end, the provisions of this chapter are declared severable.


Source. 2019, 320:2, eff. Jan. 1, 2020.

    402-O:1 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Location
" means any physical location in the state of New Hampshire.

III. "
Owner
" means a business entity that is the owner, lessor, or sublessor of a self-service storage facility, the owner's agent, or any other person authorized by the owner to manage the facility, or to receive rent from a renter. The owner may be a resident or non-resident of this state.

IV. "
Personal property
" means movable property not affixed to land.

V. "
Rental agreement
" means any written agreement that establishes or modifies the terms, conditions, or rules concerning the use and occupancy of a rented space at a self-service storage facility.

VI. "
Renter
" means a person, or any agent or representative of the person, entitled to the use of rented space at a self-service storage facility under a rental agreement to the exclusion of others.

VII. "
Self-service storage facility
" means any real property designed and used for the purpose of renting or leasing individual storage space in which the renters themselves customarily store and remove their own personal property on a self-service basis. A self-service storage facility is not a warehouse as the term "warehouse" is used in RSA 382-A:7-102.

VIII. "
Self-service storage insurance
" means personal property insurance offered in connection with and incidental to the rental of a rented space at a self-service storage facility and which provides coverage to renters for the loss of or damage to personal property occurring at the facility or when the property is in transit to or from the facility during the period of the rental agreement.

IX. "
Supervising entity
" means a business entity that is a licensed admitted insurer or insurance producer licensed under RSA 402-J that is appointed or authorized by an insurer to supervise the administration of a self-service storage insurance program.


Source. 2021, 119:2, Pt. III, Sec. 1, eff. Jan. 1, 2022.

    402-O:2 Licensure of Owners. 

I. An owner shall hold a limited lines license to sell or offer coverage for self-service storage insurance at any location in this state. An owner is not required to hold a license solely to display and make available to renters and prospective renters brochures and other promotional materials created by or on behalf of an authorized insurer or surplus lines insurer.

II. A limited lines license issued under this chapter shall authorize the owner and the employees and authorized representatives of the owner to sell and offer coverage for self-service storage insurance to renters at each location at which the owner conducts business.

III. The supervising entity shall maintain a registry of each location at which the owner sells or offers self-service storage insurance in this state.

IV. Notwithstanding any other provision of law, a license issued pursuant to this chapter shall authorize the licensee and its employees and authorized representatives to engage in those activities that are permitted in this chapter.

V. Owners, and their employees and authorized representatives, are exempt from all examination and education requirements under RSA 402-J in regard to self-service storage insurance.


Source. 2021, 119:2, Pt. III, Sec. 1, eff. Jan. 1, 2022.

    402-O:3 Marketing Requirements for Sale of Self-Service Storage Insurance. 

I. An owner shall not offer or sell insurance under this section unless:

(a) The owner provides to the renter written notice that:

(1) Summarizes the material terms of insurance coverage offered to renters, including the identity of the insurer, premium amount, benefits, exclusions, and conditions.

(2) Discloses that the policies offered by the owner may provide a duplication of coverage already provided by a renter's homeowner's insurance policy, residential renter's insurance policy, vehicle insurance policy, watercraft insurance policy, or other source of property insurance coverage and that no liability coverage is provided by the insurance coverage. This disclosure shall be displayed prominently in 12-point type or capital letters and shall read as follows:

Your renters' or homeowners' policy may provide the insurance you need. Check with your insurance agent to determine if your personal property stored at a location other than your home or business is covered.

(3) States that if insurance is required as a condition of rental, the requirement may be satisfied by the renter purchasing the insurance described in this section or by presenting evidence of other applicable insurance coverage.

(4) Describes the process for filing a claim.

(b) All costs related to the insurance are stated in writing.

(c) Evidence of coverage in a form developed by the insurer or supervising entity is provided to every renter who purchases the coverage.

(d) The insurance is provided by an insurer authorized to transact the applicable kinds of insurance in this state.

II. Self-service storage insurance may be offered on a month-to-month or other periodic basis under an individual policy or a group or master commercial policy coverage with limits not exceeding $10,000 in aggregate. All self-service storage insurance policy forms, endorsements, and other contract language shall be submitted pursuant to RSA 412:5, II. RSA 412:5, VI shall not apply to self-service storage insurance regardless of the type of insurance.


Source. 2021, 119:2, Pt. III, Sec. 1, eff. Jan. 1, 2022.

    402-O:4 Authority of Owners. 

I. The employees and authorized representatives of owners may sell and offer self-service storage insurance to renters and shall not be subject to licensure as an insurance producer under this chapter provided that:

(a) The owner obtains a limited lines license to authorize its employees and authorized representatives to sell and offer self-service storage insurance pursuant to this chapter.

(b) The insurer issuing the self-service storage insurance either directly supervises or appoints a supervising entity to supervise the administration of the program, including development of a training program for employees and authorized representatives of the owners. The training required by this section shall comply with the following:

(1) The training shall be delivered to the employees and authorized representatives who are directly engaged in the activity of selling and offering self-service storage insurance.

(2) The training may be provided in electronic form. However, if conducted in electronic form the supervising entity shall implement a supplemental education program regarding the self-service storage insurance that is conducted and overseen by a licensed producer.

(3) Each employee and authorized representative who is directly engaged in the activity of selling and offering self-service storage insurance shall receive basic instruction about the self-service storage insurance offered to renters and the disclosures required under RSA 402-O:3.

(4) The training program shall be submitted to the commissioner for approval.

(c) No employee or authorized representative of an owner shall advertise, represent, or otherwise hold himself or herself out as a non-limited lines licensed insurance producer, unless otherwise licensed.

II. The charges for self-service storage insurance coverage may be billed and collected by the owner and its employees and authorized representatives. Owners billing and collecting such charges shall not be required to maintain such funds in a segregated account provided that the owner is authorized by the insurer or supervising entity to hold such funds in an alternative manner and remits such amounts to the insurer or supervising entity within 60 days of receipt. All premiums received by an owner from a renter for the sale of self-service storage insurance shall be considered funds held by the owner in a fiduciary capacity for the benefit of the insurer. An owner may receive compensation for billing and collection services.


Source. 2021, 119:2, Pt. III, Sec. 1, eff. Jan. 1, 2022.

    402-O:5 Application for License. 

I. A sworn application for a license under this chapter shall be made to and filed with the commissioner on forms prescribed and furnished by the commissioner. The applicant may be a resident or non-resident of this state.

II. The application shall provide:

(a) The name, residence address, and other information required by the commissioner for an authorized representative of the owner or supervising entity that is designated by the applicant as the person responsible for the owner's compliance with the requirements of this chapter. However, if the owner derives more than 50 percent of its revenue from the sale of self-service storage insurance the information noted above shall be provided for all officers, directors, and shareholder of record having beneficial ownership of 10 percent or more of any class of securities registered under the federal securities law; and

(b) The location of the owner's home office.

III. Any owner engaging in self-service storage insurance transactions on or before the effective date of this chapter shall apply for licensure within 90 days of the application being made available by the commissioner. Any applicant commencing operations after the effective date of this chapter shall obtain a license prior to offering self-service storage insurance.

IV. Initial licenses issued pursuant to this chapter shall expire on the second May 31 from the date of issue. Renewed licenses shall be effective for 2 years, expiring on May 31.

V. Each owner licensed under this chapter shall pay a fee as determined by the commissioner provided that the fee shall not exceed $500 for an initial self-service storage insurance license and $250 for each license renewal. However, for an owner who sells self-service storage insurance at 10 or fewer locations in the state the fee shall not exceed $150 for an initial license and for each renewal of a license.

VI. A self-service storage insurance license which lapses may, within 24 months from the due date of the renewal, be reinstated with a penalty in the amount of double the unpaid renewal fee for any renewal received after the due date pursuant to paragraph IV.


Source. 2021, 119:2, Pt. III, Sec. 1, eff. Jan. 1, 2022.

    402:1 Members' Liability. 

Members of mutual insurance companies shall not be individually liable to pay any debts of their respective companies, beyond their liability to assessments for losses occurring therein, nor to such assessments beyond the amount of their deposit notes.


Source. 1847, 501:1. CS 154:2. GS 158:1. GL 173:1. PS 168:1. PL 273:1. RL 323:1.

    402:10 Requirement. 

No insurance company organized under the laws of this state shall do insurance business unless it has obtained a license from the insurance commissioner authorizing it to do so.


Source. 1903, 18:1. PL 273:9. RL 323:10.

    402:11-a Prohibitions. 

I. No insurer which is directly or indirectly owned or controlled in whole or in substantial part by any government or governmental agency shall be authorized to transact insurance in this state. Membership in a mutual insurer or subscribership in a reciprocal insurer or ownership of stock in an insurer by the alien property custodian or similar official of the United States or ownership of stock or other security which does not have voting rights with respect to the management of the insurer or supervision of an insurer by public authority shall not be deemed to be an ownership or control of the insurer for the purposes of this section.

II. The commissioner shall not grant or continue authority to transact insurance in this state as to any insurer or proposed insurer that management of which is found by the commissioner after investigation or upon reliable information to be incompetent or dishonest or untrustworthy or of unfavorable business repute or so lacking in insurance company managerial experience in operations of the kind proposed in this state as to make such operation, currently or prospectively, hazardous to or contrary to the best interests of, the insurance-buying or investing public of this state, or which the commissioner has good reason to believe is affiliated directly or indirectly through ownership, control, reinsurance transactions, or other business relations with any person or persons of unfavorable business repute or whose business operations are or have been marked, to the injury of insurers, stockholders, policyholders, creditors, or the public, by illegality, or by manipulation of assets or of accounts or of reinsurance or by bad faith.


Source. 2008, 18:8, eff. July 11, 2008.

    402:11 Information. 

Before a license is granted to the company it shall file with the commissioner a certified copy of its charter and bylaws, a certificate giving the amount of capital paid in in cash, and a full statement, under oath of its president and secretary, showing its financial standing and condition in accordance with blanks furnished by the commissioner, and such other information in relation to its condition as may be required by the commissioner.


Source. 1903, 18:2. PL 273:10. RL 323:11.

    402:12 Licenses. 

I. On compliance with the foregoing conditions and if the company is found upon examination made by or under the direction of the commissioner to (a) have complied with the laws of the state applicable to it; (b) have been consistent with the NAIC's Uniform Certificate of Authority Application process and standards; and (c) have complied with any other terms or documentation the commissioner may require, a license to transact the kind of business specified in the license shall be issued until June 14 thereafter. Annually thereafter, on June 14, such license may be renewed so long as the company shall comply with the requirements of the law and the commissioner shall regard it as safe, reliable, and entitled to confidence, so long as its application is consistent with the standards set forth by state law and NAIC guidelines and so long as the company continues to conduct a meaningful insurance business, as determined by the commissioner, within New Hampshire.

II. Every insurance company shall conduct its business in the legal name of the insurer as it appears on the insurer's application filed with the NAIC for a company code number. If an insurer is part of a group of affiliated insurers, the group name may appear in addition to the name of the individual insuring company, but the group name shall not be used in lieu of the legal name of the individual company.

(a) All insurance policies and contracts, and any endorsements or amendments separately issued and intended to be attached to such policies or contracts, shall identify the legal name, as set forth in paragraph II, of the insurer that is directly assuming the obligations under the policy or contract. Inclusion of the legal name of the insurer in a policy jacket, declaration, or other similar cover page issued with the policy, contract, or endorsement shall be deemed to be in compliance with this requirement.

(b) Identification of the insuring company on any advertisement or promotional materials shall be governed by the laws or rules related to advertisements, misrepresentations in sale of insurance, and misrepresentation in insurance transactions.


Source. 1903, 18:2. 1917, 78:1. PL 273:11. 1939, 22:1. RL 323:12. RSA 402:12. 1973, 74:2. 1975, 229:1. 1977, 232:1. 1983, 371:2. 2009, 215:1, eff. Jan. 1, 2010. 2021, 207:2, Pt. VI, Sec. 1, eff. Oct. 9, 2021.

    402:13 Stock Companies. 

No such license shall be issued to a stock company unless in addition to its paid-up capital it shall have a surplus over all liabilities, consisting of money or other lawful assets, to an amount not less than 25 percent of its capital stock.


Source. 1917, 78:2. PL 273:12. RL 323:13.

    402:14-a New License Required for Changed Conditions. 

The commissioner shall require a company licensed under this chapter to apply for a new license in accordance with this chapter, if, after notifying the company and after holding a hearing if requested, the commissioner finds that the company has undergone a substantial change in finances or managerial control since its last application for a license. The current license shall expire upon approval of the new application of the company or 30 days after the decision of the commissioner that a substantial change has occurred, whichever is sooner.


Source. 1975, 313:1, eff. Aug. 6, 1975.

    402:14 Mutual Companies. 

No such license shall be issued to a mutual insurance company which charges a full cash premium, unless it has applications for insurance aggregating not less than $500,000 in not less than 200 separate risks, upon which it shall have received in cash at least one premium for a term not less than one year, amounting in the aggregate to at least $10,000; provided, that this requirement shall not apply to a mutual insurance company having a fully paid up guaranty capital of not less than $500,000, nor to mutual life insurance companies, nor to mutual employers' liability insurance companies.


Source. 1917, 78:2. PL 272:13. RL 323:14. RSA 402:14. 1969, 283:4, eff. June 25, 1969.

    402:15-a Transactions Through Credit Card Facilities. 

I. No person may knowingly solicit or negotiate any insurance, seek or accept applications for insurance, issue or deliver any policy to or for any insurer or relative to a subject of insurance resident, located or to be performed in this state, through the arrangement or facilities of a credit card facility or organization, for the purpose of insuring credit card holders or prospective credit card holders. Credit card holders as used in this section means any person who may pay the charge for purchases or other transactions through the credit card facility or organization, and whose credit with such facility or organization is evidenced by a credit card, identifying such person as being one whose charges the credit card facility or organization will pay, and who is identified as such upon the credit card either by name, account number, symbol, insignia, or any other method or device of identification.

I-a. Any premiums returned as a result of cancellation on any policy paid with a credit card, or financed through a credit card facility or organization, shall be paid directly to the credit card holder. The commissioner may issue rules for the proper administration of this paragraph pursuant to RSA 400-A:15.

II. Whenever any person does or performs in this state any of the acts set forth in the preceding paragraph I for or on behalf of any insurer therein referred to, such insurer shall be held to be doing business in this state and shall be subject to the same taxes, state, county and municipal, as insurers that have been legally qualified and admitted to do business in this state by agents or otherwise are subject, the same to be assessed and collected against such insurers; and such persons so doing or performing any of such acts shall be personally liable for all such taxes.

III. The provisions of this section shall not apply to group or individual policies of accident insurance written by insurance companies duly authorized to do business in this state. However, any individual policies of accident insurance must be placed through agents who are residents of this state and who are licensed to transact business in this state.


Source. 1965, 288:1. 1973, 257:1. 1979, 448:2. 1981, 502:6. 1986, 194:1, eff. Aug. 2, 1986.

    402:15-b Direct Billing Restricted. 

No insurer authorized and licensed to issue policies of insurance other than life and accident and health insurance and to transact business in this state shall demand or make mandatory upon any agent so licensed in this state, any system of direct billing to the insured by the insurer unless such system shall be approved, accepted and endorsed by any such agent in writing, on a form prescribed by the commissioner. No insurer authorized and licensed to issue policies of insurance other than life and accident and health insurance and to transact business in this state shall cancel an agent's book of business with such insurer in its entirety or in part following an agent's decision not to accept a direct billing proposal advanced by the said insurer wherein such cancellation can be attributed to the agent's decision not to accept a system of direct billing to the insured.


Source. 1975, 498:1, eff. June 24, 1975.

    402:15-c Termination of Insurance Agency Contracts. 

I. Any insurance company authorized to transact fire or casualty business in this state shall, upon termination of an agent's appointment by said company, permit the renewal of all contracts of insurance written by such agent for a period of one year from the date of such termination, as determined by the individual underwriting requirements of said company; provided, however, that if any contract does not meet such underwriting requirements, the company shall give the agent 60 days' notice of its intention not to renew said contract.

II. No insurance agency contract entered into in this state by a licensed insurer with an insurance agent licensed under this chapter shall be terminated by the licensed insurer unless the licensed insurer upon terminating such contract shall give not less than 90 days' written notice in advance to the other party unless the contract shall be terminated by the licensed insurer for failure of the licensed insurance agent, after receiving a written demand, to pay over monies due to such insurer, provided during said 90-day period after any such notice, the licensed insurance agent shall not write or bind any new business on behalf of the licensed insurer without the specific written approval by such insurer of such business. This paragraph shall not apply to any contract with an agent for the sale of life insurance.

III. Any insurance company renewing contracts of insurance in accordance with this section shall pay commissions for such renewals to the terminated agent in the same amount as had been paid to him on similar policies during the 12 months immediately preceding the notice of termination.

IV. This section shall not apply to business owned by the insurer and not the agent; provided, that the insurer offers to continue such policies through another of its agents.


Source. 1975, 498:1. 2004, 29:1, eff. June 22, 2004.

    402:15 Eligibility as Agent. 

 An insurance producer license to act as an agent shall be issued to any eligible person or business entity pursuant to the provisions of RSA 402-J.


Source. 1933, 124:2. RL 323:16. RSA 402:15. 1969, 366:1. 2000, 315:9, eff. Jan. 1, 2001.

    402:16-a Repealed by 2015, 62:2, eff. Aug. 31, 2015. 

    402:16-b Insurance Referrals. 

Notwithstanding other provisions of this title, a person who has not complied with all applicable state insurance licensing and appointment laws and regulations may refer a party to a person who has complied with all applicable state insurance licensing and appointment laws and regulations, if the person making such referral is compensated for such referral in an amount that does not exceed the nominal amount of $25 and such amount is not based on or related to the party's purchase of insurance.


Source. 2000, 313:1, eff. Aug. 20, 2000. 2022, 42:3, eff. July 2, 2022.

    402:16 Repealed by 2000, 315:26, I, eff. Jan. 1, 2001. 

    402:17 Repealed by 2000, 315:26, II, eff. Jan. 1, 2001. 

    402:18-a Repealed by 2000, 315:26, IV, eff. Jan. 1, 2001. 

    402:18 Repealed by 2000, 315:26, III, eff. Jan. 1, 2001. 

    402:19 Repealed by 2000, 315:26, V, eff. Jan. 1, 2001. 

    402:2 Contingent Liability. 

Any mutual fire or casualty insurance company organized under the laws of this state, which charges a full cash premium, may limit the liability of policyholders to assessment by a stipulation in the policy, which shall have the same effect as a deposit note signed by the insured; but such contingent liability of a member shall not be less than an amount equal to and in addition to the cash premium written in his policy. Any such mutual fire insurance company, from and after May 20, 1941, and any such mutual casualty insurance company, from and after January 1, 1943, may issue nonassessable policies in this state upon compliance with the following requirements:

I. It shall have and at all times maintain a surplus to policyholders as determined from its latest annual statement on file, which together with 30 percent of its unearned premium reserve is at least equal to the minimum capital required for the organization of a domestic stock insurance company to do the same kind or kinds of insurance. Provided that this additional requirement shall not apply to those mutual fire or casualty companies organized under the laws of this state which are lawfully authorized to issue nonassessable policies in this state and are in fact issuing such nonassessable policies in this state on May 1, 1969. Provided further that this additional requirement of surplus to policyholders may be reduced by the commissioner to a sum not less than the amount of the deposit required under paragraph II as to any domestic mutual fire or casualty company in existence on May 1, 1969, whenever the commissioner finds that such mutual company will, under the circumstances, be safe, reliable and entitled to confidence.

II. Mutual companies formed to do business under RSA 401:1, I and II, shall maintain a deposit with the insurance commissioner of $300,000 and mutual companies formed to do business under RSA 401:1, IV, V, VI or VII shall maintain a deposit with the insurance commissioner of $500,000 in cash or in securities which are legal investments for savings banks and in such other investments as may be approved by the insurance commissioner.

III. A mutual fire or casualty insurance company shall issue nonassessable policies only so long as it maintains these financial requirements and if it fails to maintain these requirements it shall not thereafter issue nonassessable policies in this state for one year from the time when its surplus, unearned premium reserve and deposit again meet the financial requirements of this section.

IV. Every policy issued by any such company shall clearly state whether or not the holder of such policy is subject to liability for assessment. Any policy issued by any such company which subjects the policyholder to liability for assessment shall contain a clear statement of the liability of the policyholder for the payment of his proportionate share of any deficiency or impairment as provided by law within the limit established by the policy, and shall further state that any assessment shall be for the exclusive benefit of holders of policies which provide for such contingent liability; and the holders of such policies shall not be liable to assessment in an amount greater in proportion to the total deficiency than the ratio that the deficiency attributable to the assessable business bears to the total deficiency.


Source. 1887, 35:1. PS 168:2. 1917, 30:1. PL 273:2. 1929, 104:1. 1941, 122:1. RL 323:2. RSA 402:2. 1969, 283:3. 1981, 431:1, eff. Aug. 22, 1981.

    402:20 Repealed by 2000, 315:26, VI, eff. Jan. 1, 2001. 

    402:21 Repealed by 2000, 315:26, VII, eff. Jan. 1, 2001. 

    402:22 Repealed by 2000, 315:26, VIII, eff. Jan. 1, 2001. 

    402:23 Repealed by 2000, 315:26, IX, eff. Jan. 1, 2001. 

    402:24 Repealed by 1971, 244:19, II, eff. Aug. 17, 1971. 

    402:25 Repealed by 2000, 315:26, X, eff. Jan. 1, 2001. 

    402:26 Repealed by 2000, 315:26, XI, eff. Jan. 1, 2001. 

    402:27 Scope of Subdivision. 

I. This subdivision applies to insurance companies organized under the laws of this state, other than life insurance companies. The percentage limitations contained in RSA 402:28 and RSA 402:29 shall not be effective until January 1, 1993. Any such domestic company may invest its funds in investments as provided in this subdivision and not otherwise. Notwithstanding the provisions of this subdivision, the insurance commissioner may, after notice and hearing, order a domestic company to limit or withdraw from certain investments, or discontinue certain investment practices, to the extent that the commissioner finds that such investments or investment practices endanger the solvency of such company.

II. No investment, loan, or investment practice, shall be made or engaged in by any domestic company, unless the same has been authorized or ratified by the board of directors, or by a committee of the board of directors charged with the duty of supervising investments and loans.

III. No such domestic company shall subscribe to, or participate in, any underwriting of the purchase or sale of securities or property or enter into any agreement to withhold from sale any of its property, but the disposition of its property shall be at all times within the control of the board of directors. Any agreement or contract providing for the lawful disposition of property wherein such disposition may be determined at the option of a third person at some specified future price or condition or specified time or upon demand shall be construed to be within the control of the board of directors.

IV. Nothing contained in paragraph III shall prevent the board of directors of any such company from depositing any of its securities with a committee appointed for the purpose of protecting the interest of security holders or with authorities of any state or country where it is necessary to do so in order to secure permission to transact its appropriate business. Nothing contained in this subdivision shall prevent the board of directors of such company from depositing securities as collateral for the securing of any bond or obligation required for the business of the company.

V. All investments and deposits of the funds of a domestic company shall be made in its corporate name except that, subject to the approval of the commissioner, securities may be kept under a custodial or similar agreement with a bank or banking and trust company or registered investment advisor and issued in the name of a nominee of such bank or banking and trust company or registered investment advisor.


Source. 1917, 30:4. PL 273:22. RL 323:27. RSA 402:27. 1957, 43:1. 1991, 372:1, eff. Jan. 1, 1992.

    402:28 Types of Investments. 

I. Except for those investments which are authorized by RSA 401-B:2, which investments shall be governed exclusively by those sections respectively, every domestic insurance company, other than a life insurance company, shall invest and keep invested all its funds in investments enumerated below, except such cash as may be required in the transaction of its business. Such investments shall include:

(a) Government Obligations. Bonds, notes, or obligations issued, assumed, guaranteed, or insured by the United States, or by any state, territory, or possession thereof, the District of Columbia or by any county, city, town, village, municipality, or district therein or by any political subdivision or public instrumentality of one or more of the foregoing.

(b) Government Agencies. Bonds, notes, obligations, or stock issued, assumed, guaranteed, or insured by the following agencies of the United States or in which such government is a participant, whether or not such obligations are guaranteed by such government:

(1) Farm loan bank.

(2) Commodity credit corporation.

(3) Federal intermediate credit banks.

(4) Federal land banks.

(5) Central bank for cooperatives.

(6) Federal home loan banks and stock of such banks.

(7) Federal national mortgage association and stock of such association.

(8) Government national mortgage association.

(9) Federal home loan mortgage corporation.

(10) International bank for reconstruction and development.

(11) Inter-American development bank.

(12) Asian development bank.

(13) African development bank.

(14) Any other similar agency of, or in which there is participation by, the government of the United States, and the instruments are of similar financial quality.

(c) Business Obligations and Equity Interests. Stock, warrants, rights or other securities, bonds, notes or obligations issued, assumed, guaranteed, insured, or accepted by any solvent corporation, joint-stock association, trust, partnership, joint venture, or other entity or combination of entities incorporated or existing under the laws of the United States or of any state, district, or territory thereof, and any interest in any of the foregoing. An insurer shall not short sell equity investments unless the insurer covers the short sale by owning the equity investment or an unrestricted right to the equity instrument exercisable within 6 months of the short sale.

(d) Limited Partnerships. A domestic company may become a limited partner in a limited partnership on the following conditions:

(1) The partnership shall be organized under the limited partnership laws of the state of the partnership formation.

(2) The company's interest in any one limited partnership shall be subject to the general 5 percent diversification requirement in RSA 402:29-d, I(a).

(3) All investments in limited partnerships shall be subject, as applicable, to the limitations on equity interests in RSA 402:29-d, I(b) and the limitations on interests in mortgage loans and real estate in RSA 402:29-d, IV-VII.

(e) Bank Obligations. Interest-bearing deposits, banks' and bankers' acceptances, including bills of exchange, or certificates of deposit in banks, bank and trust companies, savings banks, savings associations, savings and loan associations or national banking associations, incorporated or existing under the laws of the United States or any state, district, or territory thereof, including branches of any of the foregoing, or foreign banking institutions or branches of such institutions located in the United States or any state, district, or territory thereof.

(f) Revenue Obligations. Obligations or participations in obligations which are not issued, assumed, guaranteed, or accepted by any person described under subparagraph I(c), but are:

(1) Adequately secured by an assignment or right to receive rent or other payment or revenues payable or guaranteed by any one or more persons or entities; or adequately secured by a mortgage, interest in a mortgage pool, or mortgage participation, or lien or security interest in real or personal property or any interest therein.

(2) The obligations or participations in such obligations of any person or entity whose principal assets are any one of the foregoing obligations or participations secured in accordance with subparagraph (f)(1).

(g) Mortgage Backed Securities. Mortgage backed securities include, but are not limited to: mortgage pass-through securities; mortgage backed bonds; collateralized mortgage obligations; and real estate mortgage investments conduits, adequately secured by a pool of mortgages and served by a governmental unit or instrumentality of the United States or any entity incorporated under the laws of the United States or of any state thereof.

(h) Mortgage Loans.

(1) Subject to the limitations of RSA 402:29-d, I(a), an insurer may acquire, either directly, indirectly through limited partnership interests, joint ventures, stock of an investment subsidiary, or membership interests in a limited liability company, trust certificates, or other similar instruments, obligations secured by mortgages on real estate situated within a domestic jurisdiction, but a mortgage loan which is secured by other than a first lien shall not be acquired unless the insurer is the holder of the first lien. The obligations held by the insurer and any obligations with an equal lien priority, shall not, at the time of acquisition of the obligation, exceed:

(A) Ninety percent of the fair market value of the real estate, if the mortgage loan is secured by a purchase money mortgage or like security received by the insurer upon disposition of the real estate;

(B) Eighty percent of the fair market value of the real estate, if the mortgage loan requires immediate scheduled payment in periodic installments of principal and interest, has an amortization period of 30 years or less and periodic payments made no less frequently than annually. Each periodic payment shall be sufficient to assure that at all times the outstanding principal balance of the mortgage loan shall not be greater than the outstanding principal balance that would be outstanding under a mortgage loan with the same original principal balance, with the same interest rate and requiring equal payments of principal and interest with the same frequency over the same amortization period. Mortgage loans permitted under this subparagraph are permitted notwithstanding the fact that they provide for a payment of the principal balance prior to the end of the period of amortization of the loan. For residential mortgage loans, the 80 percent limitation may be increased to 97 percent if acceptable private mortgage insurance has been obtained; or

(C) Seventy-five percent of the fair market value of the real estate for mortgage loans that do not meet the requirements of subparagraphs (1) and (2).

(2) For the purposes of subparagraph (1), the amount of an obligation required to be included in the calculation of the loan-to-value ratio may be reduced to the extent the obligation is insured by the Federal Housing Administration or guaranteed by the Administrator of Veterans Affairs, or their successors.

(3) A mortgage loan that is held by an insurer as an admitted asset on December 31, 2016 and is restructured in a manner that meets the requirements of a restructured mortgage loan in accordance with the NAIC Accounting Practices and Procedures Manual or successor publication shall continue to qualify as a mortgage loan under this subparagraph.

(4) Subject to the limitations of RSA 402:29-d, I(a), credit lease transactions that do not qualify as rated securities under subparagraph (n) with the following characteristics shall be exempt from the provisions of subparagraph (1).

(A) The loan amortizes over the initial fixed lease term at least in an amount sufficient so that the loan balance at the end of the lease term does not exceed the original appraised value of the real estate;

(B) The lease payments cover or exceed the total debt service over the life of the loan;

(C) A tenant or its affiliated entity whose rated credit instruments have a SVO 1 or 2 designation from the Securities Valuation Office of the National Association of Insurance Commissioners or a comparable rating from a nationally recognized statistical rating organization recognized by the Securities Valuation Office has a full faith and credit obligation to make the lease payments;

(D) The insurer holds or is the beneficial holder of the first lien mortgage on the real estate;

(E) The expenses of the real estate are passed through to the tenant, excluding exterior, structural, parking, and heating, ventilation, and air conditioning replacement expenses, unless annual escrow contributions, from cash flows derived from the lease payments, cover the expense shortfall; and

(F) There is a perfected assignment of the rents due pursuant to the lease to, or for the benefit of, the insurer.

(i) Income Producing Real Estate.

(1) An insurer may acquire, manage, and dispose of real estate situated in a domestic jurisdiction either directly or indirectly through limited partnership interests, joint ventures, stock of an investment subsidiary or membership interests in a limited liability company, trust certificates, or other similar instruments. The real estate shall be income producing or intended for improvement or development for investment purposes under an existing program in which case the real estate shall be deemed to be income producing.

(2) The real estate may be subject to mortgages, liens, or other encumbrances, the amount of which shall, to the extent that the obligations secured by the mortgages, liens, or encumbrances are without recourse to the insurer, be deducted from the amount of the investment of the insurer in the real estate for purposes of determining compliance with RSA 402:29-d, IV and V.

(j) Real Estate for the Accommodation of Business. An insurer may acquire, manage, and dispose of real estate for the convenient accommodation of the insurer, which may include its affiliates, business operations, including home office, branch office and field office operations.

(1) Real estate acquired under this subparagraph may include excess space for rent to others, if the excess space, valued at its fair market value, would otherwise be a permitted investment under subparagraph (i) of this section and is so qualified by the insurer;

(2) The real estate acquired under this subparagraph may be subject to one or more mortgages, liens, or other encumbrances, the amount of which shall, to the extent that the obligations secured by the mortgages, liens, or encumbrances are without recourse to the insurer, be deducted from the amount of the investment of the insurer in the real estate for purposes of determining compliance with RSA 402:29-d, V; and

(3) For purposes of this subparagraph, business operations shall not include that portion of real estate used for the direct provision of health care services by an insurer whose insurance premiums and required statutory reserves for accident and health insurance constitute at least 95 percent of total premium considerations or total statutory required reserves, respectively. An insurer may acquire real estate used for these purposes under RSA 402:28, I(h) and subject to the limitations set out in RSA 402:29-d, V.

(k) Collateral Loans. Direct obligations for the payment of money adequately secured by the pledge of any property which would be authorized as an investment under this subdivision.

(l) Derivative transactions. An insurer may use derivative instruments to engage in hedging transactions, income generation transactions, and replication transactions on the following conditions:

(1) An insurer may enter into hedging transactions if, measured at the time of acquisition after giving effect to such transactions, all of the following apply:

(A) The aggregate statement value of options, caps, floors, and warrants not attached to another financial instrument purchased and used in hedging transactions does not exceed 7-
1/2 percent of its admitted assets.

(B) The aggregate statement value of options, caps, and floors written in hedging transactions does not exceed 3 percent of its admitted assets.

(C) The aggregate potential exposure of collars, swaps, forwards, and futures used in hedging transactions does not exceed 6-
1/2 percent of its admitted assets.

(D) Transactions entered into to hedge the currency risk of investments denominated in a currency other than United States dollars shall not be included in the limits under this subparagraph. An insurer may purchase, sell, or enter into one or more derivative transactions to offset, in whole or in part, any derivative instrument or derivative transaction previously purchased, sold, or entered into, without regard to the quantitative limitations of this paragraph, provided that such derivative instrument or derivative transaction is an exact offset, in whole or in part, to the original derivative instrument or derivative transaction being offset.

(2) An insurer may enter into the following types of income generation transactions if, at the time of acquisition after giving effect to the transactions the aggregate statement value of the fixed income assets that are subject to call or that generate the cash flows for payments under the caps or floors, plus the face value of fixed income securities underlying a derivative instrument subject to call, plus the amount of the purchase obligations under the puts, does not exceed 10 percent of its admitted assets:

(A) Sales of covered call options on noncallable fixed income securities, callable fixed income securities if the option expires by its terms before the end of the noncallable period or derivative instruments based on fixed income securities.

(B) Sales of covered call options on equity securities, if the insurer holds in its portfolio or can immediately acquire through the exercise of options, warrants, or conversion rights already owned the equity securities subject to call during the complete term of the call option sold.

(C) Sales of covered puts on investments that the insurer is permitted to acquire under this section, if the insurer has escrowed, or entered into a custodian agreement segregating, cash or cash equivalents with a market value equal to the amount of its purchase obligations under the put during the complete term of the put option sold.

(D) Sales of covered caps or floors, if the insurer holds in its portfolio the investments generating the cash flow to make the required payments under the caps or floors during the complete term that the cap or floor is outstanding.

(3) An insurer may enter into replication transactions if both of the following apply:

(A) The insurer would otherwise be authorized to invest its funds under this section in the asset being replicated.

(B) The asset being replicated is subject to all the provisions of this section relating to the making of investments by the insurer in that type of asset as if the transaction constituted a direct investment by the insurer in the replicated asset.

(4) The commissioner may approve of additional transactions involving the use of derivative instruments in excess of the limits of this paragraph or for other risk management purposes, except that replication transactions under this subparagraph shall be permitted only for risk management purposes.

(m) Each derivative instrument shall be one of the following:

(1) Traded on or entered into with a qualified exchange.

(2) Entered into with or guaranteed by a business entity.

(3) Issued or written with the issuer of the underlying interest on which the derivative instrument is based.

(4) Traded on or entered into with a qualified foreign exchange.

(n) For the purposes of subparagraphs I(l) and (m), unless the context otherwise requires:

(1) "
Business entity
" includes a sole proprietorship, corporation, limited liability company, association, bank, partnership, joint stock company, joint venture, mutual fund, trust, joint tenancy, or other similar form of business organization, whether organized for-profit or not-for-profit.

(2) "
Cap
" means an agreement obligating the seller to make payments to the buyer, with each payment based on the amount by which a reference price or level or the performance or value of one or more underlying interests exceeds a predetermined number, sometimes called the strike rate or strike price.

(3) "
Collar
" means an agreement, or series of agreements to receive payments as the buyer of an option, cap, or floor and to make payments as the seller of a different option, cap, or floor.

(4) "
Derivative instrument
" means an agreement, option, or instrument, or a series or combination that:

(A) Either requires a party to make or take delivery of, or assume or relinquish, a specified amount of one or more underlying interests, or to make a cash settlement in lieu thereof, or has a price, performance, value, or cash flow based primarily on the actual or expected price, level, performance, value, or cash flow of one or more underlying interests.

(B) Includes options, warrants used in a hedging transaction and not attached to another financial instrument, caps, floors, collars, swaps, forwards, futures, and any other agreements, options, or instruments substantially similar thereto or any series or combination thereof and any agreements, options, or instruments permitted under rules adopted to carry out the provisions of subparagraphs I(l) and (m).

(C) Does not include an investment authorized by RSA 402:28, I(a) through (k), RSA 402:28, I(o) through (p), RSA 402:28, I(r) through (s), or RSA 402:28, II through IV.

(5) "
Derivative transaction
" means a transaction involving the use of one or more derivative instruments.

(6) "
Floor
" means an agreement obligating the seller to make payments to the buyer in which each payment is based on the amount by which a predetermined number exceeds a reference price, level, performance, or value of one or more underlying interests.

(7) "
Forward
" means an agreement, other than a future, to make or take delivery of, or effect a cash settlement based on the actual or expected price, level, performance, or value of, one or more underlying interests, but shall not mean or include spot transactions effected within customary settlement periods, when-issued purchases, or other similar cash market transactions.

(8) "
Future
" means an agreement, traded on a qualified exchange or qualified foreign exchange, to make or take delivery of, or effect a cash settlement based on the actual or expected price, level, performance, or value of, one or more underlying interests.

(9) "
Hedging transaction
" means a derivative transaction that is entered into and maintained to reduce either:

(A) The risk of a change in the value, yield, price, cash flow, or quantity of assets or liabilities that the insurer has acquired or incurred or anticipates acquiring or incurring either directly or indirectly through an investment in an underlying entity.

(B) The currency exchange rate risk or the degree of exposure as to assets or liabilities that an insurer has acquired or incurred or anticipates acquiring or incurring either directly or indirectly through an investment in an underlying entity.

(10) "
Income generation transaction
" means a derivative transaction involving the writing of covered call options, covered put options, covered caps, or covered floors that is intended to generate income or enhance return.

(11) "
Option
" means an agreement giving the buyer the right to buy or receive, referred to as a "call option", to sell or deliver, referred to as a "put option", to enter into, extend, or terminate, or to effect a cash settlement based on the actual or expected price, spread, level, performance, or value of one or more underlying interests.

(12) "
Qualified exchange
" means:

(A) A securities exchange registered as a national securities exchange, or a securities market regulated under the Securities Exchange Act of 1934, as amended.

(B) A board of trade, commodities exchange, or clearing organization designated as a contract market or derivatives clearing organization by the Commodity Futures Trading Commission or any successor thereof.

(C) Private offerings, resales, and trading through automated linkages.

(D) A designated offshore securities market as defined in securities exchange commission regulations, 17 C.F.R. part 230, as amended.

(E) A qualified foreign exchange.

(13) "
Qualified foreign exchange
" means a foreign exchange, board of trade, or contract market located outside the United States or its territories or possessions if one of the following applies:

(A) The exchange, board of trade, or contract market has received regulatory comparability relief under Commodity Futures Trading Commission rule 30.10, as set forth in 17 C.F.R. part 30, appendix C.

(B) The exchange, board of trade, or contract market is, or its members are, subject to the jurisdiction of a foreign futures authority that has received regulatory comparability relief under Commodity Futures Trading Commission rule 30.10, as set forth in 17 C.F.R. part 30, appendix C as to futures transactions in the jurisdiction where the exchange, board of trade, or contract market is located.

(C) Foreign stock index futures contracts are listed on the exchange, board of trade, or contract market and the contracts are the subject of no-action relief issued by the Commodity Futures Trading Commission office of general counsel if the exchange, board of trade, or contract market that qualifies as a qualified foreign exchange under this subdivision is a qualified foreign exchange only as to foreign stock index futures contracts that are the subject of no-action relief.

(14) "
Replication transaction
":

(A) Means a derivative transaction that is intended to replicate the performance of one or more assets that an insurer is authorized to acquire under this section.

(B) Does not include a derivative transaction that is entered into as a hedging transaction.

(15) "
Spot transaction
" means a transaction that settles via an actual delivery of the underlying asset within the standard settlement period for such asset.

(16) "
Swap
" means an agreement to exchange or to net payments at one or more times based on the actual or expected price, level, performance, or value of one or more underlying interests.

(17) "
Underlying interest
" means the assets, liabilities, other interests or a combination thereof underlying a derivative instrument, including any securities, currencies, rates, indices, commodities, or derivative instruments.

(18) "
Warrant
" means an instrument that gives the holder the right to purchase an underlying financial instrument at a given price and time or at a series of prices and times outlined in the warrant agreement. Warrants may be issued alone or in connection with the sale of other securities, including as part of a merger or recapitalization agreement or to facilitate divestiture of the securities of another business entity.

(o) Securities Lending. The investment practice of lending securities and entering into repurchase agreements and reverse repurchase agreements is authorized on the following conditions:

(1) "
Lending of securities
" means an investment other than a repurchase agreement, whereby an agreement is entered into which transfers ownership rights and possession of securities to the borrower of such securities with the agreement providing for a return of ownership rights and possession of the securities to the lender at a specified date or upon demand.

(2) "
Repurchase agreement
" means a bilateral agreement whereby a company purchases securities with a related agreement that the seller will purchase or repurchase at a specified price the equivalent or similar securities within a specified period of time or on demand.

(3) "
Reverse repurchase agreement
" means a bilateral agreement whereby a company:

(A) Sells securities with a related agreement to purchase or repurchase at a specified price the equivalent or similar securities within a specified period of time or upon demand; or

(B) Borrows funds and transfers securities to the lender with a related agreement that equivalent or similar securities shall be returned to the company upon repayment of the loan within a specified period of time or on demand.

(4) Lending of securities, repurchase agreements, and reverse repurchase agreements are authorized on the following conditions:

(A) The agreement for each transaction or the master agreement for a series of transactions shall be reduced to writing.

(B) Securities acquired by a company owned subject to reacquisition pursuant to an outstanding repurchase agreement may not be sold pursuant to a reverse repurchase agreement nor lent pursuant to a lending of securities agreement. Consideration, or collateral, received from a reverse repurchase agreement or lending of securities agreement may be used to acquire securities which are equivalent or similar to the securities transferred pursuant to such repurchase agreement or lending of securities agreement; however, such acquired securities may not be sold pursuant to a reverse repurchase agreement nor lent pursuant to a lending of securities agreement.

(C) A company is limited to no more than 10 percent of its admitted assets being subject to lending of securities, repurchase agreements or reverse repurchase agreements transactions outstanding with any one entity under this paragraph.

(D) A company may engage in lending its securities or repurchase or reverse repurchase agreements not to exceed 40 percent of its admitted assets, provided, however, that such transactions are collateralized 102 percent of the market value of loaned securities at the close of every business day in which such agreement remains open.

(p) Rated Securities. Obligations which are rated by a securities rating agency, which agency is acceptable to the commissioner, and which securities are rated so as to be in one of the highest 4 generic lettered rating classifications, or awarded a "yes" rating by the Securities Valuation Office of the National Association of Insurance Commissioners.

(q) Basket Provision. Any investment of any kind not otherwise authorized by this subdivision up to an amount not exceeding in the aggregate 10 percent of such company's admitted assets.

(r) Mutual Funds. Equity interest in an open-ended investment company registered with the United States Securities and Exchange Commission under the Investment Company Act of 1940 (15 U.S.C. section 80a-1 et seq.) as amended, provided that substantially all the investments of such mutual funds are traded on a nationally recognized stock exchange or on the NASDAQ system.

(s) With approval of the commissioner, funds loaned to the New Hampshire Insurance Guaranty Association pursuant to RSA 404-H:8, II(b).

II. (a) 
Foreign Securities; Insurance Policy Related. A domestic company which is lawfully doing business in any foreign country may also invest its funds in:

(1) Bonds, notes, or obligations of such foreign country, or of a political subdivision, governmental corporation or agency, of such foreign country.

(2) Stocks, warrants, rights or other securities, bonds, notes, or obligations of any business entity formed or located in such foreign country, which are of the same kinds, classes and grades as those eligible for investments under this subdivision.

(b) The aggregate carrying value of all investments under this paragraph shall not exceed 150 percent of the liabilities arising from the outstanding policies of insurance issued or delivered in such foreign country.

III. 
United States Dollar Denominated Foreign Investments. A domestic company may invest in stocks, warrants, rights or other securities, bonds, notes, or obligations, of foreign entities which are denominated in United States dollars, which are of the same kind, class and grade of United States investments which are authorized under any other provision of this subdivision. Any investment authorized under this paragraph shall be aggregated with United States investments of the same category in determining compliance with percentage limitations, if any, contained in other provisions of this subdivision.

IV. 
Foreign Investments Denominated in Foreign Currency. A domestic company may invest in stocks, warrants, rights or other securities, bonds, notes, or obligations, of foreign entities which are denominated in a foreign currency, which are of the same kind, class and grade of United States investments which are authorized under any other provision of this subdivision. The aggregate carrying value of all investments under this paragraph shall be 10 percent of such company's admitted assets.


Source. 1917, 30:4. PL 273:23. RL 323:28. RSA 402:28. 1975, 232:1. 1977, 334:1. 1991, 372:2. 1997, 221:4. 2004, 197:3. 2016, 254:1, eff. Aug. 9, 2016. 2021, 119:2, Pt. II, Sec. 1, eff. July 9, 2021.

    402:29-a Lawful Distributions. 

I. Nothing in this subdivision shall prohibit the acquisition by a domestic company of other or additional securities or property if received as a dividend or as a lawful distribution of assets, or upon a debt or judgment, or under a lawful and bona fide agreement of bulk reinsurance, merger, or consolidation, or if acquired by it through the exercise of warrants, options, or similar rights to acquire securities received by it in accordance with this subdivision.

II. Nothing in this subdivision shall prevent any company from entering into an agreement for the purpose of protecting the interests of the company in securities lawfully held by it, or for the purpose of reorganization of a corporation which issued securities so held, and from depositing such securities with a committee or depositaries appointed under such agreement, nor from accepting stock, bonds, or other securities or other property which may be distributed pursuant to any such agreement, or to any plan of reorganization or arrangement.

III. No provision of this subdivision shall prevent any company from acquiring or holding any property acquired in satisfaction of any debt previously contracted, or that shall be obtained by sale or foreclosure of any security held by it. Any security or property so acquired which is not otherwise an eligible investment under this subdivision shall be disposed of within 5 years from date of acquisition, unless within such period the security or property has attained to the standard of eligibility, except that any security or personal property acquired under any agreement of bulk reinsurance, merger, or consolidation may be retained for a longer period if so provided in the plan for such reinsurance, merger, or consolidation. The commissioner may grant from time to time reasonable extensions of the period within which an insurer shall dispose of any such property or security.


Source. 1991, 372:4, eff. Jan. 1, 1992.

    402:29-b Prohibited Acts. 

No director or other officer of a company, and no member of a committee having any authority in the investment or disposition of its funds, shall accept, or be the beneficiary of, either directly or indirectly, any fee, brokerage, commission, gift or other consideration for or on account of any loan, deposit, purchase, sale, payment or exchange made by or in behalf of such company, or be pecuniarily interested in any such purchase, sale or loan, either as borrower, principal, agent or beneficiary, except that, if a policyholder, he shall be entitled to all the benefits accruing under the terms of his contract. This section shall not prohibit the purchase by an insurance company of real property serving as the residence of any of its officers, employees, or directors, when such purchase is made in connection with the relocation by the insurer of the place of employment of such officer, employee, or director and at no more than the fair market value of such property as determined by an independent appraisal. No such real property having a purchase price in excess of $500,000 may be so acquired except with the approval of the insurance commissioner.


Source. 1991, 372:4, eff. Jan. 1, 1992.

    402:29-c Purchasing Its Own Stock. 

No company shall invest its funds in, or loan them on its own stock without the prior approval of the insurance commissioner. This section shall not prohibit a company from investing its funds in the stock or obligations of its parent company provided that:

I. Such stock shall be valued according to the Securities Valuation Manual of the National Association of Insurance Commissioners.

II. No company shall hold, at any one time, more than 10 percent of its policyholder surplus, in such stock or obligations.

III. Such stock, in order to qualify under this section, shall be traded on a nationally recognized stock exchange or on the NASDAQ system.


Source. 1991, 372:4, eff. Jan. 1, 1992.

    402:29-d Quantitative Limitations. 

I. Except for investments in subsidiaries, an insurer shall not acquire:

(a) Directly or indirectly through an investment subsidiary, an investment under this chapter if, as a result of and after giving effect to the investment, the insurer would hold more than 5 percent of its admitted assets in investments of all kinds issued, assumed, accepted, insured, or guaranteed by a single person; provided, that this subparagraph shall not apply to general obligations of, or obligations guaranteed by, the United States, its agencies or government-sponsored enterprises, or obligations of any state, or of Canada or any province thereof; or

(b) Equity interests in business entities if, as a result of and after giving effect to the investment, the aggregate amount of investments then held by the insurer under this section would exceed the greater of 25 percent of its admitted assets or 100 percent of its surplus as regards policyholders. An insurer shall not acquire, under this paragraph, any investments that the insurer may acquire under RSA 402:28, I(g), (h), or (i), and any investments made under RSA 402:28, I(g), (h), or (i) shall be subject to the limitations established in paragraphs IV-VI.

II. The 5 percent limitation established in subparagraph I(a) shall not apply to the aggregate amounts insured by a single financial guaranty insurer with the highest generic rating issued by a nationally recognized statistical rating organization. In addition, asset-backed securities shall not be subject to the limitations of subparagraph I(a), except that an insurer shall not acquire an asset-backed security if, as a result of and after giving effect to the investment, the aggregate amount of asset-backed securities secured by or evidencing an interest in a single asset or single pool of assets held by a trust or other business entity, then held by the insurer would exceed 5 percent of its admitted assets.

III. 
Equity interests
, as used in subparagraph I(b), shall mean common stock, general, preferred or limited partnership interest, trust certificate, investment in an investment company other than a money market mutual fund, investment in a common trust fund of a bank regulated by a federal or state agency, warrant, or other similar right to acquire an equity interest, member interests in limited liability companies, or any other similar interest.

IV. An insurer shall not acquire an investment in obligations secured by mortgages on real estate under RSA 402:28, I(g) if, as a result of and after giving effect to the investment, the aggregate amount of all investments then held by the insurer under RSA 402:28, I(g) would exceed:

(a) One percent of its admitted assets in mortgage loans covering any one secured location;

(b) One quarter of one percent of its admitted assets in construction loans covering any one secured location; or

(c) One percent of its admitted assets in construction loans in the aggregate.

V. An insurer shall not acquire an investment in income producing real estate under RSA 402:28, I(i) if, as a result of and after giving effect to the investment and any outstanding guarantees made by the insurer in connection with the investment, the aggregate amount of investments then held by the insurer under RSA 402:28, I(i) plus the guarantees then outstanding would exceed:

(a) One percent of its admitted assets in one parcel or group of contiguous parcels of real estate, except that this limitation shall not apply to that portion of real estate for the direct provision of health care services by an insurer whose insurance premiums and required statutory reserves for accident and health insurance constitute at least 95 percent of total premium considerations or total statutory required reserves, respectively, such as hospitals, medical clinics, medical professional buildings, or other health facilities used for the purpose of providing health services; or

(b) The lesser of 10 percent of its admitted assets or 40 percent of its surplus as regards policyholders in the aggregate, except for an insurer whose insurance premiums and required statutory reserves for accident and health insurance constitute at least 95 percent of total premium considerations or total statutory required reserves, respectively, this limitation shall be increased to 15 percent of its admitted assets in the aggregate.

VI. An insurer shall not acquire an investment in obligations secured by mortgages on real estate under RSA 402:28, I(g) or in income producing real estate under RSA 402:28, I(i) if, as a result of and after giving effect to the investment and any guarantees it has made in connection with the investment, the aggregate amount of all investments then held by the insurer under RSA 402:28, I(g) and RSA 402:28, I(i) plus the guarantees then outstanding would exceed 25 percent of its admitted assets.

VII. The limitations of paragraph I(a) shall not apply to an insurer's acquisition of real estate for the accommodation of business under RSA 402:28, I(j). An insurer shall not acquire real estate under RSA 402:28, I(j) if, as a result of and after giving effect to the acquisition, the aggregate amount of real estate then held by the insurer under RSA 402:28, I(j) would exceed 10 percent of its admitted assets. With the permission of the commissioner, additional amounts of real estate may be acquired under RSA 402:28, I(j).

VIII. Each investment or asset held by an insurer on January 1, 1994, which was eligible as an admitted asset at the time it was acquired, committed for, or engaged in, and any refinancing, modification, or extension thereof, shall be deemed to be eligible as an admitted asset under this chapter but shall be included as part of the limitation described above.

IX. Investments exceeding the limitation established by this section shall not be permitted under any other provision of this chapter including, but not limited to, RSA 402:28, I (q) and shall not be considered admitted assets of the insurer.

X. An insurer may invest in mutual funds in excess of the limits set forth in this section, provided the insurer shall not invest:

(a) More than 10 percent of its admitted assets in equity interests of a single mutual fund; or

(b) More than the greater of 25 percent of its admitted assets or 100 percent of its capital and surplus in equity interests held either directly by the insurer or indirectly through interests in mutual funds.

XI. An insurer shall not acquire under this section any investments that the insurer may acquire under RSA 402:29-a.


Source. 1993, 254:5. 1997, 221:5. 2016, 254:2, eff. Aug. 9, 2016. 2018, 67:1, eff. July 24, 2018. 2020, 37:47, eff. Sept. 27, 2020.

    402:29 Loans to Transferred Employees. 

A company may lend funds, on a secured basis, to an employee to defray, in whole or in part, the expenses of such employee who has been transferred. The maximum amount of any such loan to an employee shall be $250,000. This section also shall not prohibit the taking of a secured mortgage by a company on real property serving as the residence of any of its officers, employees, or directors. Such mortgage shall not exceed 85 percent of the appraised value of such realty as determined by an independent appraiser or the market value, whichever is the lesser amount. One of the terms of such mortgage shall provide that the outstanding balance of the mortgage becomes immediately due and payable to the company upon termination of the employment, or officer or director relationship, between the company and the mortgagor, or upon termination of said person's ownership of said real property.


Source. 1911, 87:1. 1913, 88:1. PL 273:24. RL 323:29. RSA 402:29. 1978, 11:2. 1991, 372:3, eff. Jan. 1, 1992.

    402:3 Assessment. 

No person insured in such company, or in any class thereof, in which the amount insured is less than $50,000, shall be assessed any greater sum than he would be if that amount were insured; but the officers of the company shall be individually liable for the indebtedness of the company not provided for by such assessments.


Source. 1858, 2082:2. GS 158:5. GL 173:5. PS 168:3. PL 273:3. RL 323:3.

    402:30-a Rulemaking. 

The commissioner may adopt rules, under RSA 541-A, which are reasonable and necessary for the implementation and administration of this chapter relative to:

I. Financial solvency standards, for investments under RSA 402:28.

II. Valuation standards, for investments under RSA 402:28.

III. Reporting requirements, for investments under RSA 402:28.

IV. Valuation of eligible investments not covered under RSA 402:30.

V. [Repealed.]


Source. 1963, 69:1. 1978, 11:3. 1991, 372:6. 2002, 207:28. 2012, 171:26, XVIII, eff. Aug. 10, 2012.

    402:30-b Misconduct. 

If an insurance company organized under the laws of this state shall be guilty of gross waste, misconduct or negligence in the management of its affairs, its charter or authority to do business shall be liable to forfeiture as provided in this subdivision.


Source. 1975, 311:1, eff. Aug. 6, 1975.

    402:30-c Petition. 

Whenever the commissioner is of the opinion that any such cause for revocation exists he shall file a petition against the company in the superior court of the county in which it has its principal place of business, praying for a decree of forfeiture and for a settlement of its affairs, which shall be entered and prosecuted according to the course of equity proceedings.


Source. 1975, 311:1, eff. Aug. 6, 1975.

    402:30-d Prosecution. 

The attorney general shall act for the commissioner in making and prosecuting the petition. The incidental expenses of the prosecution shall be paid by the state.


Source. 1975, 311:1, eff. Aug. 6, 1975.

    402:30-e Orders. 

If the court is satisfied that there has been gross waste, misconduct or negligence in the management of its affairs, it shall decree a forfeiture of the company's charter or authority to do business, and shall make all other orders required for closing up and settling its affairs; otherwise the petition shall be dismissed and the defendant's taxable costs shall be paid by the state.


Source. 1975, 311:1, eff. Aug. 6, 1975.

    402:30 Valuation of Securities. 

Investments shall be valued as follows:

I. Securities held in accordance with the provisions of this subdivision shall be valued in accordance with the published valuation standards of the Securities Valuation Office of the National Association of Insurance Commissioners.

II. Securities as to which the National Association of Insurance Commissioners has not published valuation standards in its Valuation of Securities Manual, or its successor publication, shall be valued as follows:

(a) As obligations having a fixed term and rate shall, if not in default as to principal or interest, be valued as follows: if purchased at par, at the par value; if purchased at or below par, on the basis of the purchase price adjusted so as to bring the value to par at maturity and so as to yield in the meantime the effective rate of interest at which the purchase was made.

(b) Common, preferred, except sinking fund preferred stock valued under subparagraph (c), or guaranteed stocks, shall be valued at their market value or at the option of the company, they may be valued at purchase price if purchase price is less than market value.

(c) Sinking fund preferred stocks which are subject to mandatory redemption shall be valued at cost.

(d) Any investment that is not valued by standards published by the National Association of Insurance Commissioners may be submitted by the company to the Securities Valuation Office for valuation, which valuation shall govern.

(e) No other investment shall be valued at more than its purchase price. Purchase price for real property includes capitalized permanent improvements, less depreciation spread evenly over the life of the property or, at the option of the company, less depreciation computed on any basis permitted under the United States Internal Revenue Code of 1986, as amended and regulations thereunder. Such investments that have been affected by permanent declines in value shall be valued at not more than their market value.

(f) Any investment, including real property, not purchased by a company, but acquired in satisfaction of a debt or otherwise shall be valued in accordance with the applicable procedures for that type of investment contained in this section. For purposes of applying the valuation procedures, the purchase price shall be deemed to be the market value at the time the investment is acquired or in the case of any investment acquired in satisfaction of debt, the amount of the debt, including interest, taxes and expenses, whichever amount is less.

(g) The eligibility of an investment shall be determined as of the date of its making or acquisition or the date of commitment in the case of commitment to invest.


Source. 1887, 47:1. PS 168:5. 1917, 30:2. PL 273:25. RL 323:30. RSA 402:30. 1991, 372:5. 1992, 288:13, 14, eff. Jan. 1, 1993.

    402:31 to 402:35 Repealed by 1969, 272:2, eff. June 23, 1969. 

    402:36 to 402:38 Repealed by 1971, 244:19, III, eff. Aug. 17, 1971. 

    402:39 to 402:41 Repealed by 2019, 127:2, eff. Aug. 24, 2019. 

    402:4 Assessments on Closing Business. 

No more than 30 percent above its actual indebtedness shall be assessed by any such company to close its affairs; and the officers and agents thereof shall not receive more than 20 percent of the money collected for their services in closing its business.


Source. 1858, 2082:4. GS 158:6. GL 173:6. PS 168:4. PL 273:4. RL 323:4.

    402:42 Penalty. 

Whoever violates any provision of this subdivision shall be fined not more than $2,500 or shall have any license suspended or revoked or shall both be fined and have any license suspended or revoked.


Source. 1907, 111:2. PL 273:36. RL 323:41. RSA 402:42. 1973, 529:99. 1983, 473:5, eff. Sept. 3, 1983.

    402:43 to 402:45 Repealed by 2009, 96:1, I, eff. June 12, 2009. 

    402:46 Terms of Policies. 

No insurance company, association, or society or officer, director, agent, broker, or solicitor thereof, shall issue, circulate, or use, or cause or permit to be issued, circulated, or used, any statement, estimate, illustration, or circular misrepresenting the terms of any policy issued or to be issued by such company, or the benefits or privileges promised, or the future dividends payable, under any such policy.


Source. 1913, 127:2. PL 273:40. RL 323:45.

    402:47 Inducing Lapses. 

No insurance company, association or society, officer, director, agent, solicitor or broker, nor any person, firm, association, or corporation, shall make any misrepresentation, oral, written, or otherwise, or any misleading estimate of the dividends or share of surplus to be received thereon or any incomplete comparison of policies, to any person insured in any company for the purpose of inducing or tending to induce such person to take out a policy of insurance, or for the purpose of inducing, or tending to induce, a policyholder in any company to lapse, forfeit, or surrender his insurance therein and to take out a policy of insurance in another like company.


Source. 1913, 127:2. PL 273:41. 1929, 47:1. RL 323:46.

    402:48 Penalty. 

Whoever violates any provision of this subdivision shall be fined not more than $2,500 or shall have any license suspended or revoked or shall both be fined and have any license suspended or revoked.


Source. 1913, 127:4. PL 273:42. RL 323:47. RSA 402:48. 1973, 528:275. 1983, 473:6, eff. Sept. 3, 1983.

    402:49 Revocation of Licenses. 

The commissioner may, after notice and hearing, revoke or suspend a license theretofore issued to any company, association or society, agent or broker for a period not exceeding 3 years, for any such knowing or wilful violation.


Source. 1913, 127:4. PL 273:43. RL 323:48.

    402:5 Territory. 

A mutual fire insurance company, organized under the laws of the state, may limit its operations within certain prescribed boundaries; and in such case it shall be barred from insuring property situated outside those boundaries.


Source. 1850, 999:1. CS 154:1. GS 158:2. GL 173:2. PS 168:6. PL 273:5. RL 323:5.

    402:50 General Penalty. 

Whoever violates any provision of this subdivision shall be fined not more than $2,500 or shall have any license suspended or revoked or shall both be fined and have any license suspended or revoked.


Source. 1870, 1:13. GL 171:10. PS 168:18. PL 273:44. RL 323:49. RSA 402:50. 1973, 529:100. 1983, 473:7, eff. Sept. 3, 1983.

    402:51 Embezzlement;  Fraud. 

If any officer of an insurance company organized under the laws of this state shall embezzle, abstract or wilfully misapply any of the money, funds or other securities of the company, or shall represent as the property of the company any money, funds or other securities which belong to others, or shall make any false entry in any book, report or statement of the company with intent in either case to injure or defraud it, or to deceive any of its officers or the commissioner or any other person or persons appointed to examine its affairs, he shall be guilty of a class A felony.


Source. 1895, 106:1. PL 273:45. RL 323:50. RSA 402:51. 1973, 528:276, eff. Oct. 31, 1973 at 11:59 p.m.

    402:52 Illegal Fees, etc. 

If any officer or employee of any such insurance company shall directly or indirectly receive any fee, present or benefit whatever from any borrower or applicant for a loan from such company as an inducement to making the loan, or from any one negotiating securities to the company (except the usual compensation for drawing mortgages and other papers pertaining to the loan), or for negotiating loans in his own behalf as an official of the company, shall be guilty of a class A felony.


Source. 1895, 106:2. PL 273:46. RL 323:51. RSA 402:52. 1973, 528:277, eff. Oct. 31, 1973 at 11:59 p.m.

    402:53 Conversion by Agent. 

Any money, substitute for money or thing of value whatever, received by any agent, solicitor or broker, as premium or return premium, on or under any policy of insurance or application therefor, shall be received by him in his fiduciary capacity, and any agent, solicitor or broker who embezzles or fraudulently converts or appropriates to his own use, or, with intent to embezzle, takes, secretes or otherwise disposes of, or fraudulently withholds, appropriates, lends, invests or otherwise uses or applies any such premium or return premium received by him, contrary to the instructions or without the consent of the company, association or society, for or on account of which the same was received by him, shall be deemed guilty of embezzlement, and shall be punished accordingly, irrespective of whether or not he has, or claims to have, any commission or other interest in such receipts.


Source. 1913, 176:1. 1917, 4:1. PL 273:47. RL 323:52.

    402:54 Revocation of Authority. 

Whenever the insurance commissioner of the state shall determine after a hearing, 10 days' notice of which shall be given stating the time, place and purpose of such hearing, that any insurer organized under the laws of this state, whether on the stock, mutual, reciprocal, fraternal or other plan, or that any of the representatives of such insurer wilfully shall have transacted or attempted to transact or solicited business in any manner or accepted risks in any jurisdiction in which such insurer is not licensed in accordance with the laws of such jurisdiction, and which jurisdiction has adopted an act similar hereto, it shall be his duty to revoke the certificate of authority of any such offending insurer; provided, however, that the foregoing provisions shall not apply to a domestic insurer when the major portion of such risks originated in a jurisdiction wherein such insurer was licensed to transact such class or classes of business and when such origin was by other means than by circularization or by advertising locally in any such jurisdiction wherein such insurer is not licensed.


Source. 1943, 105:1, par. 55, eff. April 7, 1943.

    402:55 Definitions. 

The term "transacting business," as used in this subdivision, shall be defined to include in addition to its usual interpretation, advertising locally in any foreign jurisdiction in which an insurer is not licensed or circularizing in any such jurisdiction without regard for the source of such circularization whenever such advertising locally or such circularization is for the purpose of solicitation of insurance business. The word "jurisdiction" as used in this subdivision shall be defined to include any state of the United States, the District of Columbia or any province of the Dominion of Canada.


Source. 1943, 105:1, par. 56, eff. April 7, 1943.

    402:56-a Repealed by 1997, 221:6, eff. July 1, 1997. 

    402:56 Fees. 

Every insurance company making application for an original license to transact insurance business in this state, shall pay to the commissioner a fee as established by RSA 400-A:29 for the examination, investigation and processing of the application. Such fee shall be retained by the commissioner even though the application may be withdrawn, denied or otherwise acted upon. Any reapplication for such a license shall be subject to the same fee. Every such company shall annually thereafter pay a fee as established by RSA 400-A:29 for the renewal of such license, payable on or before April 1 of each year. Such renewal fee shall include all charges in connection thereof except fee for agents' licenses and the renewal thereof. All fees collected by the commissioner shall be turned over to the state treasurer for deposit in the general fund as unrestricted revenue.


Source. 1870, 1:3, 4, 5, 7. GL 174:2, 3. 1889, 86:1, 2, 4. PS 169:13. 1907, 116:1. PL 275:58. 1933, 32:2. 1941, 78:1, 3. RL 325:63. 1945, 71:4, par. 57. RSA 402:56. 1963, 310:1. 1983, 473:8. 1997, 221:1, eff. July 1, 1997.

    402:57-a, 402:57-b Repealed by 1971, 244:19, VI, eff. Aug. 17, 1971. 

    402:57 Repealed by 1970, 37:4, I, eff. May 4, 1970. 

    402:58 When Effective  [Omitted.] 

    402:59 Repealed by 1983, 473:16, I, eff. Sept. 3, 1983. 

    402:6 Duties of Treasurer. 

The treasurer of every such company shall enter in books provided for the purpose a correct account of all assessments made, of all sums by him received and paid out for the company, and of all evidences of debt and other assets belonging to the company coming into his possession. He shall balance his accounts yearly, prior to the annual meeting, and shall report to the company, at that time, its financial standing as shown by the books. Any treasurer who neglects to comply with either of the provisions of this section shall be fined $25.


Source. 1858, 2082:5. GS 158:3. GL 173:3. PS 168:7. PL 273:6. RL 323:6.

    402:60 Repealed by 1983, 473:16, II, eff. Sept. 3, 1983. 

    402:61 Repealed by 1970, 37:4, II, eff. May 4, 1970. 

    402:62 When Effective. 

[Repealed 1983, 473:16, III, eff. Sept. 3, 1983.]



    402:63 Exemption. 

The provisions of RSA 402:24 and RSA 402:56 and 57 shall not apply to mutual insurance companies that operate on an assessment plan and require as a condition for granting insurance the signing of a premium deposit note by the insured, which note is given for the purpose of establishing a limit of liability to assessment, while their total receipts from policyholders is less than $10,000 per year.


Source. 1945, 71:4, par. 59, eff. March 22, 1945.

    402:64 Repealed by 1983, 473:16, IV, eff. Sept. 3, 1983. 

    402:65 Repealed by 1983, 473:16, V, eff. Sept. 3, 1983. 

    402:66 Relief Fund. 

Six thousand dollars of the amount received as the taxes imposed by RSA 400-A shall annually be set apart by the state treasurer, and kept distinct from all other funds, and shall be known as the firemen's relief fund.


Source. 1899, 64:2. 1915, 152:1. 1917, 195:1. PL 275:62. RL 325:67. 1945, 71:4, par. 62. RSA 402:66. 1971, 244:3. 1973, 232:1, eff. Aug. 18, 1973.

    402:67 Expenditure. 

Such fund, in the month of May after its receipt, shall be paid over, upon the order of the governor, to the treasurer of the New Hampshire State Firemen's Association, as trustee, and shall be devoted to, and paid out for, the relief of any fireman injured or disabled in the discharge of his duty as fireman, who is a member in good standing in any regularly organized town or city fire company in this state belonging to said association and who is himself a member of said association, and for the relief of the dependent parent, surviving spouse or children of such fireman whose death was occasioned by injuries received in the line of his duty as a fireman; said sum of $6,000 to be in full for any appropriation for any one year.


Source. 1899, 64:2. 1915, 195. PL 275:63. RL 325:68. 1945, 71:4, par. 63. RSA 402:67. 1992, 103:1, eff. June 28, 1992.

    402:68 Additional Relief. 

In addition to said firemen's relief fund, in the event of the depletion of the treasury of the New Hampshire State Firemen's Association below the amount necessary to meet its obligations, the state treasurer shall, having received a certified statement of such condition from the treasurer of said association, upon the order of the governor, pay to the treasurer of said association as trustee a sum not to exceed $2,000 annually.


Source. 1899, 64:3. 1903, 128:1. PL 275:64. RL 325:69. 1945, 71:4, par. 64, eff. March 22, 1945.

    402:69 Exemption. 

The money due a fireman, or in case of his death his parents, widow or children, by reason of any rule or bylaw of said association, shall be exempt from attachment or trustee process.


Source. 1899, 64:3. PL 275:65. RL 325:70. 1945, 71:4, par. 65, eff. March 22, 1945.

    402:7 Terminating Risks. 

Any such company may terminate its policies by publishing a notice of the time when they will terminate, and by giving or mailing a like notice to each party insured, 30 days at least before the time fixed for such termination, and by tendering to the insured under each policy a ratable proportion of the premium.


Source. 1858, 2082:3. GS 158:4. GL 173:4. PS 168:8. 1917, 30:3. PL 273:7. RL 323:7.

    402:70 Regulations;  Reports. 

The New Hampshire State Firemen's Association shall make and observe just and equitable rules, bylaws and regulations for the proper apportionment and disbursement of such fund, subject to the approval of the governor and council. It shall, through its president and treasurer, make a full and detailed report of its disposal of such fund and file the same with the secretary of state in the month of May annually.


Source. 1899, 64:4. PL 275:66. RL 325:71. 1945, 71:4, par. 66, eff. March 22, 1945.

    402:71 Definitions. 

The word "fireman" as used in the subdivision shall be construed to include any woman member of such fire company and of such association, and the word "widow" as used therein shall be construed to include the widower of any such woman member.


Source. 1945, 71:4, par. 67, eff. March 22, 1945.

    402:72 Repealed by 1971, 244:19, IV, eff. Aug. 17, 1971. 

    402:73 Deposits in Trust. 

In all cases in which the laws of any other state of the United States require that the insurance companies incorporated by the laws of other states shall deposit with some officer of the state in which such insurance company is incorporated stocks or other securities in trust or for the benefit of policyholders of such companies, as a condition for doing business in such other states, the insurance commissioner shall receive from any insurance company incorporated under the laws of this state stocks or other securities, in such amount as may be required by the laws of such other state or states, on deposit in trust for the benefit of the policyholders of such company.


Source. 1911, 131:1. 1917, 21:1. PL 273:49. RL 323:54.

    402:74 Controlled Insurance;  Prohibited Interest. 

I. It is the policy of this state that an insurance agent or an insurance company should not be licensed to act or do business primarily for the purpose of placing insurance on his or its own property or on property which is owned or controlled in any manner by employees or close relatives of the agent or of the company or owners of the company, and it is the purpose of this section to further that policy.

II. If any applicant for a license from the commissioner of insurance to act as an insurance agent or to do insurance business in the state receives in any calendar year more than 10 percent of his or its total commissions or premiums from insurance that the agent or company writes in that year, from any insurance involving in any way the property or any interest in property of the persons, associations, or corporations listed in paragraph III of this section, the agent or company is deemed to be licensed primarily for the purpose of insuring his or its own property or of insuring property which is owned or controlled to some extent by employees or close relatives of the agent or of the company or owners of the company, and the commissioner shall not issue him or it a license unless the agent or company shows to the satisfaction of the commissioner that he or it is not so licensed.

III. If the property insured by an applicant is owned by any of the persons listed in this paragraph, the commissioner shall not issue a license to the applicant unless the applicant shows to the satisfaction of the commissioner that the applicant is not licensed contrary to the policy of the state as set forth in paragraph I of this section.

(a) an applicant;

(b) any member of any firm or association if an applicant is also a member or owner;

(c) an owner of any interest in an association or partnership which is an applicant and the spouse of such an owner;

(d) the stockholders of a corporation which is an applicant and their spouses;

(e) any corporation owning an interest in a corporation which is an applicant;

(f) any firm or association, its members or owners and their spouses who individually or collectively own more than 50 percent of the capital stock of a corporation which is an applicant;

(g) any corporation if any firm or association, its members or owners or their spouses own more than 50 percent of the capital stock of a corporation which is an applicant;

(h) any corporation if an applicant or the applicants, individually or collectively, own more than 50 percent of its capital stock;

(i) any affiliate or subsidiary of any corporation mentioned in this paragraph;

(j) an employee or an employer of an applicant;

(k) any person for whom an applicant is or acts as trustee;

(l) any company if the property insured is manufactured, sold or financed by the company, unless the insurance protects the insured against a physical damage to an automobile manufactured, sold, or financed by the company to the insured;

(m) the employees of a corporation which owns the controlling interest in an applicant, if over 10 percent of the commissions or premiums received by the applicant come from the employees of the corporation.

IV. The provisions of this section do not apply to an agent licensed as of the effective date of this section.


Source. 1967, 373:1, eff. Sept. 1, 1967.

    402:75 Repealed by 1983, 473:16, VI, eff. Sept. 3, 1983. 

    402:76 Modification. 

Any existing contract between an insurance agent and insurance company may be modified only by mutual consent.


Source. 1977, 566:2, eff. July 16, 1977.

    402:77 Retention of Unpaid Premium. 

Any insurance company, broker or agent may retain an amount equal to any unpaid premium due on the policy under which a claim is being presented, in connection with claims by and settled with an insured; provided, however, that the unpaid premium remains unpaid 60 days after the effective date of such policy or the date of the original billing for the unpaid premium, whichever occurs later. Such unpaid premium shall not be retained as against any loss payee or mortgagee named in said policy up to the amount of the unpaid balance owed to such loss payee or mortgagee on the date the loss occurred which gave rise to said claim. This section shall not be applicable to a health insurance policy.


Source. 1981, 217:1, eff. Aug. 10, 1981.

    402:78 Request for Information. 

I. Any law enforcement investigator may request an insurance company to release any information in its possession relative to the disappearance, theft or loss of any motor vehicle, or other personal property. The insurance company shall release the information and cooperate with any official authorized to request such information pursuant to this section. The information may include but not be limited to:

(a) Any relevant insurance policy;

(b) Policy premium payments records;

(c) History of previous claims made by the insured for the theft, loss or disappearance of any motor vehicle or other personal property;

(d) Any other material relating to the investigation of the theft, loss or disappearance.

II. If an insurance company has reason to suspect that a theft, loss or disappearance of a motor vehicle or other personal property in the amount of $500 or more was caused by other than accidental means, the company shall notify the local or state law enforcement authorities and furnish them, either through a recognized bureau or organization of companies or through the secretary or other officer of the insurance company, with all relevant material acquired during its investigation of the theft, loss or disappearance of a motor vehicle or other personal property. The insurance company shall cooperate with and take such reasonable action as may be requested of it by any law enforcement agency, and permit any person so ordered by a court to inspect any of its records pertaining to the policy and the loss.

III. In the absence of fraud or malice, no public official or insurance company or person who furnishes information on behalf of the insurance company shall be liable for damages in a civil action or subject to criminal prosecution for any oral or written statement made or any other action taken that is necessary to supply information required pursuant to this section.

IV. The recipient of any information furnished pursuant to this section shall hold the information in confidence, and shall only release it to a law enforcement authority or agency or to the insurance department, until such time as its release is required pursuant to a criminal or civil proceeding.

V. An insurer or other person licensed by the insurance department who fails to comply with this section may be subject to administrative action to be taken by the insurance commissioner. The penalty imposed by the commissioner may include a fine not exceeding $2,500 in the discretion of the insurance commissioner, or suspension or revocation of such insurer's license, or both.


Source. 1981, 502:4, eff. Aug. 28, 1981.

    402:79 Custody;  Reimbursement for Medical Expenses. 

Whenever the state or any of its subdivisions, or any agency of the state or of any of its subdivisions, is required to pay under the provisions of RSA 623:1, I for the medical care of any person in its custody pursuant to a valid arrest or detention, such governmental unit shall be entitled to obtain reimbursement for such payments from any insurer to the extent that such insurer would be liable to pay for such medical care pursuant to any health, medical, group health or medical, liability, or other insurance policy.


Source. 1987, 250:1, eff. July 17, 1987.

    402:8 Dividends. 

From time to time the directors of a mutual insurance company may, by vote, fix and determine the percentage of dividend or expiration return of premium to be paid on expiring policies, and may classify its risks as to dividends and assessments; but policies insuring risks in this state in the same classification shall have an equal rate of dividend and assessment.


Source. 1855, 1662:2. GS 158:8. GL 173:8. PS 168:10. 1917, 30:5. PL 273:8. RL 323:8.

    402:80 Cancellation or Termination of Policies. 

No cancellation or termination of an insurance policy of any type for nonpayment of a premium shall be effective if:

I. Payment of the premium is actually received by the insurance company or by the insurance company's agent, before the date and time of the cancellation or termination of the policy as stated in the notice of cancellation or termination; or

II. Payment of the premium is sent to the insurance company, or the insurance company's agent, by certified mail before the date and time of cancellation or termination of the policy as stated in the notice of cancellation or termination.


Source. 1988, 115:1. 2012, 100:1, eff. July 28, 2012.

    402:81 Insurance Premium Refunds. 

I. Whenever an insurer owes a refund on an insurance premium paid, that insurer shall pay the refund within 30 days of the date when the refund becomes due.

(a) When an insurance policy is cancelled by a named insured, a refund shall be due from the company or its appointed producer upon receipt of:

(1) The original policy to be cancelled; or

(2) A signed lost policy release; or

(3) A cancellation request from the insured which has been submitted in accordance with provisions of the policy or statute.

(b) When an insurance policy is cancelled by an insurer, a refund shall become due upon the date of cancellation as stated in the notice of cancellation.

(c) For auditable policies:

(1) Audits shall be completed promptly, no more than 120 days after the expiration or cancellation of the policy, provided that there is no bona fide dispute; and

(2) If there is no bona fide dispute, the refund of gross unearned premium shall become due on the date of the completed audit or 120 days after the expiration or cancellation of the policy, whichever occurs first.

(3) Any insurer that violates this subparagraph shall be subject to the penalty provisions of RSA 402:50.

(4) In cases where the amount of refund is in bona fide dispute, the refund shall not become due until the dispute is resolved and the audit is completed. The insurer shall notify the insured in writing that there is a bona fide dispute and this notice shall toll the 120-day time period until the dispute is resolved. Upon resolution of the dispute, the insurer shall proceed to complete the audit within the time remaining in the 120-day time period.

(5) A bona fide dispute includes the insured's failure to cooperate with the audit, provided the insurer has notified the insured of:

(A) The acts or omissions that constitute the insured's failure to cooperate; and

(B) The consequences of the insured's failure to cooperate, including delay in the completion of the audit and payment of any refund due.

(d) This paragraph shall not apply to retrospectively rated policies.

(e) No refund shall be required if the return premium is $1 or less.

II. Whenever the premium refunds described in paragraph I are refunded to an authorized third party, such as an insurance producer or a party with cancellation power of attorney from the insured, the authorized third party shall credit the premium refund for the account of the named insured. In the event that crediting of return premiums to the account of the named insured results in a surplus over the amount owed the authorized third party by the named insured, the surplus shall be paid to the named insured within 10 days of receipt of the return premium, being credited to the third party, provided that no such refund shall be required if it amounts to less than $1.

III. For any refund that is not paid to the named insured within the specified period set forth in paragraph I, the party to whom the premium is owed shall be entitled to interest beginning on the first day after the expiration of the period, at a rate determined by the state treasurer pursuant to RSA 336:1, II. Any interest developed because of late refunding shall ultimately benefit only the named insured. This paragraph shall not apply to retrospectively rated policies.


Source. 1988, 221:1. 1989, 173:1. 1993, 210:1, 2. 2005, 248:3. 2008, 275:3. 2010, 212:3. 2014, 31:3, eff. July 26, 2014.

    402:82 Claim Forms and Applications. 

I. All insurance claim forms shall contain the following statement : "Any person who, with a purpose to injure, defraud, or deceive any insurance company, files a statement of claim containing any false, incomplete, or misleading information is subject to prosecution and punishment for insurance fraud, as provided in RSA 638:20."

II. No insurance company or producer shall accept an application for workers' compensation or life, accident and health insurance unless the application includes:

(a) A written or electronic signature of the producer, unless the transaction does not involve a producer; and

(b) A written or electronic signature of the applicant. In the case of group life, accident, or health insurance, the certificate holder insured under the group health policy is not the applicant.

III. Paragraph II shall not apply to a request for a binder providing temporary coverage, provided the binder is effective for a period of no more than 30 days. The insurer shall comply with the provisions of paragraph II before the issuance of the insurance policy.

IV. The lack of the information required by paragraphs I and II shall not constitute a defense against prosecution under RSA 638:20 or any other criminal statute.

V. "
Electronic signature
" shall have the same definition as under RSA 294-E:2.

VI. "
Written signature
" means an original signature or a duplicate copy made by photocopying, facsimile, or other means similar and does not include stamped signatures.


Source. 1991, 248:2. 2008, 378:3. 2010, 212:4. 2011, 189:1. 2014, 196:1, eff. July 11, 2014. 2022, 42:4, eff. July 2, 2022.

    402:83 Applicability of Federal Law. 

No provisions of this title relating to investments shall be preempted by the provisions of the federal Secondary Mortgage Market Enhancement Act of 1984 (15 U.S.C.  77r-1). The provisions of this title specifically pertaining to, or otherwise affecting, investments of the type specified in the federal Secondary Mortgage Market Enhancement Act of 1984 shall remain in full force and effect notwithstanding the provisions of the Secondary Mortgage Market Enhancement Act of 1984.


Source. 1991, 372:7, eff. July 2, 1991.

    402:84 Discontinuance of Lines of Business;  Notice Required. 

Any licensed insurance company authorized to transact fire or casualty business in this state shall provide 120 days' notice to its appointed agents of record in New Hampshire of the insurance company's decision to cease writing an entire line of business. Any nonrenewal notices to affected policyholders shall be issued in accordance with applicable law, provided that the effective date of any such nonrenewals shall be at least 120 days after notice to the agents of record under this section.


Source. 2018, 31:1, eff. Jan. 1, 2019.

    402:9 Dividend Notice to Policyholders. 

Every mutual and participating stock, fire, marine, fidelity, and casualty insurance company shall send a written dividend notice through its resident agent to all policyholders who have not renewed and who have not received their dividend as shown by the records of the company. Such notice shall be sent within 60 days of the expiration of the policy, and such notice should include receipt to be executed by the insured and shall state the amount of the dividend payable. The company shall cause payment of such dividend to be made within 10 days after receiving the dividend receipt properly executed and no policyholder shall be discriminated against because of the period of time for which insurance has been carried.


Source. 1939, 104:1. RL 323:9.

    403-A:1 Definitions. 

As used in this chapter, the term:

I. "Assets" includes all the property and rights of every kind of a domestic insurance company, or association.

II. "Total assets" means the dollar amount of the company's total assets as reported in its most recent convention statement.

III. "Disposal" includes any sale, transfer, exchange, assignment, alienation or other conveyance of an interest in assets, but does not include a ceding of policies pursuant to a reinsurance contract.


Source. 1969, 293:1, eff. June 30, 1969.

    403-A:12 Rules and Regulations. 

The insurance commissioner may, by regulation, prescribe the rules necessary for the administration of this chapter.


Source. 1969, 293:1. 2002, 207:46, eff. July 15, 2002.

    403-A:2 Disposal of Assets. 

Any domestic insurance company or association that, within any period of 30 days, by one or more transactions, disposes of any of its assets which, in the aggregate, amount to more than 10 percent of its total assets, shall send written notification thereof to the insurance commissioner. Such notification shall be given at least 10 business days prior to the making of such disposal, and shall specify the nature and amount thereof, and identify all of the parties thereto.


Source. 1969, 293:1, eff. June 30, 1969.

    403-A:3 Reinsurance. 

Any domestic insurance company or association except a domestic life insurance company, which, during any period of 12 consecutive months, by any contract or contracts of reinsurance, cedes an amount of its insurance on which the total gross reinsurance premiums are more than 50 percent of the unearned premiums on the net amount of its insurance in force at the beginning of such period, shall give written notification thereof to the insurance commissioner. Any domestic life insurance company which reinsures its whole risk on any individual life or joint lives or reinsures policies which, during any period of 12 consecutive months, in the aggregate, amount to more than 50 percent of its insurance in force shall give written notification thereof to the insurance commissioner. The notification required hereunder shall be given at least 10 business days before the date such reinsurance takes effect, and shall specify the nature and amount thereof, and identify the parties thereto. The requirements of this section shall not apply to reinsurance made in the ordinary course of business covering reinsurance of specified individual risks under agreements relating to current business.


Source. 1969, 293:1, eff. June 30, 1969.

    403-A:4 Fraud by Officer, etc. 

It shall be unlawful for any member, officer, director, or attorney-in-fact of any company, association, or exchange licensed to do an insurance business in this state to borrow, rent, hire, lease, or otherwise engage on behalf of such company, association or exchange the use of stocks, bonds, debentures, notes, investment certificates, securities, or other obligations or evidences of indebtedness owned or issued by any other corporation, company, association, or individual, or of any government, political subdivision or agency thereof, with intent to injure or defraud any other company, body politic or corporation, or person, or to deceive the insurance commissioner or other person legally authorized to examine the affairs of any such company, association, or exchange. Any person convicted of a violation of this section shall be guilty of a class B felony.


Source. 1969, 293:1. 1973, 528:280, eff. Oct. 31, 1973 at 11:59 p.m.

    403-A:5 Fraud by Corporation. 

It shall be unlawful for any corporation organized under any law of this state, or the laws of any other state, or which has an office or is transacting business in this state, which is engaged in, or is claiming or advertising that it is engaged in, organizing or receiving subscriptions for or disposing of stocks of, or in any manner aiding or taking part in the formation or in the business of an insurance company, association, or exchange, either as agent or otherwise, or which is holding capital stock of one or more insurance companies for the purpose of controlling the management thereof as voting trustees or otherwise, or any employee, agent, or attorney thereof, that aids and abets such insurance company, association, or exchange to borrow, rent, hire, lease, or engage the use of such stock, bonds, debentures, notes, investment certificates, securities, or other obligations or evidences of indebtedness. Any corporation convicted of a violation of this section shall be guilty of a felony.


Source. 1969, 293:1. 1973, 528:281, eff. Oct. 31, 1973 at 11:59 p.m.

    403-A:6 Possession of Stocks, etc. 

If any insurance company, association, or exchange is found in possession of stocks, bonds, debentures, notes, investment certificates, securities, or other obligations or evidences of indebtedness acquired in violation of RSA 403-A:4, or if any of its officers, directors, members, or attorneys-in-fact have been convicted of a violation of RSA 403-A:4, such company, association, or exchange may be subject to suspension of its certificate of authority by the insurance commissioner. Nothing in this section shall be construed to prevent the insurance commissioner from bringing an action to dissolve such insurance company, association, or exchange.


Source. 1969, 293:1, eff. June 30, 1969.

    403-A:7 to 403-A:11 Repealed by 1971, 176:2, II, eff. Aug. 7, 1971. 

    403-B:1 Application of Chapter. 

A mutual insurance company organized under the laws of this state, other than an assessment mutual, may convert into a stock insurance company upon compliance with the provisions of this chapter.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:2 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Conversion value" means the amount of the insurer's policyholder surplus, determined in accordance with those accounting procedures and practices prescribed by the National Association of Insurance Commissioners and by the commissioner, brought current to the date of adoption by the board of directors of the plan of conversion.

III. "Eligible policyholder" means, with respect to a mutual fire or casualty insurance company, a policyholder of the insurer on the date of adoption of the plan of conversion by the board of directors pursuant to RSA 403-B:3, I or, with respect to a mutual life insurance company, such policyholders defined in the plan of conversion approved by the commissioner.

IV. "Net premiums" means gross premiums paid by a policyholder to the insurer, less return premiums and dividends paid.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:3 Procedure for Conversion. 

I. An insurer may apply to the commissioner for conversion pursuant to this chapter by filing with the commissioner a plan of conversion adopted by 
2/3 of the entire board of directors, which shall contain the following:

(a) The proposed articles of incorporation and bylaws to be adopted by the insurer upon its conversion to a stock insurance company.

(b) A statement of the manner of treating holders of surplus notes, if any notes are outstanding.

(c) Provisions for distribution of the conversion value in accordance with RSA 403-B:4.

(d) Provisions stating the manner and basis of exchanging the equitable share of each eligible policyholder for securities of the stock insurance company into which the insurer is to be converted, and the disposition of any unclaimed shares.

(e) The effective date of the plan of conversion or the method of determination of such effective date.

(f) Such other information as the commissioner may reasonably require.

II. The commissioner may retain at the insurer's expense such attorneys, actuaries, accountants, appraisers and other experts as shall be reasonably necessary to assist in the review of the insurer's plan of conversion.

III. Within 60 days after receipt of the completed plan of conversion the commissioner shall hold a hearing, written notice of which shall be given to the insurer not less than 30 days in advance of the hearing. Within 15 days after receiving the notice of hearing, the insurer shall notify eligible policyholders. Notice of such hearing shall be made at the expense of the insurer by mail to eligible policyholders, which notice shall include a copy of the plan of conversion or a summary of such plan approved by the commissioner.

IV. At the hearing, the insurer and any eligible policyholders shall have the right to appear and to present evidence, orally and in writing.

V. Within 30 days after the conclusion of the hearing, the commissioner shall approve the plan of conversion, unless the commissioner finds:

(a) The plan of conversion is unfair or inequitable to policyholders;

(b) The plan of conversion will cause the insurer to become unable to fulfill its contractual obligations;

(c) After the conversion of the insurer the stock insurance company would not be able to satisfy the requirements for the issuance of a license to write the line or lines of insurance for which it is presently licensed;

(d) The financial condition of the insurer would be such as might jeopardize the financial stability of the converted stock insurance company, or prejudice the interest of its policyholders;

(e) The competence, experience and integrity of those persons who would control the operation of the stock insurance company are such that it would not be in the interest of policyholders of the insurer and of the public to permit conversion; or

(f) The plan of conversion does not comply with the provisions of this chapter.

VI. Upon approval by the commissioner, the plan of conversion shall be submitted to a vote of eligible policyholders. The board of directors shall schedule a meeting to be held for such purpose, and shall provide at least 10 days' prior written notice to eligible policyholders. Notice to eligible policyholders shall contain a copy of the plan of conversion and such other information as the commissioner may require. The notice of such meeting may be sent prior to the commissioner's approval, provided the notice clearly states that the plan of conversion is subject to such approval. The vote of 
2/3 of the eligible policyholders voting in person or by proxy shall be necessary for the adoption of the plan of conversion.

VII. At any time prior to the date of the vote of eligible policyholders, the plan of conversion may be withdrawn or amended by majority vote of the entire board of directors, except that no amendment which materially changes the plan of conversion shall take effect unless such amendment is approved by the commissioner and eligible policyholders in accordance with the same conditions and procedures applicable to the original plan of conversion.

VIII. Upon adoption of the plan of conversion by the eligible policyholders, the commissioner shall certify his approval of the plan of conversion by an endorsement upon the articles of incorporation, which may then be recorded in accordance with the provisions of RSA 293-A, provided that copies of the original documents filed with the secretary of state shall also be filed with the commissioner.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:4 Distribution of Conversion Value. 

The insurer shall follow the following conversion methodology:

I. Each eligible policyholder of a mutual fire or casualty insurance company shall have the right to purchase securities of the stock insurance company into which the insurer is to be converted, based upon such policyholder's proportionate amount of the conversion value determined by dividing the net premium paid by each eligible policyholder to the insurer with respect to the 3-year period immediately preceding the date of adoption of the resolution by the board of directors approving the plan of conversion by the total net premiums received by the insurer from eligible policyholders with respect to that period.

II. Each eligible policyholder of a mutual life insurance company shall have the right to purchase securities of the stock insurance company into which the insurer is to be converted based upon such policyholder's proportionate amount of the conversion value determinable under a fair formula approved by the commissioner.

III. The stock offering shall provide that eligible policyholders have the first right to purchase the stock at its stated value. Shares remaining unsold or not subscribed for may be offered to the general public, including the insurer's directors, officers, agents or employees, provided, however, that the price of shares offered to the general public shall be greater than or equal to the price of shares offered to eligible policyholders.

IV. The above distribution method shall constitute full payment and discharge of the policyholder's proportionate conversion value, but this provision shall not be held to prohibit the stock insurance company from including in the plan of conversion provisions for the distribution of any other valuable consideration to policyholders. Notwithstanding any other provision of law, the policyholders shall have no other rights with respect to the conversion of the insurer after the effective date of the conversion under this chapter.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:5 Compensation. 

No director, officer or other employee of the insurer shall receive any fee, commission or other valuable consideration whatsoever, other than regular salary and compensation, for in any manner aiding, promoting or assisting in the conversion.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:6 Issuance of New Certificate of Authority. 

After approval by the secretary of state of the articles of incorporation and certification by the insurer that the conversion has been effected, the commissioner shall issue a new certificate of authority to the insurer as a stock insurance company, effective as of the effective date of the conversion. The conversion shall be deemed to have been completed and the insurer shall become a domestic stock insurance company on such effective date, unless the plan of conversion shall have been terminated by the board of directors with the concurrence of the commissioner prior to such effective date. The stock insurance company shall be a continuation of the insurer and deemed to have been organized at the time the insurer was formed. The conversion shall not eliminate or change any of the insurer's rights and obligations existing prior to the date of conversion except as provided by this chapter. The stock insurance company, after conversion, shall exercise all the rights and powers and perform all the duties conferred or imposed by law upon insurers writing the classes of insurance written by it.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:7 Officers and Directors. 

The directors and officers of the insurer shall serve until the directors and officers of the stock insurance company have been duly elected and qualified pursuant to the articles of incorporation and bylaws of the stock insurance company.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:8 Judicial Review. 

Any person aggrieved by any order or decision of the commissioner pursuant to this chapter may appeal from such decision in accordance with the provisions of RSA 541.


Source. 1992, 288:16, eff. May 18, 1992.

    403-B:9 Rules. 

The commissioner may adopt rules, pursuant to RSA 541-A, as may be necessary for the administration of this chapter.


Source. 1992, 288:16. 2002, 207:47, eff. July 15, 2002.

    403-C:1 Report. 

I. Every insurer domiciled in this state shall file a report with the commissioner disclosing material acquisitions and dispositions of assets or material nonrenewals, cancellations, or revisions of ceded reinsurance agreements unless such acquisitions and dispositions of assets or material nonrenewals, cancellations or revisions of ceded reinsurance agreements have been submitted to the commissioner for review, approval, or information purposes pursuant to other provisions of the insurance code, laws, rules, or other requirements.

II. The report required in paragraph I is due within 15 days after the end of the calendar month in which any of the transactions specified in paragraph I occurs.

III. One complete copy of the report, including any exhibits or other attachments, shall be filed with:

(a) The insurance department of the insurer's state of domicile; and

(b) The National Association of Insurance Commissioners.

IV. All reports obtained by or disclosed to the commissioner pursuant to this chapter shall be given confidential treatment and shall not be subject to subpoena and shall not be made public by the commissioner, the National Association of Insurance Commissioners, or any other person, except to insurance departments of other states, without the prior written consent of the insurer to which it pertains unless the commissioner, after giving the insurer who would be affected notice and an opportunity to be heard, determines that the interest of policyholders, shareholders, or the public will be served by the publication, in which event the commissioner may publish all or any part in the manner the commissioner may deem appropriate.


Source. 1995, 146:1, eff. Jan. 1, 1996.

    403-C:2 Acquisitions and Dispositions of Assets. 

I. No acquisitions or dispositions of assets need be reported pursuant to RSA 403-C:1 if the acquisitions or dispositions are not material. For purposes of this chapter, a material acquisition (or the aggregate of any series of related acquisitions during any 30-day period) or disposition (or the aggregate of any series of related dispositions during any 30-day period) is one that is nonrecurring and not in the ordinary course of business and involves more than 5 percent of the reporting insurer's total admitted assets as reported in its most recent statutory statement filed with the insurance department of the insurer's state of domicile.

II. (a) Asset acquisitions subject to this chapter include every purchase, lease, exchange, merger, consolidation, succession, or other acquisition other than the construction or development of real property by or for the reporting insurer or the acquisition of materials for such purpose.

(b) Asset dispositions subject to this chapter include every sale, lease, exchange, merger, consolidation, mortgage, hypothecation, assignment (whether for the benefit of creditors or otherwise), abandonment, destruction, or other disposition.

III. (a) The following information is required to be disclosed in any report of a material acquisition or disposition of assets:

(1) Date of the transaction.

(2) Manner of acquisition or disposition.

(3) Description of the assets involved.

(4) Nature and amount of the consideration given or received.

(5) Purpose of, or reason for, the transaction.

(6) Manner by which the amount of consideration was determined.

(7) Gain or loss recognized or realized as a result of the transaction.

(8) Name of each person from whom the assets were acquired or to whom they were disposed.

(b) Insurers are required to report material acquisitions and dispositions on a nonconsolidated basis unless the insurer is part of a consolidated group of insurers which utilizes a pooling arrangement or 100 percent reinsurance agreement that affects the solvency and integrity of the insurer's reserves and the insurer ceded substantially all of its direct and assumed business to the pool. An insurer is deemed to have ceded substantially all of its direct and assumed business to a pool if the insurer has less than $1,000,000 total direct plus assumed written premiums during a calendar year that are not subject to a pooling arrangement and the net income of the business not subject to the pooling arrangement represents less than 5 percent of the insurer's capital and surplus.


Source. 1995, 146:1, eff. Jan. 1, 1996.

    403-C:3 Nonrenewals, Cancellations, or Revisions of Ceded Reinsurance Agreements. 

I. (a) No nonrenewals, cancellations, or revisions of ceded reinsurance agreements need be reported pursuant to RSA 403-C:1 if the nonrenewals, cancellations, or revisions are not material. For purposes of this chapter, a material nonrenewal, cancellation, or revision is one that affects:

(1) As respects property and casualty business, including accident and health business written by a property and casualty insurer:

(A) More than 50 percent of the insurer's total ceded written premium; or

(B) More than 50 percent of the insurer's total ceded indemnity and loss adjustment reserves.

(2) As respects life, annuity, and accident and health business: more than 50 percent of the total reserve credit taken for business ceded, on an annualized basis, as indicated in the insurer's most recent annual statement.

(3) As respects either property and casualty or life, annuity, and accident and health business, either of the following events shall constitute a material revision which must be reported:

(A) An authorized reinsurer representing more than 10 percent of a total cession is replaced by one or more unauthorized reinsurers; or

(B) Previously established collateral requirements have been reduced or waived as respects one or more unauthorized reinsurers representing collectively more than 10 percent of a total cession.

(b) However, no filing shall be required if:

(1) As respects property and casualty business, including accident and health business written by a property and casualty insurer, the insurer's total ceded written premium represents, on an annualized basis, less than 10 percent of its total written premium for direct and assumed business; or

(2) As respects life, annuity, and accident and health business, the total reserve credit taken for business ceded represents, on an annualized basis, less than 10 percent of the statutory reserve requirement prior to any cession.

II. (a) The following information is required to be disclosed in any report of a material nonrenewal, cancellation, or revision of ceded reinsurance agreements:

(1) Effective date of the nonrenewal, cancellation, or revision.

(2) The description of the transaction with an identification of its initiator.

(3) Purpose of, or reason for, the transaction.

(4) If applicable, the identity of the replacement reinsurers.

(b) Insurers are required to report all material nonrenewals, cancellations, or revisions of ceded reinsurance agreements on a nonconsolidated basis unless the insurer is part of a consolidated group of insurers which utilizes a pooling arrangement or 100 percent reinsurance agreement that affects the solvency and integrity of the insurer's reserves and the insurer ceded substantially all of its direct and assumed business to the pool. An insurer is deemed to have ceded substantially all of its direct and assumed business to a pool if the insurer has less than $1,000,000 total direct plus assumed written premiums during a calendar year that are not subject to a pooling arrangement and the net income of the business not subject to the pooling arrangement represents less than 5 percent of the insurer's capital and surplus.


Source. 1995, 146:1, eff. Jan. 1, 1996.

    403-E:1 Definitions. 

In this chapter:

I. "American Council on Gift Annuities" means the organization which on the effective date of this chapter has its principal place of business in Indianapolis, Indiana, and which advises charitable organizations and promulgates recommended standards regarding the provision of charitable gift annuities.

II. "Charitable gift annuity" means a transfer of cash or other property by a donor to a charitable organization in return for an annuity payable over one or 2 lives, under which the actuarial value of the annuity is less than the value of the cash or other property transferred and the difference in value constitutes a charitable deduction for federal tax purposes.

III. "Charitable organization" means an entity described by:

(a) Section 501(c) (3), Internal Revenue Code of 1986 (26 U.S.C. section 501(c) (3)); or

(b) Section 170(c), Internal Revenue Code of 1986 (26 U.S.C. section 170(c)).

IV. "Director" means the director of charitable trusts, serving pursuant to RSA 7:20.

V. "Qualified charitable gift annuity" means a charitable gift annuity described by section 501(m)(5), Internal Revenue Code of 1986 (26 U.S.C. section 501(m)(5)), and section 514(c)(5), Internal Revenue Code of 1986 (26 U.S.C. 514(c)(5)), that is issued by a charitable organization that on the date of the annuity agreement:

(a) Has a minimum of $300,000 in unrestricted cash, cash equivalents, or publicly traded securities, exclusive of the assets funding the annuity agreement;

(b) Has been in continuous operation for at least 3 years or is a successor or affiliate of a charitable organization that has been in continuous operation for at least 3 years;

(c) Issues charitable gift annuities with payout ratios no greater than recommended by the American Council on Gift Annuities at the time of issuance;

(d) Retains 100 percent of the contribution made in exchange for each charitable gift annuity, increased by earnings on the contribution and decreased by annuity payments and expenses properly allocated to the annuity, until the annuity is terminated; and

(e) Invests contributions made in exchange for charitable gift annuities solely in conformance with article 9 of RSA 564-B, general standards of prudent investment.


Source. 1999, 68:1. 2004, 130:5, eff. Oct. 1, 2004.

    403-E:2 Qualified Charitable Gift Annuity is Not Insurance. 

I. The issuance of a qualified charitable gift annuity does not constitute engaging in the business of insurance in this state.

II. A charitable gift annuity issued before the effective date of this chapter shall be deemed to be a qualified charitable gift annuity for purposes of this chapter, and the issuance of that charitable gift annuity shall not constitute engaging in the business of insurance in this state, if the charitable organization issuing such annuity has given notice to the director pursuant to RSA 403-E:3, II(a).


Source. 1999, 68:1, eff. May 28, 1999.

    403-E:3 Disclosures;  Notification;  Recertification. 

I. (a) When entering into an agreement for a qualified charitable gift annuity, the charitable organization shall disclose to the donor in writing in the annuity agreement that a qualified charitable gift annuity is not insurance under the laws of this state and is not subject to regulation by the insurance department or protected by an insurance guaranty association. The following information shall also be similarly disclosed:

(1) The value of the property being transferred.

(2) The amount of the annuity to be paid.

(3) The manner in which, and the intervals at which, the payment is to be made.

(4) The date that payments are to begin.

(b) The disclosures required by this paragraph shall appear on the first page of the annuity agreement in a print size no smaller than that employed in the annuity agreement generally.

II. (a) A charitable organization that issues qualified charitable gift annuities shall notify the director in writing by the later of 90 days after the effective date of this chapter or the date on which it enters into the organization's first qualified charitable gift annuity agreement. The notice shall:

(1) Be signed by an officer or director of the organization;

(2) Identify the organization; and

(3) Certify that:

(A) The organization is a charitable organization; and

(B) The annuities issued by the organization shall be limited to qualified charitable gift annuities, as defined in RSA 403-E:1, V.

(b) Subsequently, each charitable organization that issues qualified charitable annuities shall, as part of its report submitted to the director pursuant to RSA 7:28, II and III, annually recertify that the annuities issued by the organization shall be limited to qualified charitable gift annuities, as defined in RSA 403-E:1, V.

(c) The organization shall not be required to submit additional information except to determine appropriate penalties that may be applicable under RSA 403-E:4.


Source. 1999, 68:1, eff. May 28, 1999.

    403-E:4 Failure to Comply. 

The failure of a charitable organization to comply with the requirements imposed under RSA 403-E:3 of this chapter shall not prevent a charitable gift annuity that otherwise meets the requirements of this chapter from constituting a qualified charitable gift annuity. The director shall enforce performance of RSA 403-E:3 by sending a letter by certified mail, return receipt requested, demanding that the charitable organization comply with the requirements of RSA 403-E:3. The director may fine the charitable organization in an amount not to exceed $1,000 per qualified charitable gift annuity agreement issued until such time as the charitable organization complies with RSA 403-E:3.


Source. 1999, 68:1, eff. May 28, 1999.

    403-E:5 Not Unfair or Deceptive Trade Practice. 

The issuance of a qualified charitable gift annuity shall not constitute a violation of RSA 417.


Source. 1999, 68:1, eff. May 28, 1999.

    403-F:1 Authorization. 

A mutual insurance company organized under the laws of this state may reorganize by converting to a stock insurance company and forming a mutual insurance holding company, upon compliance with the provisions of this chapter.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:10 Members' Share of Assets on Voluntary Dissolution. 

I. Upon any voluntary dissolution of a domestic mutual insurance holding company, its assets remaining after discharge of its indebtedness, if any, and expenses of administration, shall be distributed to existing persons who were its members at any time within the 3-year period preceding the date such liquidation was authorized or ordered, or date of last termination of the insurer's certificate of authority, whichever date is earlier; except, if the commissioner has reason to believe that those in charge of the management of the mutual insurance holding company have caused or encouraged the reduction of the number of members of the insurer in anticipation of liquidation and for the purpose of reducing thereby the number of persons who may be entitled to share in distribution of the insurer's assets, the commissioner may enlarge the 3-year qualification period by such additional time as the commissioner may deem to be reasonable.

II. The distributive share of each such member shall be determined by a formula based upon such reasonable classifications of members as the commissioner may approve.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:11 Application of Holding Company Statutes and Regulations. 

Each reorganized subsidiary insurance company shall be subject to the applicable laws of this state relating to insurance holding company systems. A mutual insurance holding company shall not be subject to provisions of this title or rules adopted thereunder with respect to the writing of insurance or required capital or surplus. A mutual insurance holding company system shall be considered an insurance holding company.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:12 Converting Mutual Insurance Holding Company. 

A mutual insurance holding company may convert to a stock holding company by complying with the procedures set forth in RSA 403-B, with the mutual insurance holding company to be treated as the "insurer" and with its members to be treated as "eligible policyholders" for purposes of such chapter.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:13 Rulemaking. 

The commissioner shall adopt rules, pursuant to RSA 541-A, as may be necessary for the administration of this chapter.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Eligible policyholder
" means, with respect to a mutual fire or casualty insurance company, a policyholder of the insurer on the date of adoption of the plan of reorganization by the board of directors pursuant to RSA 403-F:4, II or, with respect to a mutual life insurance company, such policyholders defined in the plan of reorganization approved by the commissioner.

III. "
Mutual insurance holding company
" means an incorporated entity without permanent capital stock that is organized under this chapter.

IV. "
Subsidiary insurance company
" means a stock insurance company, the majority of the voting shares of the capital stock of which are at all times owned, directly or through an intermediate holding company, by a mutual insurance holding company.

V. "
Intermediate holding company
" means a holding company which is a subsidiary of a mutual insurance holding company, and which directly or through a subsidiary intermediate holding company owns a majority of the voting shares of the capital stock of one or more subsidiary insurance companies.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:3 Formation of a Mutual Insurance Holding Company. 

I. A mutual insurance company may reorganize as a mutual insurance holding company system consisting of a mutual insurance holding company and a subsidiary insurance company. The reorganization may be effected by the organization of one or more companies, amendment or restatement of the articles of incorporation and bylaws of one or more companies, transfer of assets and liabilities among 2 or more companies, issuance, acquisition or transfer of capital stock of one or more companies, or merger or consolidation of 2 or more companies. The mutual insurance holding company shall at all times own a majority of the voting shares and a majority in economic value of the capital stock of each controlled subsidiary and any intermediate stock holding company.

II. All of the initial shares of the capital stock of the insurance company which reorganized as a subsidiary insurance company shall be issued either to the mutual insurance holding company or to an intermediate holding company which is wholly owned by the mutual insurance holding company. This restriction shall not preclude the subsequent issuance of additional shares of stock by the subsidiary insurance company so long as the requirements of paragraph I are not violated. The membership interests of the policyholders of the subsidiary insurance company shall become membership interests in the mutual insurance holding company. Policyholders of the subsidiary insurance company which was formerly the mutual insurer shall be members of the mutual insurance holding company in accordance with the articles of incorporation and bylaws of the mutual insurance holding company.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:4 Plan of Reorganization. 

I. A plan of reorganization shall include the following provisions:

(a) A description of the structure of the mutual insurance holding company system.

(b) A description of the qualifications for membership in and the rights of members of the mutual insurance holding company.

(c) A description of the corporate restructuring and other transactions, and the parties to such transactions, that will effect the reorganization, including the organization of companies, amendment or restatement of articles of incorporation or bylaws, mergers, consolidations, and transfer and assumption of policies, contracts, assets, and liabilities.

(d) The reasons and purposes of the proposed restructuring, including an analysis of alternative transactions considered.

(e) An analysis of the benefits and risks associated with the proposed reorganization to the mutual insurance company.

(f) An explanation of how the restructuring will benefit policyholders, as well as a description of any potential risks to policyholder interests.

(g) A complete disclosure of all anticipated transaction costs, including:

(1) Any changes to director or management compensation or compensation plans; and

(2) The issuance or sale, to officers or directors, of shares or options to purchase shares of stock of any corporate member of the mutual insurance holding company system.

(h) All amendments to the mutual insurance company's articles of incorporation to address the restructuring from a mutual to a stock insurer.

(i) The proposed articles of incorporation and bylaws of the mutual insurance holding company and any other entities to be created in the restructuring.

(j) If applicable, a description of rights of policyholders in any initial stock offering.

(k) If applicable, a description of any plans for sale of stock to third parties, including:

(1) A statement of intent to conduct an initial sale of voting stock within a specified time after the effective date of the restructuring;

(2) A description of the maximum percentage of stock to be sold;

(3) A description of the process to be used in offering the stock and setting the initial sale price for the stock;

(4) A description of the rights of members to subscribe to the stock offering; and

(5) A description of any limitations on management participation in the stock offering and ownership.

(l) Any other documents filed with other regulatory bodies relating to the reorganization.

(m) In the case of a mutual life insurer, provisions for the establishment, for policyholder dividend purposes only, of a closed block. The closed block will consist of all of the participating individual policies of life insurance of the mutual life insurer in force on the effective date of the plan for which the insurer had an experience-based dividend scale payable in the year in which the plan is adopted. Assets of the insurer shall be allocated to the closed block in an amount that produces cash-flows, together with anticipated revenues from the closed block business, expected to be sufficient (1) to support the closed block business, including payment of claims and those expenses and taxes specified in the plan and (2) to provide for continuation of dividend scales in effect on the adoption date if the experience underlying the scales continues, and for appropriate adjustments in the scales if the experience changes. The plan may provide for conditions under which the converted insurer may cease to maintain the closed block and its allocated assets. Regardless of such a cessation, the obligation under the policies constituting the closed block business remain the obligations of the converted insurer. Dividends on those policies shall be apportioned by the board of directors of the converted insurer in accordance with the terms of the policies.

II. A plan of reorganization must be adopted by 
2/3 of the board of directors of the mutual insurance company.

III. Upon the adoption of a plan of reorganization the mutual insurance company shall submit to the commissioner the following:

(a) The plan of reorganization.

(b) The form of notice to be sent to eligible policyholders, informing them of their right to vote on the plan of reorganization.

(c) The form of proxy statement to be sent to eligible policyholders, informing them of their right to vote by proxy on the plan of reorganization, and describing the plan.

(d) The form of proxy to be sent to eligible policyholders to solicit their vote on the plan of reorganization.

(e) Proposed articles of incorporation, merger, or consolidation, restatements of or amendments to articles of incorporation or bylaws, and plans of merger or consolidation, with respect to each entity to be organized, reorganized, or otherwise subject to such action under the plan of reorganization.

(f) Such other information as the commissioner may reasonably require.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:5 Hearing;  Approval. 

I. Within 60 days after receipt of a complete plan of reorganization, the commissioner shall hold a public hearing to allow public comment on the plan of reorganization. The commissioner shall give written notice of the hearing to the mutual insurer not less than 30 days before the hearing. Within 15 days after receiving the notice of hearing, the mutual insurer shall notify eligible policyholders. Such notice shall include a copy of the plan of reorganization or a summary of the plan approved by the commissioner.

II. The commissioner may retain, at the insurer's expense, such attorneys, actuaries, accountants, and other experts not otherwise a part of the commissioner's staff as shall be reasonably necessary to assist in the conduct of the examination hereunder. Any persons so retained shall be under the direction and control of the commissioner and shall act in a purely advisory capacity.

III. Within 30 days after the conclusion of the hearing, the commissioner shall approve the plan of reorganization, unless the commissioner finds:

(a) The plan of reorganization is unfair or inequitable to policyholders;

(b) The plan of reorganization will cause the insurer to become unable to fulfill its contractual obligations;

(c) After the reorganization, the stock insurance company would not be able to satisfy the requirements for the issuance of a license to write the line or lines of insurance for which the mutual insurer is presently licensed;

(d) The financial condition of the insurer would be such as might jeopardize the financial stability of the stock insurance company, or prejudice the interest of its policyholders;

(e) The competence, experience, and integrity of those persons who would control the operation of the stock insurance company are such that it would not be in the interest of policyholders of the insurer and of the public to permit reorganization; or

(f) The plan of reorganization does not comply with the provisions of this chapter.

IV. Upon approval by the commissioner, the plan of reorganization shall be submitted to a vote of eligible policyholders. The board of directors shall schedule a meeting to be held for such purpose, and shall provide at least 20 days' prior written notice to eligible policyholders. Notice to eligible policyholders shall contain a copy of the plan of reorganization and such other information as the commissioner may require. The vote of either (a) 
2/3 of the eligible policyholders voting in person or by proxy or (b) if at least 20 percent of eligible policyholders vote, a simple majority of the eligible policyholders voting in person or by proxy, shall be necessary for the adoption of the plan of reorganization.

V. At any time prior to the date of the vote of eligible policyholders, the plan of reorganization may be withdrawn or amended by majority vote of the entire board of directors, except that no amendment which materially changes the plan of reorganization shall take effect unless such amendment is approved by the commissioner and policyholders in accordance with the same conditions and procedures applicable to the original plan of reorganization.

VI. Upon adoption of the plan of reorganization by the eligible policyholders, the commissioner shall certify approval of the plan of reorganization by an endorsement upon the articles of incorporation of the mutual insurance holding company, which may then be recorded in accordance with the provisions of RSA 293-A, provided that copies of the original documents filed with the secretary of state shall also be filed with the commissioner.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:6 Issuance of Shares to Officers, Directors, and Employees. 

A number of shares or options to purchase shares equal in the aggregate to 5 percent of the outstanding voting shares of the capital stock of one corporate member of the mutual insurance holding company system selected by the mutual insurance holding company may be issued or sold to directors and officers as part of a plan of compensation, and such shares shall not be considered part of the majority shares to be owned by the mutual insurance company under RSA 403-F:3. A number of shares or options to purchase shares equal in the aggregate to an additional 5 percent of the outstanding voting shares of the capital stock of one corporate member of the mutual insurance holding company system selected by the mutual insurance holding company may be issued or sold to employees, which may not include any officer or director, as part of an employee stock dividend or benefit plan, and such shares shall not be considered part of the majority shares to be owned by the mutual insurance company under RSA 403-F:3. Prior to issuance of shares or options to purchase shares in excess of the authorized 5 percent to either officers and directors or employees, the commissioner may require a fairness opinion by an independent authority acceptable to the commissioner to assure that the long term interests of the shareholders and policyholders are adequately protected. The commissioner shall approve or disapprove the issuance of such shares within 30 days after receipt of the fairness opinion. Directors and officers shall be prohibited from purchasing shares of stock, whether or not part of a plan of compensation, for a period of 6 months following any initial public offering of such shares.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:7 Applicability of General Corporation Statutes. 

A mutual insurance holding company organized under this chapter shall be subject to only those provisions of the laws relating to corporations in general that are not inconsistent with the provisions of title XXXVII, the insurance code.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:8 Merger. 

Subject to applicable requirements of this chapter, a mutual insurance holding company may merge or consolidate with a mutual insurance holding company licensed pursuant to this chapter or any similar entity organized pursuant to the laws of any other state.


Source. 2000, 247:1, eff. June 8, 2000.

    403-F:9 Membership. 

I. Membership in a mutual insurance holding company shall be determined in accordance with the mutual insurance holding company's articles of incorporation and bylaws and shall be based upon each member holding a policy of insurance with a subsidiary insurance company. Group certificate holders may also be members of the mutual insurance holding company if specified in the bylaws.

II. No member of a mutual insurance holding company may transfer membership or any right arising therefrom.

III. A member of a mutual insurance holding company is not, as such, personally liable for the acts, debts, liabilities, or obligations of the company and may not be assessed by the directors of such company.

IV. A membership interest in a mutual insurance holding company shall not constitute a security, as defined in RSA 421-B:1-102(53).


Source. 2000, 247:1. 2015, 273:15, eff. Jan. 1, 2016.

    403:1 Guaranty Fund Established Out of Surplus. 

Any mutual insurance company organized under the laws of this state may establish a guaranty fund in any amount not exceeding $500,000 or not to exceed 
1/2 its net policyholders' surplus, whichever is smaller, by appropriation from its net assets. Such guaranty fund shall be considered as paid up capital and be available to meet the obligations of the company, but not to pay dividends or to be otherwise distributed except to meet the obligations of the company when all other assets of the company shall become exhausted.


Source. 1947, 149:1 par. 11, eff. May 15, 1947.

    403:2 Guaranty Fund Established by Subscription. 

Any mutual insurance company organized under the laws of this state may create not more than one guaranty fund by borrowing a sum of money not exceeding $500,000, by the issue of certificates of indebtedness upon such terms as the policyholders shall determine provided that such certificates shall not be divided into classes in any way and that the holders of such certificates shall not be entitled to vote in the direction of the affairs of the company and shall not receive a greater return on their investment than 10 percent per annum. The commissioner, upon notice to the company and after hearing its objections, if any, may require any guaranty fund established under this section to be retired when he shall find it is no longer needed for protection of the policyholders.


Source. 1947, 149:1 par. 12. RSA 403:2. 1969, 293:2, eff. June 30, 1969.

    403:3 Retirement of Guaranty Funds. 

Any mutual insurance company which shall create a guaranty fund under either of the 2 preceding sections may, with the approval of the insurance commissioner, reduce or retire such fund in whole or in part, but it may not be otherwise distributed except to pay the obligations of the company.


Source. 1947, 149:1 par. 13, eff. May 15, 1947.

    403:4 Loans to Companies. 

Any director, officer, or member of any mutual insurance company, other than a mutual life company, or any other person, may advance to such company any sum or sums of money necessary for the purpose of its business or to enable it to comply with any of the requirements of the law. Such moneys, and such interest thereon as may have been agreed upon, not exceeding 10 per centum per annum, shall not be a liability or claim against the company or any of its assets, and shall be repaid only out of the surplus of such company. No commission or promotion expenses shall be paid in connection with the advance of any such money to the company, and the amount of such advance shall be reported in each annual statement. Such company shall prior to making such advances provide the insurance commissioner with such evidence as he may by regulation prescribe concerning the making of any such advance or the making of any payments, whether of principal or interest, on account thereof.


Source. 1969, 293:3, eff. June 30, 1969.

    403:5 Rules. 

The insurance commissioner is hereby granted authority to issue such rules, regulations and orders as may be necessary to properly administer this chapter.


Source. 1969, 293:3, eff. June 30, 1969.

    404-B:1 Title. 

This chapter shall be known and may be cited as the New Hampshire Insurance Guaranty Association Act.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:10 Duties and Powers of the Commissioner. 

I. The commissioner shall:

(a) Forward to the association a copy of any complaint seeking an order of liquidation with a finding of insolvency against a member company at the same time such complaint is filed with a court of competent jurisdiction.

(b) Notify the association of the existence of an insolvent insurer not later than 3 days after he receives notice of the determination of the insolvency.

(c) Upon request of the board of directors, provide the association with a statement of the net direct written premiums of each member insurer.

(d) Make available to the association as soon as practicable after receipt, but only after court approval, that fraction of any reinsurance treaty proceeds which are directly related to covered claims so that said funds may be used by the association for the prompt payment of said covered claims.

II. The commissioner may:

(a) Require that the association notify the insureds of the insolvent insurer and any other interested parties of the determination of insolvency and of their rights under this chapter. Such notification shall be by mail at their last known address, where available, but if sufficient information for notification by mail is not available, notice by publication in a newspaper of general circulation shall be sufficient.

(b) Suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a fine on any member insurer which fails to pay an assessment when due. Such fine shall be paid to the association and shall not exceed 5 percent of the unpaid assessment per month, except that no fine shall be less than $100 per month.

(c) Revoke the designation of any servicing facility if he finds claims are being handled unsatisfactorily.

(d) Upon request of the association, hold hearings, subpoena witnesses and compel their attendance, administer oaths, examine any person under oath and compel any person to subscribe to his testimony after it has been correctly reduced to writing, and in connection with such hearings require the production of any books, papers, records, or other documents which he deems relevant to the inquiry conducted by said association with respect to covered claims.

III. Any final action or order of the commissioner under this chapter shall be subject to judicial review in a court of competent jurisdiction.


Source. 1970, 37:3. 1975, 348:6, 7, eff. Aug. 6, 1975.

    404-B:11 Effect of Paid Claims. 

I. Any person recovering under this chapter shall be deemed to have assigned his rights under the policy to the association to the extent of his recovery from the association. Every insured or claimant seeking the protection of this chapter shall cooperate with the association to the same extent as such person would have been required to cooperate with the insolvent insurer. The association shall have no cause of action against the insured of the insolvent insurer for any sums it has paid out except such causes of action as the insolvent insurer would have had if such sums had been paid by the insolvent insurer. In the case of an insolvent insurer operating on a plan with assessment liability, payments of claims of the association shall not operate to reduce the liability of insureds to the receiver, liquidator, or statutory successor for unpaid assessments.

II. The receiver, liquidator, or statutory successor of an insolvent insurer shall be bound by settlements of covered claims by the association or a similar organization in another state. The court having jurisdiction shall grant such claims priority equal to that which the claimant would have been entitled in the absence of this chapter against the assets of the insolvent insurer. The expenses of the association or similar organization in handling claims shall be accorded the same priority as the liquidator's expenses.

III. The association shall periodically file with the receiver or liquidator of the insolvent insurer statements of the covered claims paid by the association and estimates of anticipated claims on the association which shall preserve the rights of the association against the assets of the insolvent insurer.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:12 Nonduplication of Recovery. 

I. Any person having a claim against an insurer under any provision in an insurance policy other than a policy of an insolvent insurer which is also a covered claim, including but not limited to the provisions of uninsured motorist coverage of any policy, shall be required to exhaust first his right under such policy. Any amount payable on a covered claim under this chapter shall be reduced by the amount of any recovery under such insurance policy.

II. Any person having a claim which may be recovered under more than one insurance guaranty association or its equivalent shall seek recovery first from the association of the place of residence of the insured except that if it is a first party claim for damage to property with a permanent location, he shall seek recovery first from the association of the location of the property, and if it is a workmen's compensation claim, he shall seek recovery first from the association of the residence of the claimant. Any recovery under this chapter shall be reduced by the amount of recovery from any other insurance guaranty association or its equivalent.


Source. 1970, 37:3. 1975, 348:8, eff. Aug. 6, 1975.

    404-B:13 Prevention of Insolvencies. 

To aid in the detection and prevention of insurer insolvencies:

I. It shall be the duty of the board of directors, upon majority vote, to notify the commissioner of any information indicating any member insurer may be insolvent or in a financial condition hazardous to the policyholders or the public.

II. The board of directors may, upon majority vote, request that the commissioner order an examination of any member insurer which the board in good faith believes may be in a financial condition hazardous to the policyholders or the public. Within 30 days of the receipt of such request, the commissioner shall begin such examination. The examination may be conducted as a National Association of Insurance Commissioners examination or may be conducted by such persons as the commissioner designates. The cost of such examination shall be paid by the association and the examination report shall be treated as are other examination reports. In no event shall such examination report be released to the board of directors prior to its release to the public, but this shall not preclude the commissioner from complying with paragraph III. The commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the commissioner but it shall not be open to public inspection prior to the release of the examination report to the public.

III. It shall be the duty of the commissioner to report to the board of directors when he has reasonable cause to believe that any member insurer examined or being examined at the request of the board of directors may be insolvent or in a financial condition hazardous to the policyholders or the public.

IV. The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer. Such reports and recommendations shall not be considered public documents.

V. The board of directors may, upon majority vote, make recommendations to the commissioner for the detection and prevention of insurer insolvencies.

VI. The board of directors shall, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report on the history and causes of such insolvency, based on the information available to the association, and submit such report to the commissioner.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:14 Examination of the Association. 

The association shall be subject to examination and regulation by the commissioner. The board of directors shall submit, not later than March 30 of each year, a financial report for the preceding calendar year in a form approved by the commissioner.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:15 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 or personal property.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:16 Recognition of Assessments in Rates. 

The rates and premiums charged for insurance policies to which this chapter applies shall include amounts sufficient to recoup a sum equal to the amounts paid to the association by the member insurer less any amounts returned to the member insurer by the association and such rates shall not be deemed excessive because they contain an amount reasonably calculated to recoup assessments paid by the member insurer.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:17 Immunity. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer, the association or its agents or employees, the board of directors, or the commissioner or his representatives for any action taken by them in the performance of their powers and duties under this chapter.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:18 Stay of Proceedings;  Reopening of Default Judgments. 

All proceedings in which the insolvent insurer is a party or is obligated to defend a party in any court in this state shall be stayed for 6 months and any additional time thereafter as may be determined by the court from the date the insolvency is determined or an ancillary proceeding is instituted in this state, whichever is later, to permit proper defense by the association of all pending causes of action. As to any covered claims arising from a judgment under any decision, verdict or finding based on the default of the insolvent insurer or its failure to defend an insured, the association either on its own behalf or on behalf of such insured may apply to have such judgment, order, decision, verdict, or finding set aside by the same court or administrator that made such judgment, order, decision, verdict or finding and shall be permitted to defend against such claim on the merits.


Source. 1970, 37:3. 1975, 348:9, eff. Aug. 6, 1975.

    404-B:2 Purpose. 

The purpose of this chapter is to provide a mechanism for the payment of covered claims under certain insurance policies to avoid excessive delay in payment and to avoid financial loss to claimants or policyholders because of the insolvency of an insurer, to assist in the detection and prevention of insurer insolvencies, and to provide an association to assess the cost of such protection among insurers.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:3 Scope. 

This chapter shall apply to all kinds of direct insurance, except life, title, surety, credit, mortgage guaranty, ocean marine, and health insurance as defined in RSA 404-D:3, I.


Source. 1970, 37:3. 1975, 348:1, eff. Aug. 6, 1975.

    404-B:4 Construction. 

This chapter shall be liberally construed to effect the purpose under RSA 404-B:2 which shall constitute an aid and guide to interpretation.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:5 Definitions. 

As used in this chapter:

I. "Account" means any one of the 3 accounts created by RSA 404-B:6.

II. "Association" means the New Hampshire Insurance Guaranty Association created under RSA 404-B:6.

III. "Commissioner" means the commissioner of insurance of this state.

IV. "
Covered claim
" means a net unpaid claim, in excess of $50 (after application of all deductions or commissions as provided for by any contract of insurance) including one for unearned premiums, which arises out of and is within coverage and not in excess of the applicable limits of an insurance policy to which this chapter applies issued by an insurer, if such insurer after the effective date of this chapter is declared insolvent by the superior court, and (a) the claimant or insured is a resident of this state at the time of the insured event; or (b) the property from which the claim arises is permanently located in this state. Claims may not be cumulated by assignment to avoid the application of the $50 deductible provision. "
Covered claim
" shall not include any amount due any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries or otherwise. Any such claim asserted against an insured or an insurer which has become insolvent shall have as its exclusive remedy a direct claim against the assets of the insolvent insurer filed with the liquidator as provided for in RSA 402-C in a maximum amount not to exceed the policy limits of the insured. For an order of liquidation with a finding of insolvency issued on or after August 23, 2003, "
covered claim
" shall also not include an unpaid claim of an insured or third party liability claimant whose net worth as of December 31 of the year preceding the date the insurer becomes an insolvent insurer exceeds $25,000,000; provided, that an insured's or third party liability claimant's net worth on such date shall be deemed to include the aggregate net worth of the insured or third party liability claimant and all of its affiliates as calculated on a consolidated basis.

V. "Insolvent insurer" means (a) an authorized insurer licensed to transact insurance in this state either at the time the policy was issued or when the insured event occurred and (b) declared insolvent by a court of competent jurisdiction after the effective date of this chapter.

VI. "Member insurer" means any person who (a) writes any kind of insurance to which this chapter applies under RSA 404-B:3, including the exchange of reciprocal or inter-insurance contracts, and (b) is licensed to transact insurance in this state, except mutual insurance companies that operate on an assessment plan and require as a condition for granting insurance the signing of a premium deposit note by the insured, which note is given for the purpose of establishing a limit of liability to assessment, while their total receipts from policyholders is less than $10,000 per year.

VII. "Net direct written premiums" means direct gross premiums written in this state on insurance policies to which this chapter applies, less return premiums thereon and dividends paid or credited to policyholders on such direct business. "Net direct written premiums" does not include premiums on contracts between insurers or reinsurers.

VIII. "Person" means any individual, corporation, partnership, association or voluntary organization.


Source. 1970, 37:3. 1975, 348:2, 3. 2003, 184:1. 2004, 197:2, eff. Aug. 6, 2004.

    404-B:6 Creation of the Association. 

There is created a nonprofit unincorporated legal entity to be known as the New Hampshire Insurance Guaranty Association. All insurers defined as member insurers in RSA 404-B:5, VI shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under a plan of operation established and approved under RSA 404-B:9 and shall exercise its powers through a board of directors established under RSA 404-B:7. For purposes of administration and assessment, the association shall be divided into 3 separate accounts: (a) the workmen's compensation insurance account; (b) the automobile insurance account; and (c) the account for all other insurance to which this chapter applies.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:7 Board of Directors. 

I. The board of directors of the association shall consist of not less than 5 nor more than 9 persons serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term in the same manner as initial appointments. If no members are selected within 60 days after the effective date of this chapter, the commissioner may appoint the initial members of the board of directors.

II. In approving selections to the board, the commissioner shall consider among other things whether all member insurers are fairly represented.

III. Members of the board may be reimbursed from the assets of the association for expenses incurred by them as members of the board of directors.


Source. 1970, 37:3, eff. May 4, 1970.

    404-B:8 Powers and Duties of the Association. 

I. The association shall:

(a) Be obligated to the extent of the covered claims existing prior to the determination of insolvency and arising within 30 days after the determination of insolvency, or before the policy expiration date if less than 30 days after the determination, or before the insured replaces the policy or causes its cancellation, if he does so within 30 days of the determination, but such obligation shall include only that amount of each covered claim which is less than $300,000 except that the association shall pay the full amount of any covered claim arising out of a workmen's compensation policy, provided however RSA 281-A:37 shall not apply to payments or settlements made pursuant to this chapter. In no event shall the association be obligated to a policyholder or claimant in an amount in excess of the obligation of the insolvent insurer under the policy from which the claim arises.

(b) Be deemed the insurer to the extent of its obligation on the covered claims and to such extent shall have all rights, duties, and obligations of the insolvent insurer as if the insurer had not become insolvent.

(c) Allocate claims paid and expenses incurred among the 3 accounts separately, and assess member insurers separately for each account amounts necessary to pay the obligations of the association under paragraph I(a) subsequent to an insolvency, the expenses of handling covered claims subsequent to an insolvency, the cost of examinations under RSA 404-B:13 and other expenses authorized by this chapter. The assessments of each member insurer shall be in the proportion that the net direct written premiums of the member insurer for the preceding calendar year on the kinds of insurance in the account bears to the net direct written premiums of all member insurers for the preceding calendar year on the kinds of insurance in the account. Each member insurer shall be notified of the assessment not later than 30 days before it is due. No member insurer may be assessed in any year an amount greater than 2 percent of that member insurer's net direct written premiums for the preceding calendar year on all kinds of insurance written by the insolvent insurer which are covered by the scope of this chapter. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in any account an amount sufficient to make all necessary payments from that account, the funds available shall be pro rated and the unpaid portion shall be paid as soon thereafter as funds become available. The association may exempt or defer, in whole or in part, the assessment of any member insurer, if the assessment would cause the member insurer's financial statement to reflect amounts of capital or surplus less than the minimum amounts required for a certificate of authority by any jurisdiction in which the member insurer is authorized to transact insurance. Each member insurer may set off against any assessment, authorized payments made on covered claims and expenses incurred in the payment of such claims by the member insurer if they are chargeable to the account for which the assessment is made.

(d) Investigate claims brought against the association and adjust, compromise, settle, and pay covered claims to the extent of the association's obligation and deny all other claims and may review settlements, releases and judgments to which the insolvent insurer or its insureds were parties to determine the extent to which such settlements, releases and judgments may be properly contested.

(e) Notify such persons as the commissioner directs under RSA 404-B:10, II(a).

(f) Handle claims through its employees or through one or more insurers or other persons designated as servicing facilities. Designation of a servicing facility is subject to the approval of the commissioner, but such designation may be declined by a member insurer.

(g) Reimburse each servicing facility for obligations of the association paid by the facility and for expenses incurred by the facility while handling claims on behalf of the association and shall pay the other expenses of the association authorized by this chapter.

(h) Notwithstanding any of the powers of the commissioner or liquidator as provided for in RSA 402-C, the association shall have the final authority with respect to the processing and settlement of covered claims for which it becomes responsible pursuant to this chapter, including authority for the use of records of the insolvent insurer directly related to covered claims. At the conclusion of the association's responsibility with respect to any insolvent insurer, any original records of said insolvent insurer then in the possession of the association shall be turned over to the liquidator for ultimate disposal in accordance with RSA 402-C. The association shall cooperate with any agent to the extent possible in identifying policyholders of the agent and the insolvent insurer.

II. The association may:

(a) Employ or retain such persons as are necessary to handle claims and perform other duties of the association.

(b) Borrow funds necessary to effect the purposes of this chapter in accord with the plan of operation.

(c) Sue or be sued.

(d) Negotiate and become a party to such contracts as are necessary to carry out the purposes of this chapter.

(e) Perform such other acts as are necessary or proper to effectuate the purposes of this chapter.

(f) Refund to the member insurers in proportion to the contribution of each member insurer to that account that amount by which the assets of the account exceed the liabilities, if, at the end of any calendar year, the board of directors finds that the assets of the association in any account exceed the liabilities of that account as estimated by the board of directors for the coming year.


Source. 1970, 37:3. 1975, 348:4, 5. 1994, 158:17, eff. May 23, 1994.

    404-B:9 Plan of Operation. 

I. The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the commissioner.

II. If the association fails to submit a suitable plan of operation within 90 days following the effective date of this chapter or if at any time thereafter the association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this chapter. Such rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner.

III. All member insurers shall comply with the plan of operation.

IV. The plan of operation shall:

(a) Establish the procedures whereby all the powers and duties of the association under RSA 404-B:8 will be performed.

(b) Establish procedures for handling assets of the association.

(c) Establish the amount and method of reimbursing members of the board of directors under RSA 404-B:7.

(d) Establish procedures by which claims may be filed with the association and establish acceptable forms of proof of covered claims. Notice of claims to the receiver or liquidator of the insolvent insurer shall be deemed notice to the association or its agent and a list of such claims shall be periodically submitted to the association or similar organization in another state by the receiver or liquidator.

(e) Establish regular places and times for meetings of the board of directors.

(f) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors.

(g) Provide that any member insurer aggrieved by any final action or decision of the association may appeal to the commissioner within 30 days after the action or decision.

(h) Establish the procedures whereby selections for the board of directors will be submitted to the commissioner.

(i) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

V. The plan of operation may provide that any or all powers and duties of the association, except those under RSA 404-B:8, I(c) and II(b), are delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association, or its equivalent, in 2 or more states. Such a corporation, association or organization shall be reimbursed as a servicing facility would be reimbursed and shall be paid for its performance of any other functions of the association. A delegation under this paragraph shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.


Source. 1970, 37:3, eff. May 4, 1970.

    404-C:1 Establishment of Plans. 

If the commissioner of insurance finds after a hearing that, in any part of this state, automobile insurance, aviation insurance, property insurance, workers' compensation, accident and health insurance or any form of liability insurance is not readily available in the voluntary market, and that the public interest requires such availability, he may, by rule, either adopt plans to provide such insurance coverage for any risks in this state which are equitably entitled to but otherwise unable to obtain such coverage or he may call upon industry to prepare plans for his approval.


Source. 1971, 488:1. 1975, 218:1. 1990, 254:38, eff. July 1, 1990.

    404-C:10 Transition. 

Procedures established under the existing assigned risk plan as provided in RSA 412:43, II shall continue in effect until and unless changed as provided in this chapter.


Source. 1971, 488:1. 2003, 150:5, eff. Jan. 1, 2004.

    404-C:11 State Contribution for Federally Reinsured Losses and Assessment of Insurers. 

The commissioner is authorized to assess each insurance company authorized to do business in this state an aggregate amount sufficient to provide a fund to reimburse the United States Secretary of Housing and Urban Development as provided in section 1223(a)(1) of the National Housing Act as amended by section 1103 of the Urban Property Protection and Reinsurance Act of 1968, P.L. 90-448, 82 Stat. 476. The assessment shall be made on those lines of insurance coverage reinsured during the current year in this state by the United States Secretary of Housing and Urban Development pursuant to such chapter. The assessment shall be in the proportion that the premiums earned during the preceding calendar year by each such company in this state bear to the aggregate premiums earned on those lines of insurance in this state by all insurers. The fund may be provided in whole or in part from appropriations by the legislature.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:12 Recoupment. 

Rates used by an insurer shall not be deemed excessive because they contain an amount reasonably calculated to recoup assessments made under RSA 404-C:11.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:13 Voluntary Risk Sharing Plans. 

Insurers doing business within this state are authorized to prepare voluntary plans providing any specified kind, line or class of insurance coverage or subdivision or combination thereof for all or any part of this state in which such insurance is not readily available in the voluntary market and in which the public interest requires the availability of such coverage. Such plans shall be submitted to the commissioner and if approved by him may be put into operation.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:14 Repealed by 2015, 263:4, I, eff. July 20, 2015. 

[RSA 404-C:15 repealed by 2015, 263:4, II, effective as provided by 2015, 263:5.]
    404-C:15 Conclusion of the New Hampshire Medical Malpractice Joint Underwriting Association's Business;  Issuance of Policies. 

I. Upon the effective date of this section, the insurance commissioner shall bring a petition to the superior court for Merrimack county for the receivership of the New Hampshire medical malpractice joint underwriting association (NHMMJUA) pursuant to RSA 402-C. The receivership of the NHMMJUA shall include the stabilization reserve fund trust established in 1986 to pay deficits of the association incurred as a result of policies issued prior to January 1, 1986. Subject to such receivership, the NHMMJUA shall be a continuation of the same unincorporated association in existence immediately before the effective date of this section. The NHMMJUA shall be an insurer organized in this state for purposes of RSA 402-C.

II. To facilitate the orderly resolution of the obligations of the NHMMJUA and transition of policyholders to coverage in the private market, the commissioner, as receiver shall:

(a) Not cancel a NHMMJUA policy in effect upon his or her appointment as receiver unless the policyholder fails to comply with the terms of the policy, including the payment of premium.

(b) Not accept new applications for insurance for new policyholders after the effective date of this section.

(c) Renew any association policy in effect as of the effective date of this section, but shall not issue any NHMMJUA policy with an effective date after December 31, 2015, except that until December 31, 2015, the receiver may issue extended reporting coverage on policies issued before December 31, 2016.

(d) Issue notice of nonrenewal in compliance with RSA 417-C to policyholders with renewal dates on or after January 1, 2016.

(e) Upon the nonrenewal of any claims-made policy issued by the NHMMJUA that is in force as of the effective date of this section, calculate the amount of tail coverage premium collected, using reasonable actuarial methodologies and standards of practice, and return the tail coverage premium to the policyholder. For the purpose of this subparagraph, "
tail coverage premium
" shall mean that portion of the premium collected by the NHMMJUA and separately identified in NHMMJUA's financial statements, and which would have been used to provide tail coverage if tail coverage had been provided under the terms of the policy. Return of the tail coverage premium shall only be provided to those claims-made policyholders who will not otherwise receive tail coverage under their claims-made policies.

III. The NHMMJUA shall have no in-force insurance business after December 31, 2016, other than extended reporting coverage elected under policies issued on or before December 31, 2015.

IV. This section shall constitute a plan of complete liquidation for the NHMMJUA pursuant to section 331 of the Internal Revenue Code of 1986, as amended, for federal income tax purposes effective on the effective date of this section.


Source. 2015, 263:2, eff. July 20, 2015.

[RSA 404-C:16 repealed by 2015, 263:4, II, effective as provided by 2015, 263:5.]
    404-C:16 Receivership of the Association. 

I. The insurance commissioner, as receiver of the NHMMJUA, shall, consistent with this section, RSA 404-C:14, RSA 404-C:15, RSA 404-C:17, and the provisions of RSA 402-C wind-down its business, seeking to facilitate the payment of all policyholder coverage obligations in full and in the normal course of business. The receiver shall make monthly reports to the court detailing progress made in the wind-down of the NHMMJUA, including expenses incurred. Interested persons, including policyholders, shall have standing in the receivership and the right to be heard in reference to the monthly reports.

II. After the effective date of this section, the commissioner, as receiver, shall promptly seek competitive bids to have all of the coverage-related obligations under policies issued by the NHMMJUA assumed by an insurer or insurers. At the earliest practicable date, the receiver shall then enter an agreement or agreements with an insurer or insurers to provide for the assumption and novation of all of the coverage-related obligations under policies issued by the NHMMJUA. Any such assumption and novation agreement shall be subject to the approval of the supervising court after a hearing at which all interested persons, including policyholders, have standing and may be heard. The assumption and novation agreement shall be on commercially reasonable terms and shall provide for continued protection for the NHMMJUA's policyholders against liability and expense in accordance with the coverage terms of their policies, as well as providing for established obligations to claimants under such policies.

III. Within 60 days of the initiation of the receivership, the receiver shall allocate a portion of the NHMMJUA surplus to establish a hardship fund in the amount of $2,000,000. This fund shall be used for hardship claims by current NHMMJUA policyholders. The hardship fund shall be available to provide grants payable directly to midwives certified under RSA 326-D and other health care providers who are licensed or approved by the state, who have in-force policies with the NHMMJUA as of the effective date of this section, and who can demonstrate by application to the receiver that they will suffer significant adverse economic hardship as a result of an increase of at least 25 percent in the cost of medical malpractice insurance coverage in the private market as compared to their coverage from the NHMMJUA as of the effective date of this section. Any grant provided shall not exceed the difference between the cost of insurance through the NHMMJUA plus 25 percent and the premium charged in the private market for the most comparable coverage available. The receiver's determination of grant eligibility shall be subject to court approval. The hardship fund shall be administered until exhausted or until the termination of the receivership, whichever occurs first. If funds remain in the hardship fund at the termination of the receivership, the receiver shall, with court approval, and before discharge of the receiver, transfer any remaining funds to a charitable organization that promotes aid to health care providers servicing medically underserved populations.

IV. Upon appointment of the commissioner as receiver of the association, no assessments of any kind shall thereafter be made by the receiver or ordered by the court.

V. The board members and officers of the NHMMJUA shall continue to be officers, trustees, officials, or employees of the state subject to RSA 99-D through the date of the rehabilitation order.

VI. Until liquidated, the NHMMJUA shall continue as a legally cognizable unincorporated association solely for the purpose of winding down the NHMMJUA, consistent with this chapter. The provisions of this section and RSA 402-C shall control the management of claims and obligations of the association and shall supersede the provisions of administrative rules governing the operation of the NHMMJUA.


Source. 2015, 263:2, eff. July 20, 2015.

    404-C:17 Closure of the NHMMJUA. 



[Paragraph I repealed by 2015, 263:4, II, effective as provided by 2015, 263:5.]



I. Subject to the provisions of RSA 404-C:15 and RSA 404-C:16, the NHMMJUA's obligations shall be wound up through rehabilitation under RSA 402-C.


[Paragraph II repealed by 2015, 263:4, II, effective as provided by 2015, 263:5.]



II. The NHMMJUA shall be liquidated and the receiver discharged upon:

(a) The resolution or transfer of all of the NHMMJUA's administrative, operational, and coverage-related obligations, including the NHMMJUA's tax obligations and all receivership expenses; and

(b) The approval of the supervising court.


[Paragraph III repealed by 2015, 263:4, III, effective as provided by 2015, 263:5.]



III. Prior to the receiver's discharge in accordance with paragraph II, all assets remaining after court approval of the receiver's transfer of all of the NHMMJUA coverage-related obligations, payment of the NHMMJUA's administrative and operational expenses, transfer or resolution of tax obligations, and payment of receivership expenses, shall be interpleaded by the receiver into the Merrimack county superior court, docket no. 217-2010-CV-00414, for the purposes of adjudicating all policyholder claims in those funds. The interpleader into docket no. 217-2010-CV-00414 shall not prejudice the rights of any class of NHMMJUA policyholders with respect to those funds. If any class of NHMMJUA policyholders cannot be represented or is barred from the old action, a new interpleader action shall be commenced to allow such policyholders to assert their claims with respect to the funds. Neither the state of New Hampshire nor any agency thereof shall have any claim to these funds.


[Paragraph IV(a) repealed by 2015, 263:4, III, effective as provided by 2015, 263:5.]



IV. (a) The provisions of RSA 404-C:15-RSA 404-C:17 shall not alter, and shall not be construed to alter, any vested contractual rights that any class of NHMMJUA policyholders may have with respect to NHMMJUA assets. The existence and extent of any such rights shall be determined by the interpleader court after termination of the receivership proceeding. Funds that cannot be distributed to a policyholder in the interpleader proceeding referenced in this section due to the inability to locate the policyholder after reasonable efforts shall not be subject to RSA 471-C and shall be transferred to a fund within the treasury to be administered by the department of health and human services which shall utilize such undistributed funds to provide grants in aid to health care providers servicing medically underserved populations through the department's state loan repayment program.

(b) There is established in the office of the state treasurer a nonlapsing fund to be known as the grants in aid to health care providers servicing medically underserved populations fund to be administered by the commissioner of the department of health and human services, which shall be kept distinct and separate from all other funds. All moneys in the fund shall be continually appropriated to the commissioner of the department of health and human services, for the purposes of providing grants in aid to health care providers servicing medically underserved populations.


Source. 2015, 263:2, eff. July 20, 2015.

    404-C:2 Purposes and Contents of Risk Sharing Plans. 

Any plan promulgated or prepared as provided in RSA 404-C:1 shall:

I. Give consideration to:

(a) The need for adequate and readily accessible coverage;

(b) Alternative methods of improving the market affected;

(c) The inherent limitations of the insurance mechanism;

(d) The need for reasonable underwriting standards; and

(e) The requirement of reasonable loss prevention measures;

II. Establish procedures that will create minimum interference with the voluntary market;

III. Spread the burden imposed by the plan equitably and efficiently within the industry; and

IV. Establish procedures for applicants and participants to have grievances reviewed by an impartial body.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:3 Persons Required to Participate. 

Each plan shall require participation by all insurers licensed in this state to write the kinds of insurance covered by the specific plan and all agents licensed to represent such insurers for the kinds of business covered by the specific plan, except that the commissioner may exclude classes of persons for administrative convenience or because it is not equitable or practicable to require them to participate in the plan.


Source. 1971, 488:1. 1975, 218:2, eff. Aug. 2, 1975.

    404-C:4 Voluntary Participation. 

The plan may provide for optional participation by insurers not required to participate as provided in RSA 404-C:3.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:5-a Workers' Compensation Assigned Risk Plan. 

I. The workers' compensation assigned risk plan shall provide that an employer with an experience modification factor of 1.50 or greater shall lose the entitlement to a premium discount.

II. Employers who secure any portion of their obligations for compensation under RSA 281-A through self-insurance or group funded self-insurance shall not be eligible to secure any other portion of such obligations through insurance under the New Hampshire workers' compensation insurance plan.


Source. 1990, 254:39. 1994, 3:21, eff. Feb. 8, 1994.

    404-C:5 Classifications and Rates. 

Each plan shall provide for the method of classifying risks and making and filing rates applicable thereto.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:6 Basis of Participation. 

The plan shall specify the basis of participation of insurers and agents and the conditions under which risks must be accepted.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:7 Duty to Provide Service. 

Every participating insurer and agent shall provide to any person seeking coverages of kinds available in the plans, the services prescribed in the plans, including full information on the requirements and procedures for obtaining coverage under the plans whenever the business is not placed in the voluntary market.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:8 Commissions. 

The commissioner shall determine reasonable and adequate commission rates to be paid to agents or brokers for coverage written under this chapter. In determining the reasonableness and adequacy of such commission rates the commissioner shall consider the commission rates paid on similar coverage in the normal market.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-C:9 Provision of Marketing Facilities. 

If the commissioner finds that the lack of cooperating insurers or agents in an area makes the functioning of the plan difficult, he may order that the plan appoint agents in such a manner and on such terms as he designates or take other appropriate steps to insure that service is available.


Source. 1971, 488:1, eff. Aug. 31, 1971.

    404-D:1 Title. 

This chapter shall be known and may be cited as the New Hampshire life and health insurance guaranty association act.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:10 Plan of Operation. 

I. A plan of operation shall be established as follows:

(a) The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the commissioner.

(b) If the association fails to submit a suitable plan of operation within 180 days following the effective date of this chapter or if at any time thereafter the association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this chapter. Such rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner.

II. All member insurers shall comply with the plan of operation.

III. The plan of operation shall, in addition to requirements enumerated elsewhere in this chapter:

(a) Establish procedures for handling the assets of the association.

(b) Establish the amount and method of reimbursing members of the board of directors under RSA 404-D:7.

(c) Establish regular places and times for meetings of the board of directors.

(d) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors.

(e) Establish the procedures whereby selections for the board of directors will be made and submitted to the commissioner.

(f) Establish any additional procedures for assessments under RSA 404-D:9.

(g) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

IV. The plan of operation may provide that any or all powers and duties of the association, except those under RSA 404-D:8, XI(c) and RSA 404-D:9, are delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association, or its equivalent, in 2 or more states. Such a corporation, association, or organization shall be reimbursed for any payments made on behalf of the association and shall be paid for its performance of any function of the association. A delegation under this paragraph shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:11 Duties and Powers of the Commissioner. 

In addition to the duties and powers enumerated elsewhere in this chapter,

I. The commissioner shall:

(a) Notify the board of directors of the existence of an impaired insurer not later than 3 days after a determination of impairment is made or he receives notice of impairment.

(b) Upon request of the board of directors, provide the association with a statement of the premiums in the appropriate states for each member insurer.

(c) When an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time. Notice to the impaired insurer shall constitute notice to its shareholders, if any. The failure of the insurer to promptly comply with such demand shall not excuse the association from the performance of its powers and duties under this chapter.

(d) In any liquidation or rehabilitation proceeding involving a domestic insurer, be appointed as the liquidator or rehabilitator. If a foreign or alien member insurer is subject to a liquidation proceeding in its domiciliary jurisdiction or state of entry, the commissioner may be appointed conservator.

II. The commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative the commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. Such forfeiture shall not exceed 5 percent of the unpaid assessment per month, but no forfeiture shall be less than $100 per month.

III. Any action of the board of directors or the association may be appealed to the commissioner by any member insurer if such appeal is taken within 30 days of the action being appealed. Any final action or order of the commissioner shall be subject to judicial review pursuant to RSA 541.

IV. The liquidator, rehabilitator, or conservator or any impaired insurer may notify all interested persons of the effect of this chapter.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:12 Prevention of Impairments. 

To aid in the detection and prevention of insurer impairments, the commissioner shall be notified when:

I. The board of directors shall, upon majority vote, notify the commissioner of any information indicating any member insurer may be unable or potentially unable to fulfill its contractual obligations.

II. The board of directors may, upon majority vote, request that the commissioner order an examination of any member insurer which the board in good faith believes may be unable or potentially unable to fulfill its contractual obligations. The commissioner may conduct such examination. The examination may be conducted as a national association of insurance commissioners examination or may be conducted by such persons as the commissioner designates. The cost of such examination shall be paid by the association and the examination report shall be treated as are other examination reports. In no event shall such examination report be released to the board of directors of the association prior to its release to the public, but this shall not excuse the commissioner from his obligation to comply with paragraph III. The commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the commissioner but it shall not be open to public inspection prior to the release of the examination report to the public and shall be released at that time only if the examination discloses that the examined insurer is unable or potentially unable to meet its contractual obligations.

III. The commissioner shall report to the board of directors when he has reasonable cause to believe that any member or licensed insurer may be unable or potentially unable to fulfill its contractual obligations.

IV. The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer. Such reports and recommendations shall not be subject to RSA 91-A.

V. The board of directors may, upon majority vote, make recommendations to the commissioner for the detection and prevention of insurer impairments.

VI. The board of directors shall, at the conclusion of any insurer impairment in which the association carried out its duties under this chapter or exercised any of its powers under this chapter, prepare a report on the history and causes of such impairment, based on the information available to the association, and submit such report to the commissioner.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:13 Appointment of Association Nominee. 

The association may recommend a natural person to serve as a special deputy to act for the commissioner and under his supervision in the liquidation, rehabilitation, or conservation, of any member insurer.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:14 Miscellaneous Provisions. 

I. Nothing in this chapter shall be construed to reduce the liability for unpaid assessments of the insureds of an impaired insurer operating under a plan with assessment liability.

II. Records shall be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under RSA 404-D:8. Records of such negotiations or meetings shall be made public only upon the termination of a liquidation, rehabilitation, or conservation proceeding involving the impaired insurer, upon the termination of the impairment of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this paragraph shall limit the duty of the association to render a report of its activities under RSA 404-D:15.

III. For the purpose of carrying out its obligations under this chapter, the association shall be deemed to be a creditor of the impaired insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee pursuant to RSA 404-D:8, IX. All assets of the impaired insurer attributable to covered policies shall be used to continue all covered policies and pay all contractual obligations of the impaired insurer as required by this chapter. Assets attributable to covered policies, as used in this paragraph, is that proportion of the assets which the reserves that should have been established for such policies bear to the reserve that should have been established for all policies of insurance written by the impaired insurer.

IV. In distributing assets the following factors shall be considered:

(a) Prior to the termination of any liquidation, rehabilitation, or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders and policy owners of the impaired insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of such impaired insurer. In such a determination, consideration shall be given to the welfare of the policyholders of the continuing or successor insurer.

(b) No distribution to stockholders, if any, of an impaired insurer shall be made until and unless the total amount of assessments levied by the association with respect to such insurer have been fully recovered by the association.

V. It shall be a prohibited unfair trade practice for any person to make use in any manner of the protection afforded by this chapter in the sale of insurance.

VI. The recovery procedure shall provide that:

(a) If an order for liquidation or rehabilitation of an insurer domiciled in this state has been entered, the receiver appointed under such order shall have a right to recover on behalf of the insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation subject to the limitations of paragraphs (b) to (d).

(b) No such dividend shall be recoverable if the insurer shows that when paid the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.

(c) Any person who was an affiliate that controlled the insurer at the time the distributions were paid shall be liable up to the amount of distributions he received. Any person who was an affiliate that controlled the insurer at the time the distributions were declared, shall be liable up to the amount of distributions he would have received if they had been paid immediately. If 2 persons are liable with respect to the same distributions, they shall be jointly and severally liable.

(d) The maximum amount recoverable under this section shall be the amount needed in excess of all other available assets of the impaired insurer to pay the contractual obligations of the impaired insurer on a fair and equitable basis, as determined by the commissioner under this chapter.

(e) If any person liable under paragraph (c) is insolvent, all its affiliates that controlled it at the time the dividend was paid, shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate.


Source. 1971, 509:1. 1979, 440:3, eff. June 25, 1979.

    404-D:15 Examination of the Association;  Annual Report. 

The association shall be subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner, not later than May 1 of each year, a financial report for the preceding calendar year in a form approved by the commissioner and a report of its activities during the preceding calendar year.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:16 Tax Exemptions. 

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. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:17 Immunity. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or his representatives, for any action taken by them in the performance of their powers and duties under this chapter.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:18 Stay of Proceedings;  Reopening Default Judgments. 

All proceedings in which the impaired insurer is a party in any court in this state shall be stayed 60 days from the date an order of liquidation, rehabilitation, or conservation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to a judgment under any decision, order, verdict, or finding based on default the association may apply to have such judgment set aside by the same court that made such judgment and shall be permitted to defend against such suit on the merits.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:2 Purpose. 

The purpose of this chapter is to maintain public confidence in the promises of insurers by providing a mechanism for protecting policyowners, insureds, beneficiaries, annuitants, payees, and assignees of life insurance policies, health insurance policies, annuity contracts, and supplemental contracts, against failure in the performance of fair and equitable contractual obligations due to the impairment of the insurer issuing such policies or contracts. To provide this protection:

I. An association of insurers is created to enable the guaranty of payment of benefits and of continuation of coverages;

II. Members of the association are subject to assessment to provide funds to carry out the purpose of this chapter; and

III. The association is authorized to assist the commissioner, in the prescribed manner, in the detection and prevention of insurer impairments.


Source. 1971, 509:1. 1979, 440:1, eff. June 25, 1979.

    404-D:3 Scope. 

I. This chapter shall apply to direct life insurance policies, health insurance policies, annuity contracts, and contracts supplemental to life and health insurance policies and annuity contracts issued by persons authorized to transact insurance in this state at any time. The term health insurance is intended to include "
accident and health
" insurance, "
sickness and accident
" insurance, and "
disability
" insurance.

II. This chapter shall not apply to:

(a) Any such policies or contracts, or any part of such policies or contracts, under which the risk is borne by the policyholder.

(b) Any such policy or contract or part thereof assumed by the impaired insurer under a contract of reinsurance, other than reinsurance for which assumption certificates have been issued.

(c) Any such policy or contract issued by assessment mutuals, fraternals, health maintenance organizations and nonprofit hospital and medical service plans.


Source. 1971, 509:1. 1983, 399:2. 1990, 114:1. 2003, 293:6, eff. July 18, 2003.

    404-D:4 Construction. 

This chapter shall be liberally construed to effect the purpose under RSA 404-D:2 which shall constitute an aid and guide to interpretation.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:5 Definitions. 

As used in this chapter:

I. "Account" means any of the 3 accounts created under RSA 404-D:6.

II. "Association" means the New Hampshire life and health insurance guaranty association created under RSA 404-D:6.

III. "Commissioner" means the commissioner of insurance.

IV. "Contractual obligation" means any obligation under covered policies.

V. "Covered policy" means any policy or contract within the scope of RSA 404-D:3.

VI. "Impaired insurer" means:

(a) An insurer which after the effective date of this chapter, is declared insolvent and placed under a final order of liquidation, rehabilitation, or conservation by a court of competent jurisdiction, or

(b) An insurer deemed by the commissioner after the effective date of this chapter to be unable to fulfill its contractual obligations.

VII. "Member insurer" means any person authorized to transact in this state any kind of insurance to which this chapter applies under RSA 404-D:3.

VIII. "Premiums" means direct gross insurance premiums and annuity considerations written on covered policies, less return premiums and considerations thereon and dividends paid or credited to policyholders on such direct business. "Premiums" do not include premiums and considerations on contracts between insurers and reinsurers. As used in RSA 404-D:9, "premiums" are those for the calendar year preceding the determination of impairment.

IX. "Person" means any individual, corporation, partnership, association or voluntary organization.

X. "Resident" means any person who resides in this state at the time the impairment is determined and to whom contractual obligations are owed.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:6 Creation of the Association. 

I. There is created a nonprofit legal entity to be known as the New Hampshire life and health insurance guaranty association. All member insurers shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under the plan of operation established and approved under RSA 404-D:10 and shall exercise its powers through a board of directors established under RSA 404-D:7. For purposes of administration and assessment, the association shall maintain 3 accounts:

(a) The health insurance account;

(b) The life insurance account; and

(c) The annuity account.

II. The association shall come under the immediate supervision of the commissioner and shall be subject to the applicable provisions of the insurance laws of this state.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:7 Board of Directors. 

I. The board of directors of the association shall consist of not less than 5 nor more than 9 members serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term in the manner described in the plan of operation. To select the initial board of directors, and initially organize the association, the commissioner shall give notice to all member insurers of the time and place of the organizational meeting. In determining voting rights at the organizational meeting each member insurer shall be entitled to one vote in person or by proxy. If the board of directors is not selected within 60 days after notice of the organizational meeting, the commissioner may appoint the initial members.

II. In approving selections or in appointing members to the board, the commissioner shall consider, among other things, whether all member insurers are fairly represented.

III. Members of the board may be reimbursed from the assets of the association for expenses incurred by them as members of the board of directors but members of the board shall not otherwise be compensated by the association for their services.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-D:8 Powers and Duties of the Association. 

In addition to the powers and duties enumerated in other sections of this chapter:

I. If a domestic insurer is an impaired insurer, the association may, prior to an order of liquidation or rehabilitation, and subject to any fair and equitable conditions imposed by the association and approved by the impaired insurer and the commissioner:

(a) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured, all the covered policies of the impaired insurer; provided, however, if the commissioner finds that certain contractual obligations of the covered policies are not fair and equitable, then the association may, subject to the approval of the commissioner, only guarantee, assume or reinsure such contractual obligations of the covered policies on conditions which are fair and equitable;

(b) Provide such monies, pledges, notes, guarantees, or other means as are proper to effectuate subparagraph (a), and assure payment of the appropriate contractual obligations of the impaired insurer pending action under subparagraph (a);

(c) Loan money to the impaired insurer.

II. If a foreign or alien insurer is an impaired insurer, the association may prior to an order of liquidation, rehabilitation or conservation, with respect to the covered policies of residents and subject to any fair and equitable conditions imposed by the association and approved by the impaired insurer and the commissioner:

(a) Guarantee or reinsure, or cause to be guaranteed, assumed, or reinsured, the impaired insurer's covered policies of residents; provided, however, if the commissioner finds that certain contractual obligations of the covered policies are not fair and equitable, then the association may, subject to the approval of the commissioner, only guarantee, assume or reinsure such contractual obligations of the covered policies on conditions which are fair and equitable;

(b) Provide such monies, pledges, notes, guarantees or other means as are proper to effectuate subparagraph (a), and assure payment of the impaired insurer's appropriate contractual obligations to residents pending action under subparagraph (a);

(c) Loan money to the impaired insurer.

III. If a domestic insurer is an impaired insurer under an order of liquidation or rehabilitation, the association shall, subject to the approval of the commissioner:

(a) Guarantee, assume, or reinsure, or cause to be guaranteed, assumed or reinsured the covered policies of the impaired insurer; provided, however, if the commissioner finds that certain contractual obligations of the covered policies are not fair and equitable, then the association may, subject to the approval of the commissioner, only guarantee, assume or reinsure such contractual obligations of the covered policies on conditions which are fair and equitable;

(b) Assure payment of the appropriate contractual obligations of the impaired insurer; and

(c) Provide such monies, pledges, notes, guarantees, or other means as are reasonably necessary to discharge such duties. If the association fails to act within a reasonable period of time, the commissioner shall have the powers and duties of the association under this chapter with respect to such domestic impaired insurer.

IV. If a foreign or alien insurer is an impaired insurer under an order of liquidation, rehabilitation, or conservation, the association shall, subject to the approval of the commissioner:

(a) Guarantee, assume, or reinsure or cause to be guaranteed, assumed, or reinsured the covered policies of residents; provided, however, if the commissioner finds that certain contractual obligations of the covered policies are not fair and equitable, then the association may, subject to the approval of the commissioner, only guarantee, assume or reinsure contractual obligations of the covered policies on conditions which are fair and equitable;

(b) Assure payment of the appropriate contractual obligations of the impaired insurer to residents; and

(c) Provide such monies, pledges, notes, guarantees, or other means as are reasonably necessary to discharge such duties. If the association fails to act within a reasonable period of time, the commissioner shall have the powers and duties of the association under this chapter with respect to such foreign or alien impaired insurer.

V. (a) In carrying out its duties under paragraphs III and IV, the association may request that there be imposed policy liens, contract liens, moratoriums on payments, or other similar means and such liens, moratoriums, or similar means may be imposed if the commissioner:

(1) Finds that the amounts which can be assessed under this chapter are less than the amounts needed to assure full and prompt performance of the impaired insurer's contractual obligations, or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of policy or contract liens, moratoriums or similar means to be in the public interest, or that the imposition of policy or contract liens, moratoriums or similar means is fair and equitable, and

(2) Approves the specific policy liens, contract liens, moratoriums, or similar means to be used.

(b) Before being obligated under paragraphs III and IV the association may request that there be imposed temporary moratoriums or liens on payments of cash values and policy loans and such temporary moratoriums and liens may be imposed if they are approved by the commissioner.

VI. The association shall have no liability under this paragraph for any covered policy of a foreign or alien insurer whose domiciliary jurisdiction or state of entry provides by statute or regulation for residents of this state protection substantially similar to that provided by this chapter for residents of other states.

VII. The association may render assistance and advice to the commissioner, upon his request, concerning rehabilitation, payment of claims, continuations of coverage, or the performance of other contractual obligations of any impaired insurer.

VIII. The association shall have standing to appear before any court in this state with jurisdiction over an impaired insurer concerning which the association is or may become obligated under this chapter. Such standing shall extend to all matters germane to the powers and duties of the association, including, but not limited to, proposals for reinsuring or guaranteeing the covered policies of the impaired insurer and the determination of the covered policies and contractual obligations.

IX. Assignment of rights occurs when:

(a) Any person receiving benefits under this chapter shall be deemed to have assigned his rights under the covered policy to the association to the extent of the benefits received because of this chapter whether the benefits are payments of contractual obligations or continuation of coverage. The association may require an assignment to it of such rights by any payee, policy or contract owner, beneficiary, insured or annuitant as a condition precedent to the receipt of any rights or benefits conferred by this chapter upon such person. The association shall be subrogated to these rights against the assets of any impaired insurer.

(b) The subrogation rights of the association under this paragraph shall have the same priority against the assets of the impaired insurer as that possessed by the person entitled to receive benefits under this chapter.

X. The contractual obligations of the impaired insurer for which the association becomes or may become liable shall be as great as but no greater than the contractual obligations of the impaired insurer would have been in the absence of the impairment, except for such contractual obligations of the impaired insurer which the commissioner finds are not fair and equitable, for which the association will become liable only on conditions determined by the commissioner to be fair and equitable, including without limitation, the imposition of policy or contract liens, moratoriums or similar means which the commissioner determines to be fair and equitable. In no event shall the aggregate liability of the association exceed $100,000 in cash values, or $300,000 for all benefits, including cash values, with respect to any one life.

XI. The association may:

(a) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter.

(b) Sue or be sued, including taking any legal actions necessary or proper for recovery of any unpaid assessments under RSA 404-D:9.

(c) Borrow money to effect the purposes of this chapter. Any notes or other evidence of indebtedness of the association not in default shall be legal investments for domestic insurers and may be carried as admitted assets.

(d) Employ or retain such persons as are necessary to handle the financial transactions of the association, and to perform such other functions as become necessary or proper under this chapter.

(e) Negotiate and contract with any liquidator, rehabilitator, conservator, or ancillary receiver to carry out the powers and duties of the association.

(f) Take such legal action as may be necessary to avoid payment of improper claims.

(g) Exercise, for the purposes of this chapter and to the extent approved by the commissioner, the powers of a domestic life or health insurer, but in no case may the association issue insurance policies or annuity contracts other than those issued to perform the contractual obligations of the impaired insurer.


Source. 1971, 509:1. 1979, 440:2, eff. June 25, 1979.

    404-D:9 Assessments. 

I. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers, separately for each account, at such times and for such amounts as the board finds necessary. The board shall collect the assessments after 30 days' written notice to the member insurers before payment is due.

II. There shall be 3 classes of assessments, as follows:

(a) Class A assessments shall be made for the purpose of meeting administrative costs and other general expenses not related to a particular impaired insurer.

(b) Class B assessments shall be made to the extent necessary to carry out the powers and duties of the association under RSA 404-D:8 with regard to an impaired domestic insurer.

(c) Class C assessments shall be made to the extent necessary to carry out the powers and duties of the association under RSA 404-D:8 with regard to an impaired foreign or alien insurer.

III. Assessments shall be determined as follows:

(a) The amount of any Class A assessment for each account shall be determined by the board. The amount of any Class B or C assessment shall be divided among the accounts in the proportion that the premiums received by the impaired insurer on the policies covered by each account bear to the premiums received by such insurer on all covered policies.

(b) Class A and Class C assessments against member insurers for each account shall be in the proportion that the premiums received on business in this state by each assessed member insurer on policies covered by each account bear to such premiums received on business in this state by all assessed member insurers.

(c) Class B assessments for each account shall be made separately for each state in which the impaired domestic insurer was authorized to transact insurance at any time, in the proportion that the premiums received on business in such state by the impaired insurer on policies covered by such account bear to such premiums received in all such states by the impaired insurer. The assessments against member insurers shall be in the proportion that the premiums received on business in each such state by each assessed member insurer on policies covered by each account bear to such premiums received on business in each state by all assessed member insurers.

(d) Assessments for funds to meet the requirements of the association with respect to an impaired insurer shall not be made until necessary to implement the purposes of this chapter. Classification of assessments under paragraph II and computation of assessments under this paragraph shall be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible.

IV. The association may abate or defer, in whole or in part, the assessment of a member insurer if, in the opinion of the board, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. The total of all assessments upon a member insurer for each account shall not in any one calendar year exceed 4 percent of such insurer's premiums in this state on the policies covered by the account.

V. In the event an assessment against a member insurer is abated (or deferred), in whole or in part, because of the limitations set forth in paragraph IV, the amount by which such assessment is abated or deferred, shall be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this section. If the maximum assessment, together with the other assets of the association in either account, does not provide in any one year in either account an amount sufficient to carry out the responsibilities of the association, the necessary additional funds shall be assessed as soon thereafter as permitted by this chapter.

VI. The board may, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each insurer to that account, the amount by which the assets of the account exceed the amount the board finds is necessary to carry out during the coming year the obligations of the association with regard to that amount, including assets accruing from net realized gains and income from investments. A reasonable amount may be retained in any account to provide funds for the continuing expenses of the association and for future losses if refunds are impractical.

VII. It shall be proper for any member insurer, in determining its premium rates and policy owner dividends as to any kind of insurance within the scope of this chapter, to consider the amount reasonably necessary to meet its assessment obligations under this chapter.

VIII. The association shall issue to each insurer paying an assessment under this chapter a certificate of contribution, in a form prescribed by the commissioner, for the amount so paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. A certificate of contribution may be shown by the insurer in its financial statement as an asset in such form and for such amount, if any, and period of time as the commissioner may approve.


Source. 1971, 509:1, eff. Sept. 4, 1971.

    404-F:1 Definitions. 

In this chapter:

I. "Adjusted RBC report" means an RBC report which has been adjusted by the commissioner in accordance with RSA 404-F:2, V.

II. "Corrective order" means an order issued by the commissioner specifying corrective actions which the commissioner has determined are required.

III. "Domestic insurer" means any insurance company domiciled in this state.

IV. "Foreign insurer" means any insurance company which is licensed to do business in this state under title XXXVII but is not domiciled in this state.

IV-a. "
Health organization
" means a health maintenance organization, limited health service organization, dental or vision plan, health service corporation, or other managed care organization licensed under title XXXVII.

V. "NAIC" means the National Association of Insurance Commissioners.

VI. "
Life and/or health insurer
" means any insurance company licensed under title XXXVII writing life, accident and health insurance or a licensed property and casualty insurer writing only accident and health insurance.

VII. "Property and casualty insurer" means any insurance company licensed under title XXXVII but shall not include monoline mortgage guaranty insurers, financial guaranty insurers, and title insurers.

VIII. "Negative trend" means, with respect to a life and/or health insurer, negative trend over a period of time, as determined in accordance with the "trend test calculation" included in the RBC instructions.

IX. "RBC instructions" means the RBC report including risk-based capital instructions adopted by the NAIC, as such RBC instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC.

X. "RBC level" means an insurer's company action level RBC, regulatory action level RBC, authorized control level RBC, or mandatory control level RBC where:

(a) "Company action level RBC" means, with respect to any insurer, the product of 2.0 and its authorized control level RBC;

(b) "Regulatory action level RBC" means the product of 1.5 and its authorized control level RBC;

(c) "Authorized control level RBC" means the number determined under the risk-based capital formula in accordance with the RBC instructions;

(d) "Mandatory control level RBC" means the product of .70 and the authorized control level RBC.

XI. "RBC plan" means a comprehensive financial plan containing the elements specified in RSA 404-F:3, II. If the commissioner rejects the RBC plan, and it is revised by the insurer, with or without the commissioner's recommendation, the plan shall be called the "revised RBC plan."

XII. "RBC report" means the report required in RSA 404-F:2.

XIII. "Total adjusted capital" means the sum of:

(a) An insurer's statutory capital and surplus as determined in accordance with statutory accounting applicable to the annual financial statements required to be filed; and

(b) Such other items, if any, as the RBC instructions may provide.


Source. 1995, 113:1. 2000, 207:1, 2, eff. July 29, 2000. 2018, 177:1, eff. Aug. 7, 2018.

    404-F:10 Foreign Insurers. 

I. Any foreign insurer shall, upon the written request of the commissioner, submit to the commissioner an RBC report as of the end of the calendar year just ended the later of:

(a) The date an RBC report would be required to be filed by a domestic insurer under this chapter; or

(b) Fifteen days after the request is received by the foreign insurer. Any foreign insurer shall, at the written request of the commissioner, promptly submit to the commissioner a copy of any RBC plan that is filed with the insurance commissioner of any other state.

II. In the event of a company action level event, regulatory action level event, or authorized control level event with respect to any foreign insurer as determined under the RBC statute applicable in the state of domicile of the insurer or, if no RBC statute is in force in that state, under the provisions of this chapter, if the insurance commissioner of the state of domicile of the foreign insurer fails to require the foreign insurer to file an RBC plan in the manner specified under that state's RBC statute, or, if no RBC statute is in force in that state, under RSA 404-F:3, the commissioner may require the foreign insurer to file an RBC plan with the commissioner. In such event, the failure of the foreign insurer to file an RBC plan with the commissioner shall be grounds to order the insurer to cease and desist from writing new insurance business in this state.

III. In the event of a mandatory control level event with respect to any foreign insurer, if no domiciliary receiver has been appointed with respect to the foreign insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign insurer, the commissioner may make application to the superior court permitted under RSA 402-C with respect to the liquidation of property of foreign insurers found in this state, and the occurrence of the mandatory control level event shall be considered adequate grounds for the application.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:11 Immunity. 

There shall be no liability on the part of, and no cause of action shall arise against, the commissioner or the insurance department or its employees or agents for any action taken by them in the performance of their powers and duties under this chapter.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:12 Severability Clause. 

If any provision of this chapter, or the application thereof to any person or circumstance, is held invalid, such determination shall not affect the provisions or applications of this chapter which can be given effect without the invalid provision or application, and to that end the provisions of this chapter are severable.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:13 Notices. 

All notices by the commissioner to an insurer which may result in regulatory action hereunder shall be effective upon dispatch if transmitted by registered or certified mail, or in the case of any other transmission shall be effective upon the insurer's receipt of such notice.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:14 Phase-in Provision. 

I. For RBC reports required to be filed by life insurers with respect to 1993, the following requirements shall apply in lieu of the provisions of RSA 404-F:3, 4, 5, and 6:

(a) In the event of a company action level event with respect to a domestic insurer, the commissioner shall take no regulatory action hereunder.

(b) In the event of a regulatory action level event under RSA 404-F:4, I(a), (b), or (c) the commissioner shall take the actions required under RSA 404-F:3.

(c) In the event of a regulatory action level event under RSA 404-F:4, I(d), (e), (f), (g), (h), or (i) or an authorized control level event, the commissioner shall take the actions required under RSA 404-F:4 with respect to the insurer.

(d) In the event of a mandatory control level event with respect to an insurer, the commissioner shall take the actions required under RSA 404-F:5 with respect to the insurer.

II. For RBC reports required to be filed by property and casualty insurers with respect to 1994, the following requirements shall apply in lieu of the provision of RSA 404-F:3, 4, 5, and 6:

(a) In the event of a company action level event with respect to a domestic insurer, the commissioner shall take no regulatory action hereunder.

(b) In the event of a regulatory action level event under RSA 404-F:4, I(a), (b), or (c) the commissioner shall take the actions required under RSA 404-F:3.

(c) In the event of a regulatory action level event under RSA 404-F:4, I(d), (e), (f), (g), (h), or (i) or an authorized control level event, the commissioner shall take the actions required under RSA 404-F:4 with respect to the insurer.

(d) In the event of a mandatory control level event with respect to an insurer, the commissioner shall take the actions required under RSA 404-F:5 with respect to the insurer.

III. For RBC reports required to be filed by health organizations with respect to 1999, the following requirements shall apply in lieu of the provisions of RSA 404-F:3, 4, 5, and 6:

(a) In the event of a company action level event with respect to a health organization, the commissioner shall take no regulatory action hereunder.

(b) In the event of a regulatory action level event under RSA 404-F:4, I, (a), (b), or (c) the commissioner shall take the actions required under RSA 404-F:3.

(c) In the event of a regulatory action level event under RSA 404-F:4, I, (d), (e), (f), (g), (h), or (i) or an authorized control level event, the commissioner shall take the actions required under RSA 404-F:4 with respect to the health organization.

(d) In the event of a mandatory control level event with respect to an insurer, the commissioner shall take the actions required under RSA 404-F:5 with respect to the health organization.


Source. 1995, 113:1. 2000, 207:5, eff. July 29, 2000.

    404-F:2 RBC Reports. 

I. Every domestic insurer shall, on or prior to each March 1 (the "filing date"), prepare and submit to the commissioner a report of its RBC levels as of the end of the calendar year just ended, in a form and containing such information as is required by the RBC instructions. In addition, every domestic insurer shall file its RBC report:

(a) With the NAIC in accordance with the RBC instructions; and

(b) With the insurance commissioner in any state in which the insurer is authorized to do business, if the insurance commissioner has notified the insurer of its request in writing, in which case the insurer shall file its RBC report not later than the later of:

(1) Fifteen days from the receipt of notice to file its RBC report with that state; or

(2) The filing date.

II. A life and/or health insurer's RBC shall be determined in accordance with the formula set forth in the RBC instructions. The formula shall take into account, and may adjust for the covariance between:

(a) The risk with respect to the insurer's assets;

(b) The risk of adverse insurance experience with respect to the insurer's liabilities and obligations;

(c) The interest rate risk with respect to the insurer's business; and

(d) All other business risks and such other relevant risks as are set forth in the RBC instructions.

III. A property and casualty insurer's RBC shall be determined in accordance with the formula set forth in the RBC instructions. The formula shall take into account, and may adjust for the covariance between:

(a) Asset risk;

(b) Credit risk;

(c) Underwriting risk; and

(d) All other business risks and such other relevant risks as are set forth in the RBC instructions;

determined in each case by applying the factors in the manner set forth in the RBC instructions.

III-a. A health organization's RBC shall be determined in accordance with the formula set forth in the RBC instructions. The formula shall take into account, and may adjust for the covariance between:

(a) Asset risk;

(b) Credit risk;

(c) Underwriting risk; and

(d) All other business risks and such other relevant risks as are set forth in the RBC instructions.

IV. An excess of capital over the amount produced by the risk-based capital requirement contained in this chapter and the formulas, schedules, and instructions referenced in this chapter is desirable in the business of insurance. Accordingly, insurers should seek to maintain capital above the RBC levels required by this chapter. Additional capital is used and useful in the insurance business and helps to secure an insurer against various risks inherent in, or affecting, the business of insurance and not accounted for or only partially measured by the risk-based capital requirements contained in this chapter.

V. If a domestic insurer files an RBC report which in the judgment of the commissioner is inaccurate, then the commissioner shall adjust the RBC report to correct the inaccuracy and shall notify the insurer of the adjustment. The notice shall contain a statement of the reason for the adjustment. An RBC report as so adjusted is referred to as an "adjusted RBC report."


Source. 1995, 113:1. 2000, 207:3, eff. July 29, 2000. 2018, 177:2, eff. Aug. 7, 2018.

    404-F:3 Company Action Level Event. 

I. "Company action level event" means any of the following events:

(a) The filing of an RBC report by an insurer which indicates that:

(1) The insurer's total adjusted capital is greater than or equal to its regulatory action level RBC but less than its company action level RBC;

(2) If a life and/or health insurer, the insurer has total adjusted capital which is greater than or equal to its company action level RBC but less than the product of its authorized control level RBC and 3.0 and has a negative trend; or

(3) If a property and casualty insurer or health organization, the insurer has total adjusted capital which is greater than or equal to its company action level RBC but less than the product of its authorized control level RBC and 3.0 and triggers the trend test determined in accordance with the trend test calculation included in the property and casualty RBC instructions;

(b) The notification by the commissioner to the insurer of an adjusted RBC report that indicates an event in subparagraph (a), provided the insurer does not challenge the adjusted RBC report under RSA 404-F:7; or

(c) If, pursuant to RSA 404-F:7, an insurer challenges an adjusted RBC report that indicates the event in subparagraph (a), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.

II. In the event of a company action level event, the insurer shall prepare and submit to the commissioner an RBC plan which shall:

(a) Identify the conditions which contribute to the company action level event;

(b) Contain proposals of corrective actions which the insurer intends to take and would be expected to result in the elimination of the company action level event;

(c) Provide projections of the insurer's financial results in the current year and at least the 4 succeeding years, both in the absence of proposed corrective actions and giving effect to the proposed corrective actions, including projections of statutory operating income, net income, capital and/or surplus. The projections for both new and renewal business might include separate projections for each major line of business and separately identify each significant income, expense and benefit component;

(d) Identify the key assumptions impacting the insurer's projections and the sensitivity of the projections to the assumptions; and

(e) Identify the quality of, and problems associated with, the insurer's business, including but not limited to its assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance, if any, in each case.

III. The RBC plan shall be submitted:

(a) Within 45 days of the company action level event; or

(b) If the insurer challenges an adjusted RBC report pursuant to RSA 404-F:7, within 45 days after notification to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.

IV. Within 60 days after the submission by an insurer of an RBC plan to the commissioner, the commissioner shall notify the insurer whether the RBC plan shall be implemented or is, in the judgment of the commissioner, unsatisfactory. If the commissioner determines the RBC plan is unsatisfactory, the notification to the insurer shall set forth the reasons for the determination, and may set forth proposed revisions which will render the RBC plan satisfactory, in the judgment of the commissioner. Upon notification from the commissioner, the insurer shall prepare a revised RBC plan, which may incorporate by reference any revisions proposed by the commissioner, and shall submit the revised RBC plan to the commissioner:

(a) Within 45 days after the notification from the commissioner; or

(b) If the insurer challenges the notification from the commissioner under RSA 404-F:7, within 45 days after a notification to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.

V. In the event of a notification by the commissioner to an insurer that the insurer's RBC plan or revised RBC plan is unsatisfactory, the commissioner may at the commissioner's discretion, subject to the insurer's right to a hearing under RSA 404-F:7, specify in the notification that the notification constitutes a regulatory action level event.

VI. Every domestic insurer that files an RBC plan or revised RBC plan with the commissioner shall file a copy of the RBC plan or revised RBC plan with the insurance commissioner in any state in which the insurer is authorized to do business if:

(a) Such state has an RBC provision substantially similar to RSA 404-F:8, I; and

(b) The insurance commissioner of that state has notified the insurer of its request for the filing in writing, in which case the insurer shall file a copy of the RBC plan or revised RBC plan in that state no later than the later of:

(1) Fifteen days after the receipt of notice to file a copy of its RBC plan or revised RBC plan with the state; or

(2) The date on which the RBC plan or revised RBC plan is filed under RSA 404-F:3, III and IV.


Source. 1995, 113:1. 2013, 110:1. 2016, 113:1, eff. July 19, 2016. 2019, 183:4, eff. Sept. 8, 2019.

    404-F:4 Regulatory Action Level Event. 

I. "Regulatory action level event" means, with respect to any insurer, any of the following events:

(a) The filing of an RBC report by the insurer which indicates that the insurer's total adjusted capital is greater than or equal to its authorized control level RBC but less than its regulatory action level RBC;

(b) The notification by the commissioner to an insurer of an adjusted RBC report that indicates the event in subparagraph (a), provided the insurer does not challenge the adjusted RBC report under RSA 404-F:7;

(c) If, pursuant to RSA 404-F:7, the insurer challenges an adjusted RBC report that indicates the event in subparagraph (a), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge;

(d) The failure of the insurer to file an RBC report by the filing date, unless the insurer has provided an explanation for such failure which is satisfactory to the commissioner and has cured the failure within 10 days after the filing date;

(e) The failure of the insurer to submit an RBC plan to the commissioner within the time period set forth in RSA 404-F:3, III;

(f) Notification by the commissioner to the insurer that:

(1) The RBC plan or revised RBC plan submitted by the insurer is, in the judgment of the commissioner, unsatisfactory; and

(2) Such notification constitutes a regulatory action level event with respect to the insurer, provided the insurer has not challenged the determination under RSA 404-F:7;

(g) If, pursuant to RSA 404-F:7 the insurer challenges a determination by the commissioner under subparagraph (f), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected such challenge;

(h) Notification by the commissioner to the insurer that the insurer has failed to adhere to its RBC plan or revised RBC plan, but only if such failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event in accordance with its RBC plan or revised RBC plan and the commissioner has so stated in the notification, provided the insurer has not challenged the determination under RSA 404-F:7; or

(i) If, pursuant to RSA 404-F:7 the insurer challenges a determination by the commissioner under subparagraph (h), the notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the challenge.

II. In the event of a regulatory action level event the commissioner shall:

(a) Require the insurer to prepare and submit an RBC plan or, if applicable, a revised RBC plan;

(b) Perform such examination or analysis as the commissioner deems necessary of the assets, liabilities, and operations of the insurer including a review of its RBC plan or revised RBC plan; and

(c) Subsequent to the examination or analysis, issue an order specifying such corrective actions as the commissioner shall determine are required (a "corrective order").

III. In determining corrective actions, the commissioner may take into account such factors as are deemed relevant with respect to the insurer based upon the commissioner's examination or analysis of the assets, liabilities, and operations of the insurer, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the RBC instructions. The RBC plan or revised RBC plan shall be submitted:

(a) Within 45 days after the occurrence of the regulatory action level event;

(b) If the insurer challenges an adjusted RBC report pursuant to RSA 404-F:7 and the challenge is not frivolous in the judgment of the commissioner, within 45 days after the notification to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge; or

(c) If the insurer challenges a revised RBC plan pursuant to RSA 404-F:7 and the challenge is not frivolous in the judgment of the commissioner, within 45 days after the notification to the insurer that the commissioner has, after a hearing rejected the insurer's challenge.

IV. The commissioner may retain actuaries and investment experts and other consultants as may be necessary in the judgment of the commissioner to review the insurer's RBC plan or revised RBC plan, examine or analyze the assets, liabilities, and operations of the insurer and formulate the corrective order with respect to the insurer. The fees, costs, and expenses relating to consultants shall be borne by the affected insurer or such other party as directed by the commissioner.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:5 Authorized Control Level Event. 

I. "Authorized control level event" means any of the following events:

(a) The filing of an RBC report by the insurer which indicates that the insurer's total adjusted capital is greater than or equal to its mandatory control level RBC but less than its authorized control level RBC;

(b) The notification by the commissioner to the insurer of an adjusted RBC report that indicates the event in subparagraph (a), provided the insurer does not challenge the adjusted RBC report under RSA 404-F:7;

(c) If, pursuant to RSA 404-F:7, the insurer challenges an adjusted RBC report that indicates the event in subparagraph (a), notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge;

(d) The failure of the insurer to respond, in a manner satisfactory to the commissioner, to a corrective order, provided the insurer has not challenged the corrective order under RSA 404-F:7; or

(e) If the insurer has challenged a corrective order under RSA 404-F:7 and the commissioner has, after a hearing, rejected the challenge or modified the corrective order, the failure of the insurer to respond, in a manner satisfactory to the commissioner, to the corrective order subsequent to rejection or modification by the commissioner.

II. In the event of an authorized control level event with respect to an insurer, the commissioner shall:

(a) Take such actions as are required under RSA 404-F:4 regarding an insurer with respect to which a regulatory action level event has occurred; or

(b) If the commissioner deems it to be in the best interests of the policyholders and creditors of the insurer and of the public, take such actions as are necessary to cause the insurer to be placed under regulatory control under RSA 402-C. In the event the commissioner takes such actions, the authorized control level event shall be deemed sufficient grounds for the commissioner to take action under RSA 402-C, and the commissioner shall have the rights, powers, and duties with respect to the insurer as are set forth in RSA 402-C. In the event the commissioner takes actions under this paragraph pursuant to an adjusted RBC report, the insurer shall be entitled to such protections as are afforded to insurers under the provisions of RSA 402-C:11-14 pertaining to summary proceedings.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:6 Mandatory Control Level Event. 

I. "Mandatory control level event" means any of the following events:

(a) The filing of an RBC report which indicates that the insurer's total adjusted capital is less than its mandatory control level RBC;

(b) Notification by the commissioner to the insurer of an adjusted RBC report that indicates the event in subparagraph (a), provided the insurer does not challenge the adjusted RBC report under RSA 404-F:7; or

(c) If, pursuant to RSA 404-F:7, the insurer challenges an adjusted RBC report that indicates the event in subparagraph (a), notification by the commissioner to the insurer that the commissioner has, after a hearing, rejected the insurer's challenge.

II. In the event of a mandatory control level event:

(a) With respect to a life and/or health insurer or health organization, the commissioner shall take such actions as are necessary to place the insurer under regulatory control under RSA 402-C. In that event, the mandatory control level event shall be deemed sufficient grounds for the commissioner to take action under RSA 402-C, and the commissioner shall have the rights, powers, and duties with respect to the insurer as are set forth in RSA 402-C. If the commissioner takes actions pursuant to an adjusted RBC report, the insurer shall be entitled to the protections of RSA 402-C:11-14 pertaining to summary proceedings. Notwithstanding any of the foregoing, the commissioner may forego action for up to 90 days after the mandatory control level event if the commissioner finds there is a reasonable expectation that the mandatory control level event may be eliminated within the 90-day period.

(b) With respect to a property and casualty insurer, the commissioner shall take such actions as are necessary to place the insurer under regulatory control under RSA 402-C, or, in the case of an insurer which is writing no business and which is running-off its existing business, may allow the insurer to continue its runoff under the supervision of the commissioner. In either event, the mandatory control level event shall be deemed sufficient grounds for the commissioner to take action under RSA 402-C and the commissioner shall have the rights, powers, and duties with respect to the insurer as are set forth in RSA 402-C. If the commissioner takes actions pursuant to an adjusted RBC report, the insurer shall be entitled to the protections of RSA 402-C:11-14 pertaining to summary proceedings. Notwithstanding any of the foregoing, the commissioner may forego action for up to 90 days after the mandatory control level event if the commissioner finds there is a reasonable expectation that the mandatory control level event may be eliminated within the 90-day period.


Source. 1995, 113:1. 2000, 207:4, eff. July 29, 2000. 2019, 183:5, eff. Sept. 8, 2019.

    404-F:7 Hearings. 

Upon:

I. Notification to an insurer by the commissioner of an adjusted RBC report; or

II. Notification to an insurer by the commissioner that:

(a) The insurer's RBC plan or revised RBC plan is unsatisfactory; and

(b) Such notification constitutes a regulatory action level event with respect to such insurer; or

III. Notification to any insurer by the commissioner that the insurer has failed to adhere to its RBC plan or revised RBC plan and that such failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event with respect to the insurer in accordance with its RBC plan or revised RBC plan; or

IV. Notification to an insurer by the commissioner of a corrective order with respect to the insurer,

the insurer shall have the right to a confidential departmental hearing, on the record, at which the insurer may challenge any determination or action by the commissioner. The insurer shall notify the commissioner of its request for a hearing within 5 days after the notification by the commissioner under paragraph I, II, III, or IV. Upon receipt of the insurer's request for a hearing, the commissioner shall set a date for the hearing, which date shall be no less than 10 nor more than 30 days after the date of the insurer's request.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:8 Confidentiality;  Prohibition on Announcements;  Prohibition on Use in Ratemaking. 

I. All RBC reports, to the extent the information therein is not required to be set forth in a publicly available annual statement schedule, and RBC plans, including the results or report of any examination or analysis of an insurer performed pursuant hereto and any corrective order issued by the commissioner pursuant to examination or analysis, with respect to any domestic insurer or foreign insurer which are filed with the commissioner constitute information that might be damaging to the insurer if made available to its competitors, and therefore shall be kept confidential by the commissioner. This information shall not be made public or be subject to subpoena, other than by the commissioner and then only for the purpose of enforcement actions taken by the commissioner pursuant to this chapter or any other provision of the insurance laws of this state.

II. It is the judgment of the legislature that the comparison of an insurer's total adjusted capital to any of its RBC levels is a regulatory tool which may indicate the need for possible corrective action with respect to the insurer, and is not intended as a means to rank insurers generally. Therefore, except as otherwise required under the provisions of this chapter, the making, publishing, disseminating, circulating, or placing before the public, or causing, directly or indirectly to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio or television station, or in any other way, an advertisement, announcement, or statement containing an assertion, representation, or statement with regard to the RBC levels of any insurer, or of any component derived in the calculation, by any insurer, agent, broker, or other person engaged in any manner in the insurance business would be misleading and is therefore prohibited; provided, however, that if any materially false statement with respect to the comparison regarding an insurer's total adjusted capital to its RBC levels, or any of them, or an inappropriate comparison of any other amount to the insurer's RBC levels is published in any written publication and the insurer is able to demonstrate to the commissioner with substantial proof the falsity of such statement, or the inappropriateness, as the case may be, then the insurer may publish an announcement in a written publication if the sole purpose of the announcement is to rebut the materially false statement.

III. It is the further judgment of the legislature that the RBC instructions, RBC reports, adjusted RBC reports, RBC plans and revised RBC plans are intended solely for use by the commissioner in monitoring the solvency of insurers and the need for possible corrective action with respect to insurers and shall not be used by the commissioner for ratemaking nor considered or introduced as evidence in any rate proceeding nor used by the commissioner to calculate or derive any elements of an appropriate premium level or rate of return for any line of insurance which an insurer or any affiliate is authorized to write.


Source. 1995, 113:1, eff. July 15, 1995.

    404-F:9 Supplemental Provisions;  Rules;  Exemption. 

I. The provisions of this chapter are supplemental to any other provisions of the laws of this state, and shall not preclude or limit any other powers or duties of the commissioner under such laws, including, but not limited to, RSA 402-C.

II. The commissioner may adopt reasonable rules, under RSA 541-A, necessary for the implementation of this chapter.

III. The commissioner may exempt from the application of this chapter any domestic property and casualty insurer which:

(a) Writes direct business only in this state;

(b) Writes direct annual premium of $2,000,000 or less; and

(c) Assumes no reinsurance in excess of 5 percent of direct premium written.


Source. 1995, 113:1, eff. July 15, 1995.

    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 on premiums and carrier profitability, carriers entering or exiting the market, products being sold, basis for high risk pool eligibility, and overall denial rate. The study shall be completed within 6 months of the availability of data on the first 2 years of operation of the high risk pool. Upon completion of the study, the commissioner shall make an initial report relative to the findings of the study to the governor, the president of the senate and the speaker of the house of representatives and shall make biannual reports to such persons thereafter.


Source. 2001, 295:15, eff. July 1, 2001.

    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 high risk individuals.

II. Create a nonprofit, voluntary organization to facilitate the availability of affordable individual nongroup health insurance by establishing an assessment mechanism and an individual health insurance market mandatory risk sharing plan as a mechanism to distribute the risks associated within the individual nongroup market and to support the New Hampshire granite advantage health care program established in RSA 126-AA.

III. Establish a high risk pool that will provide access to health insurance to all residents of the state who are denied health insurance for medical or health reasons. The premiums charged for coverage in the high risk pool shall be affordable and the coverage provided shall be reasonably comprehensive and comparable to coverage available outside of the high risk pool. It is the intent of the legislature that the high risk pool shall be adequately funded through an annual, and if necessary, a special assessment mechanism, that the high risk pool shall utilize cost containment measures, including, but not limited to, providing network based coverage, and that measures shall be taken to avoid inappropriate shifting of costs and risk to the high risk pool.

IV. Authorize the association to establish a federally qualified high risk pool pursuant to section 1101 of the Patient Protection and Affordable Care Act of 2009 (PL 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (PL 111-152).


Source. 1998, 340:6. 2001, 295:4. 2010, 243:2. 2016, 13:7, eff. Apr. 5, 2016. 2018, 342:15, eff. Dec. 31, 2018.

    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 severable.


Source. 1998, 340:6, eff. Aug. 25, 1998.

    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 described in RSA 404-G:5 shall cease. The final subsidies shall be determined based on calendar year 2013 experience and paid to eligible carriers in 2014.

II. The risk adjustment and subsidization established by the commissioner through Ins 1908 with respect to individual health policies to children under age 19 shall cease. The final subsidies shall be determined based on calendar year 2013 experience and disbursed in accordance with the association's disbursement plan as approved by the commissioner.

III. The high risk pool under RSA 404-G:5-b shall cease in accordance with the following:

(a) Health care coverage provided by the pool shall cease at the close of business on December 31, 2013;

(b) On or before November 1, 2013, the association, through the high risk pool administrator, shall notify all individuals currently enrolled in the pool of the year-end termination of coverage;

(c) The association may renew coverage for existing enrollees or enroll new individuals in the high risk pool until December 1, 2013; provided, that at the time of renewal or application, such enrollees are given notice that pool coverage will terminate on December 31, 2013;

(d) Insurance laws and regulations providing for guaranteed renewal and guaranteed premiums for a period of 12-months, and any similar insurance laws or regulations, shall not apply to the high risk pool to the extent that they are inconsistent with this section;

(e) No individual shall be eligible for coverage through the high risk pool on or after January 1, 2014; and

(f) The association may extend the contract of the existing high risk pool administrator without a competitive bidding process through the period of time required to wind down the operations of the high risk pool.

IV. Coverage under the federally qualified high risk pool described in RSA 404-G:5-g shall cease as of the close of business on December 31, 2013, and the pool shall dissolve in accordance with the Act and as directed by, and under the contract of the association with, the Secretary of the United States Department of Health and Human Services.

V. The board of directors of the association shall prepare and submit to the commissioner for approval within 60 days of the effective date of this section, a plan of termination which shall be an amendment to the plans of operation described in RSA 404-G:5 and RSA 404-G:5-a. The plan of termination shall provide for such administrative measures as are necessary or desirable to terminate the risk sharing subsidy mechanism, under 19 subsidy mechanism, high risk pool and federally qualified high risk pool, and such provisions shall not be inconsistent with this section.

VI. Following the cessation of coverage on December 31, 2013, the association shall take such actions as are necessary and desirable to wind down its affairs under this chapter in accordance with the plan of termination. The association shall retain all of its powers and duties, including, but not limited to, its power to establish and collect regular and special assessments under RSA 404-G:5 and RSA 404-G:5-a, and the immunity provided by RSA 404-G:9 and the bylaws of the association. Any excess funds remaining after the satisfaction of all of the association's liabilities shall be used for the program and for the association's reasonable costs for collecting its share of the remainder amount.

VI-a. No later than October 1, 2016, the board of directors shall prepare and submit to the commissioner and the commissioner of health and human services for approval an amendment to the plan of termination that provides for the continuation of the association for the limited purpose of compliance with the provisions of RSA 404-G:5-a, IV(d).

VII. When the association has completed the winding down of its affairs under this chapter and satisfied in full all of its liabilities, then it shall submit to the commissioner for approval a plan of dissolution. Upon approval of the plan of dissolution, the association shall file a certificate of dissolution with the secretary of state, whereupon the association shall cease to exist.


Source. 2013, 200:1. 2016, 13:11, eff. Apr. 5, 2016.

    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 proposal may include resumption of a risk sharing program similar to that referenced in RSA 404-G:5, creation and operation of a reinsurance program, or such other program as the board finds will best support the availability and affordability of health insurance in the state and may also include the development of a waiver application under the Act. The commissioner shall approve the revised plan of operations if the commissioner finds that the plan will further the purpose of this chapter as stated in RSA 404-G:1, I, and is otherwise consistent with New Hampshire and federal law.

II. The board's proposal may include a recommendation that the state apply for a waiver under the Act, or any successor to the Act. If the approved plan includes an application for a waiver, the commissioner and the board shall proceed in accordance with RSA 420-N:6-a. If the waiver is approved by the federal government, the board shall prepare a revised plan of operations consistent with the terms of the waiver, and shall implement it upon approval by the commissioner.


Source. 2013, 200:2. 2017, 221:4, eff. July 10, 2017. 2019, 346:420, eff. July 1, 2019.

    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 Education Reconciliation Act of 2010 (PL 111-152).

II. "Assessment" means the liability of the member insurer to the association.

III. "Association" means the entity created within this chapter which shall be the same association as that created under the order, defined in paragraph X.

IV. "Commissioner" means the insurance commissioner.

V. "Covered lives" shall include all persons who are:

(a) Covered under an individual health insurance policy issued or delivered in New Hampshire;

(b) Covered under a group health insurance policy that is issued or delivered in New Hampshire;

(c) Covered under a group health insurance policy evidenced by a certificate of insurance that is issued or delivered in New Hampshire;

(d) Protected, in part, by a group excess loss insurance policy where the policy or certificate of coverage has been issued or delivered in New Hampshire.

V-a. "
Group excess loss insurance
" means coverage purchased by an employer against the risk that any one claim made against the employer's health plan will exceed a specified dollar amount or coverage purchased by an employer against the risk that the employer's total liability for the health plan will exceed a specified amount.

VI. "Group health insurance" means health insurance coverage other than individual health insurance coverage.

VII. "
Health insurance
" means health insurance coverage issued in accordance with RSA 415, 420-A, or 420-B. For the purposes of this chapter, health insurance shall not include accident only, credit, dental, vision, Medicare supplement, Medicare Risk, Medicare+Choice, Managed Medicaid, long-term care, disability income, coverage issued as a supplement to a liability insurance, workers' compensation or similar insurance, automobile medical payment insurance, policies or certificates of specified disease, hospital confinement indemnity, limited benefit health insurance, and coverage provided through the Federal Employees' Program. Health insurance does include group excess loss insurance.

VIII. "Individual health insurance" means health insurance sold directly to an individual and not on a group remittance basis. Individual health insurance shall include franchise health insurance.

IX. "Insurer" means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B.

X. "Order" means the insurance department findings and final order dated November 26, 1997, in the matter of the individual health insurance market in New Hampshire pursuant to RSA 404-C.

X-a. "
Plan of operation
" means the plan of operation of the risk sharing mechanism, the high risk pool, support for the program established in RSA 126-AA, and the federally qualified high risk pool, including articles, bylaws and operating rules, procedures and policies adopted by the association.

X-b. "
Pool
" means the New Hampshire health insurance high risk pool.

X-c. [Repealed.]

XI. "Writer" means a writing carrier.


Source. 1998, 340:6. 2001, 295:5, 6. 2003, 276:1, 2. 2008, 375:3, 4. 2010, 243:3, 4. 2016, 13:8, 9, eff. Apr. 5, 2016. 2018, 342:16, 24, I, eff. Dec. 31, 2018. 2020, 37:8, eff. July 29, 2020.

    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 have the following powers:

(a) Enter into contracts as necessary or proper to administer the plan of operation.

(b) Sue or be sued, including taking any legal action necessary or proper for the recovery of any assessments for, on behalf of, or against members of the association or other participating person.

(c) Take legal action as necessary to avoid the payment of improper claims against the plan or to defend the coverage provided by or through the pool.

(d) Oversee the issuance of policies of insurance and certificates or evidences of coverage.

(e) Retain appropriate legal, actuarial, and other persons as necessary to provide technical assistance in the operation of the plan, policy development, and other contract design and in any other function within the authority of the plan.

(f) Borrow money to carry out the plan of operation.

(g) Provide for reinsurance of risks incurred.

(h) Perform any other functions within the authority of the association as may be necessary or proper to carry out the plan of operation.

(i) Perform additional powers as set forth in RSA 404-G:5-g.

III. The board of directors of the association shall have the following duties:

(a) Fulfill the plan of operation as approved by the commissioner.

(b) Issue policies of insurance to persons eligible for the high risk pool.

(c) Prepare certificate of eligibility forms and enrollment instruction forms.

(d) Determine and collect assessments for the risk sharing mechanism and for the high risk pool.

(e) Disburse assessment payments, as provided in the plan of operation for the high risk pool.

(f) Establish appropriate rates, rate schedules, rate adjustments, expense allowances, agent referral fees, claim reserve formulas and any other actuarial functions appropriate to the plan of operation for the high risk pool.

(g) Provide for and employ cost-containment measures and requirements, which shall include but not be limited to, preadmission screening, second surgical opinion, concurrent utilization review, and individual case management for the purpose of making the benefit plan more cost effective.

(h) Develop a list of medical or health conditions the existence or history of which makes an individual eligible for participation in the high risk pool without first requiring application to a carrier for health coverage.

(i) In connection with the managed care or network based coverage options required pursuant to RSA 404-G:5-b, III, design, utilize, contract or otherwise arrange for the delivery of cost-effective health care services, including establishing or contracting for administration and operation of the pool with a carrier, a preferred provider organization, a health maintenance organization, or any other network provider arrangement.

IV. Neither the association nor its employees shall be liable for any obligations of the plan. No member or employee of the association shall be liable, and no cause of action of any nature may arise against them, for any act or omission related to the performance of their powers and duties under this chapter unless such act or omission constitutes willful or wanton misconduct. The association may provide in its bylaws or rules for indemnification of, and legal representation for, its members and employees.


Source. 1998, 340:6. 2001, 295:7. 2010, 243:5, eff. July 1, 2010.

    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 such other related information as the commissioner may require.


Source. 2008, 375:5, eff. July 1, 2008.

    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 representative of categories of members of the association, health care providers, consumers who have purchased or are likely to purchase coverage from the pool,
 insurance brokers, small employers, and the commissioner who shall be an ex-officio member. In the initial and in each successor board, 3 directors shall be representative of and elected by qualified writers of group health insurance, 2 directors shall be representative of and elected by qualified writers of individual health insurance,
 one director shall be representative of the health care provider community and shall be appointed by the commissioner, one director shall be representative of consumers covered through the high risk pool and shall be appointed by the commissioner, one director shall be a representative of insurance brokers and shall be appointed by the commissioner, and one director shall be a representative of small employers and shall be appointed by the commissioner.

III. There shall be no more than one director representing any one qualified writer or its affiliate. For purposes of this section, the insurance activities of any elected director's affiliate shall be deemed to be insurance activities of the elected director.

IV. Qualified writers of individual or group health insurance shall be those that provide coverage for at least 500 covered lives or 5 percent of the total covered lives in the relevant market. A member's votes for individual or group market representatives shall be proportional to the member's assessment in that market.

V. If, at any board election subsequent to the establishment of the initial board, one or more elected group representatives are also qualified individual health insurance writers, then the membership of the board shall be altered by applying the provisions in subparagraphs (a) through (d) to such elected group representatives.

(a) If the elected group representative writing in the individual market is also an elected individual representative, then that member shall take a seat on the board as an individual representative and relinquish the group seat. The group writer with the next highest number of group votes shall take the relinquished group seat.

(b) If the elected group representative writing in the individual market is not also an elected individual representative, then up to 2 directors will be added to the board as follows:

(1) If the total size of the board-elect is 9 or 10, the elected group representative shall remain on the board, but neither as a group or an individual representative, and the group writer with the next highest number of group votes shall join the board as a group representative; but

(2) If the total size of the board-elect is 11, the elected group representative shall not remain on the board and the group writer with the next highest number of group votes shall take the relinquished group seat.

(c) The provisions in subparagraphs (a) and (b) shall be applied to elected group representatives in the order of the number of votes received.

(d) The seats added to the board pursuant to subparagraph (b) shall not survive the term of the seat-holder.

VI. Members of the board of directors shall be elected to terms of one year.

VII. The board of directors shall take action by affirmative vote representing a simple majority of the entire board.

VIII. The board shall elect officers in accordance with the bylaws of the association. The bylaws of the association shall also govern the place and frequency of meetings of directors and their reimbursement for expenses incurred.


Source. 1998, 340:6. 2001, 295:8, July 1, 2001.

    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 expenses and losses of the pool not covered by premiums.

II. The plan of operation for the high risk pool shall establish:

(a) Procedures for handling and accounting for the assets and moneys of the plan;

(b) Procedures for selecting and retaining a pool administrator;

(c) Procedures to establish and maintain public awareness of the plan, including its eligibility requirements and enrollment procedures;

(d) Procedures to create a fund, under management of the board, for administrative expenses;

(e) Procedures for handling, accounting and auditing of assets, moneys and claims of the pool;

(f) Requirements for keeping financial and other records;

(g) Regular times and places for meetings of the board; and

(h) Procedures by which applicants and participants can submit utilization review determinations and grievances to the pool administrator. The procedures shall ensure that utilization review determinations and grievances will be processed properly and in accordance with all statutory and regulatory requirements.

III. The assessment for the high risk pool shall be based on the number of covered lives times a specified assessment rate. The association shall specify the basis used to set the assessment rate.

IV. The association shall establish a regular assessment rate which shall be:

(a) Calculated on a calendar year basis;

(b) Established no later than November 1 in the year preceding the calendar year for which the carrier's experience shall be used to calculate the assessment;

(c) Anticipated to be sufficient to meet the high risk pool's funding needs and the association's share of the costs of the program, as defined in subparagraph (d); and

(d) An amount not to exceed the lesser of the remainder amount, as defined in RSA 126-AA:1, V, or the amount of revenue transferred from the alcohol abuse prevention and treatment fund pursuant to RSA 176-A:1, IV and taxes attributable to premiums written for medical and other medical-related services for the newly eligible Medicaid population. The association shall transfer all amounts collected pursuant to this subparagraph to the New Hampshire granite advantage health care trust fund established pursuant to RSA 126-AA:3.

V. In addition to the regular assessment rate, the association may establish a special assessment rate. Notwithstanding RSA 420-G:4, a writer of health insurance may increase the premiums charged by the amount of the special assessment. Any assessment may appear as a separate line item on a policyholder's bill.

(a) The association shall only establish a special assessment if the association determines that its funds are or will become insufficient to pay the high risk pool's expenses in a timely manner.

(b) The association shall only assess, through the special assessment, at a rate necessary to fund the deficiency ascertained in subparagraph (1) above.

VI. The regular assessment rate, and any special assessment rate, shall be subject to the approval of the commissioner. The commissioner shall approve the rate if she or he finds that the amount is required to fulfill the purposes of the high risk pool. For the purpose of making this determination, the commissioner may, at the expense of the association, seek independent actuarial certification of the need for the proposed rate.

VII. The association shall impose and collect assessments from its members.

VIII. If the assessment exceeds the amount actually needed, the excess shall be held and invested and, with the earnings and interest thereon, be used to offset future net losses.

IX. Each covered life should be included in the assessment only once. The association shall adopt procedures by which affiliated carriers calculate their assessment on an aggregate basis and procedures to ensure that no covered life is counted more than once.

X. The initial assessment rate to fund the high risk pool shall be 60 cents per covered life per month, and shall take effect on policies or certificates issued or renewed on or after July 1, 2001.


Source. 2001, 295:10. 2016, 13:10, eff. Apr. 5, 2016. 2018, 342:11, eff. Dec. 31, 2018.

    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 of which shall be either managed care or network based plans.

II. The plans to be issued by the pool, including schedules of benefits, exclusions and other limitations shall be established by the association subject to the approval of the commissioner. In establishing the plans, the association shall take into consideration the levels of health insurance coverage provided in the state and medical economic factors as may be deemed appropriate and shall promulgate benefit levels, deductibles, coinsurance factors, exclusions and limitations determined to be generally reflective of and commensurate with comprehensive, major medical health insurance coverage provided in the state. The association shall, utilizing standard morbidity assumptions, annually place a value on all plans presently being written or issued in the individual market. The association shall average these values, weighed according to each plan's written premium volume, or some other suitable proxy, and utilizing the same standard morbidity assumptions, shall develop 2 coverage options: Option A and Option B.

III. The value of Option A developed by the association shall be 10 percent higher than the average value computed under paragraph II and the value of Option B shall be 10 percent lower than the average value computed under paragraph II. The association shall also provide either a managed care or network based version of Option A and a managed care version of Option B for a total of 4 plan choices.

III-a. The association, subject to the approval of the commissioner, may from time to time offer such plans, in addition to the 4 plans required under paragraphs II and III, as its board of directors determines would be helpful to advance the purposes of this chapter.

IV. The insurance plans developed by the association shall comply with all applicable insurance laws and rules, except as provided herein.

V. (a) The pool shall be payer of last resort of benefits whenever any other benefit or source of third-party payment is available. The pool shall have a right of subrogation for any other health insurance coverage and by all hospital and medical expense benefits paid or payable under any workers' compensation coverage, automobile medical payment or liability insurance whether provided on the basis of fault or nonfault, and by any hospital or medical benefits paid or payables under or provided pursuant to any state or federal law or program.

(b) The pool shall have a cause of action against an eligible person for the recovery of the amount of benefits paid that are not for covered expenses. Benefits due from the plan may be reduced or applied as a set-off against any amount recoverable under this paragraph.

VI. The high risk pool shall be funded by premiums charged for coverage and by assessments which the association shall calculate based on the number of covered lives times a specified amount. The high risk pool shall not be funded with state general fund revenue. The high risk pool shall never cease writing policies to eligible individuals.


Source. 2001, 295:10. 2004, 187:11, eff. July 31, 2004.

    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 to individuals;

(b) The efficiency and timeliness of the high risk pool administrator's claim processing procedures;

(c) An estimate of total charges for administering the pool;

(d) The high risk pool administrator's ability to apply effective cost containment programs and procedures and to administer the pool in a cost efficient manner; and

(e) The financial condition and stability of the high risk pool administrator.

II. (a) The high risk pool administrator shall serve for a period of at least 3 years and shall be subject to removal for cause; and

(b) At least one year prior to the expiration of each period of service by a high risk pool administrator, the association shall invite eligible entities, including the current high risk pool administrator to submit bids to serve as the high risk pool administrator. Selection of the high risk pool administrator for the succeeding period shall be made at least 6 months prior to the end of the current period.

III. The high risk pool administrator shall perform such functions relating to the plan as may be as assigned to it, including:

(a) The determination of eligibility;

(b) The payment of claims and the development of procedures to ensure that each claim is promptly paid;

(c) The establishment of a premium billing procedure for collection of premium from persons covered under the pool;

(d) The acceptance of payments of premiums from insureds;

(e) The development of procedures to ensure that medical utilization reviews and grievance determinations are conducted in a fair and timely manner and in accordance with all statutory and regulatory requirements; and

(f) Other necessary functions to assure timely payment of benefits to covered persons under the pool.

IV. The high risk pool administrator shall submit regular reports to the association and the commissioner regarding the operation of the pool. The frequency, content and form of the report shall be specified in the contract between the association and the high risk pool administrator.

V. Following the close of each calendar year, the high risk pool administrator shall determine net written and earned premiums, the expense of administration, and the paid and incurred losses for the year and report this information to the association and the commissioner on a form prescribed by the commissioner.

VI. The high risk pool administrator shall be paid as provided in the contract between the association and the high risk pool administrator.

VII. The association shall submit the contract between itself and the high risk pool administrator to the commissioner for approval.

VIII. The association may select more than one administrator for the high risk pool.

IX. The association may use the same administrator for both the high risk pool and the federally qualified high risk pool. Notwithstanding the provisions of subparagraph II(b), the association may extend the term of the current contract with the existing high risk pool administrator without a competitive bidding process until January 1, 2014.


Source. 2001, 295:10. 2010, 243:6, eff. July 1, 2010.

    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 policies which are presently available in New Hampshire and adjusted for the difference in the actuarial value of the pool's plans relative to these available plans using the factors derived pursuant to RSA 404-G:5-a, II.

III. Premium rates for coverage under the plan may not be less than 125 percent and may not exceed 150 percent of the standard risk rate pursuant to paragraph II of this section. The association shall charge high risk pool enrollees a premium charge based on the average rate for the plan adjusted for the attained age of the high risk pool enrollee. The adjustment for attained age shall conform to the provisions of RSA 420-G.

IV. All premium rates and rate schedules shall be submitted to the commissioner for approval.


Source. 2001, 295:10, eff. July 1, 2001.

    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 refused to write or issue that coverage to that individual;

(b) 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 such application has been accepted, but at a premium rate exceeding the eligibility rate set by the association from time to time and submitted to the commissioner for approval with the premium rates, which eligibility rate shall not be less than 125 percent and shall not exceed 150 percent of the standard risk rate calculated pursuant to RSA 404-G:5-d, II;

(c) The individual has a history of any medical or health condition that is on a list adopted by the association;

(d) The individual is an "eligible individual" as defined in section 2741(b) of the Public Health Service Act;

(e) The individual has been certified as eligible for either federal trade adjustment assistance or for pension benefit guarantee corporation, as prescribed by the federal Trade Adjustment Assistance Reform Act of 2002 and the association, in accordance with procedures set forth in its plan of operation, is offering coverage in the high risk pool to such eligible persons at the time of the individual's application; or

(f) The individual has received an offer of coverage from a carrier of individual health insurance that contains a rider or endorsement excluding coverage for a specified condition pursuant to RSA 420-G:5, II.

II. The association shall promulgate a list of medical or health conditions for which a person shall be eligible for plan coverage without applying for health insurance coverage. Persons who can demonstrate the existence or history of any medical or health conditions on the list promulgated by the association shall not be required to provide evidence of a notice of rejection or refusal. The list shall be effective on the first day of the operation of the pool and may be amended from time to time as may be appropriate.

III. Each resident dependent of a person who is eligible for pool coverage shall also be eligible for pool coverage. If the primary insured is a child, resident family members shall also be eligible for pool coverage.

IV. New Hampshire residents who are insured through an individual policy shall be eligible for pool coverage only if the rate assessed by the individual carrier exceeds the pool rate.

V. An individual shall not be eligible for coverage under the pool if:

(a) The individual is eligible for employer sponsored health coverage, including continuation of group coverage, as either an employee or an eligible dependent; or

(b) The individual is eligible for publicly funded health insurance coverage, including Medicare or Medicaid; or

(c) The individual's premiums are paid for or reimbursed by the health care provider or the individual's premiums are paid by any government sponsored program or government agency, except if the person is eligible under subparagraphs I(d) or (e). Nothing in this subparagraph shall be construed to prevent the association from receiving or using non-assessment funds, including but not limited to federal, state, foundation, or other grants or donations from any source to further the purposes of this chapter.

VI. Coverage shall cease:

(a) On the date a person is no longer a resident of this state;

(b) On the date a person requests coverage to end;

(c) Upon the date a person dies;

(d) On the date state law requires cancellation of the policy; or

(e) After the second of 2 successive inquiries made by the plan concerning the person's place of residence to which the person does not reply, provided the person has 90 days to respond to each inquiry.


Source. 2001, 295:10. 2002, 207:42. 2003, 201:3; 276:12, 13. 2004, 187:2. 2007, 289:38. 2011, 189:2, eff. Aug. 13, 2011.

    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 400-A:29, RSA 400-A:31 through 400-A:35, RSA 404-B, RSA 404-D, RSA 404-H, RSA 408-B, and RSA 420-K. For the purposes of this chapter, the pool shall be deemed an insurer, pool coverage shall be deemed individual health insurance, and pool coverage contracts shall be deemed policies.


Source. 2001, 295:10. 2002, 207:43. 2007, 255:10, eff. Jan. 1, 2008.

    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 pool" and the contract shall be known as the "federally qualified high risk pool contract." The eligibility requirements, premiums, benefits, and all other elements of the federally qualified high risk pool and its operations shall be governed solely by federal law and regulation and the federally qualified high risk pool contract. Individuals covered by insurance under the federally qualified high risk pool shall not be covered lives for the purposes of this chapter. The federally qualified high risk pool shall be funded solely by federal moneys and premiums charged for coverage under it, and shall not be funded with state general fund revenue or any assessments under this chapter. All federal moneys received by the association for the federally qualified high risk pool shall be used solely for the federally qualified high risk pool.

II. In addition to the powers and duties enumerated elsewhere in this chapter, the board of directors of the association shall have the following powers and duties with respect to the federally qualified high risk pool:

(a) Make application, subject to review and approval of the commissioner, to establish and operate a federally qualified high risk pool; and

(b) Enter into contract with the Secretary of the United States Department of Health and Human Services, subject to review and approval of the commissioner, to establish and operate a federally qualified high risk pool under section 1101 of the Act.

III. The board of directors of the association shall adopt a plan of operation for the federally qualified high risk pool. This plan of operation shall include the federally qualified high risk pool contract, all federal rules and guidance issued with respect to federally qualified high risk pools, and any other provisions deemed necessary by the board to operate the federally qualified high risk pool.


Source. 2010, 243:7, eff. July 1, 2010.

    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 the following:

I. Description of risks to be shared. Sharing shall be implemented through a risk adjustment and subsidization mechanism whereby writers in the group market will subsidize losses of writers in the individual market. The mechanism shall include parameters which will limit its costs and ensure proper claims management by the nongroup writers.

II. Subsidy determination for the risk sharing mechanism. For a given calendar year, the subsidy calculations for the risk sharing mechanism shall be based on the experience of the prior year. Only individual health insurance writers who are actively marketing individual health insurance, in accordance with the provisions of RSA 420-G, during the calendar year in which the subsidy is distributed shall be eligible for a subsidy. For companies that utilize health status factors, only individuals whose coverage is written at the maximum allowable health status factors under RSA 420-G and whose coverage was issued prior to July 1, 2002 shall be eligible for a subsidy. For companies that do not utilize varied health status factors, all individuals whose coverage is written under RSA 420-G and whose coverage was issued prior to July 1, 2002 shall be eligible for a subsidy. The subsidy determination process shall recognize and compensate writers based on the risk characteristics of coverage eligible for consideration in the subsidy relative to standards established by the association board. Nothing in this chapter shall preclude the commissioner from approving a subsidy mechanism that fully compensates individual health insurers for all costs incurred on subsidy-eligible coverages in excess of the premiums collected from subsidy-eligible coverages.

III. Assessment determination.

(a) Assessment liabilities shall commence on the effective date of this chapter.

(b) Assessments shall be calculated based on the number of covered lives. The number of covered lives shall be determined each month during the calendar year. The assessment shall be calculated as the number of covered lives times a specified amount. The specified amount shall be fixed throughout the calendar year and shall be determined by the board no later than the first day of November preceding the calendar year for which the amount is to be used. The amount shall be subject to approval by the commissioner. The board shall provide a basis for recommending the specified amount, including a projection of the calculated subsidy and consideration of any prior year shortfalls or overages. For the calendar years 1999 and 2000, the specified amount shall be 18 cents per covered life per month, provided, however, that the board may petition the commissioner for approval of a greater specified amount. The commissioner shall approve such amount if he or she finds, after consideration of the:

(1) Board's subsidy determination process;

(2) Number of subsidy-eligible lives;

(3) Size of the entire non-group market;

(4) Morbidity experience of the subsidy-eligible lives; and

(5) Morbidity experience of the entire non-group market; that the amount petitioned by the board is no greater than is necessary to fulfill the purposes of this chapter. For the purpose of making this determination, the commissioner may, at the expense of the association, seek independent actuarial certification of the need for the increase.

(c) Each covered life should be included in the assessment only once. The board shall adopt procedures by which affiliated carriers calculate their assessment on an aggregate basis and procedures to ensure that no covered life is counted more than once.

IV. Administrative matters. The plan of operation shall further provide for all of the following:

(a) Responsibility for the handling and accounting of funds and other assets of the association.

(b) The financial and other records required to be kept, including the annual report to be submitted to the commissioner.

(c) Such other administrative provisions as are necessary or proper for the execution of the powers and duties of the association.


Source. 1998, 340:6. 2001, 295:9, eff. July 1, 2001.

    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 demand shall not excuse the association from the performance of its powers and duties under this chapter.

I-a. The commissioner shall annually review the report required under RSA 404-G:4-a on association membership, covered lives, and the payment of assessments to ensure that all insurers that should be members of the association are participating in the association and that all association members have accurately reported covered lives and paid the proper assessment. The association shall remedy any problem identified by the commissioner with respect to membership in the association, reporting of covered lives, or payment of the assessment.

II. The commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. Such forfeiture shall not exceed 5 percent of the unpaid assessment per month, but no forfeiture shall be less than $100 per month. Any amounts so collected shall be credited to the assessment fund administered by the association.

III. Any action of the board of directors or the association may be appealed to the commissioner by any member insurer if the appeal is taken within 30 days of the final action being appealed. If a member company is appealing an assessment, the amount assessed shall be paid to the association and available to meet association obligations during the pendency of an appeal. If the appeal on the assessment is upheld, the amount paid in error or excess shall be returned to the member company from available funds of the association. Any final action or order of the commissioner shall be subject to judicial review, pursuant to RSA 541.

IV. The commissioner may adopt rules as necessary to carry out the purposes of this chapter.

V. The powers of the commissioner enumerated in this chapter shall be in addition to those established under RSA 404-C.


Source. 1998, 340:6. 2008, 375:6, eff. July 1, 2008.

    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 the proceeding fiscal year. The report shall summarize the activities of the risk sharing mechanism and the high risk pool in the preceding calendar year, including the net written and earned premiums, enrollment, the expense of administration, and the paid and incurred losses. The association's fiscal year shall be the calendar year.


Source. 1998, 340:6. 2001, 295:11, eff. July 1, 2001.

    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.

    404-G:9 Immunity for Members and Employees. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or the commissioner's representatives, for any action or omission by them in the performance of their powers and duties under this chapter.


Source. 1998, 340:6, eff. Aug. 25, 1998.

    404-H:1 Title. 

This chapter shall be known and may be cited as the New Hampshire Insurance Guaranty Association Act of 2004.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:10 Duties and Powers of the Commissioner. 

I. The commissioner shall:

(a) Forward to the association a copy of any complaint seeking an order of liquidation with a finding of insolvency against a member company at the same time such complaint is filed with a court of competent jurisdiction.

(b) Notify the association of the existence of an insolvent insurer not later than 3 days after the commissioner receives notice of the determination of the insolvency.

(c) Upon request of the board of directors, provide the association with a statement of the net direct written premiums of each member insurer.

II. The commissioner may:

(a) Suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a fine on any member insurer which fails to pay an assessment when due. Such fine shall be paid to the association and shall not exceed 5 percent of the unpaid assessment per month, except that no fine shall be less than $100 per month.

(b) Revoke the designation of any servicing facility if the commissioner finds claims are being handled unsatisfactorily.

III. Any final action or order of the commissioner under this chapter shall be subject to judicial review in a court of competent jurisdiction.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:11 Effect of Paid Claims. 

I. Any person recovering under this chapter shall be deemed to have assigned his or her rights under the policy to the association but shall retain the right to recover from the receiver or liquidator of the insolvent insurer any amount of his or her claim under the coverage of the policy not paid by the association. Every person with a right to recover under this chapter shall cooperate with the association in the handling of the claim and perform all of such person's obligations under the policy to the same extent as such person would have been required to cooperate with the insolvent insurer. The association shall have no cause of action against the insured of the insolvent insurer for any sums it has paid out except such causes of action as the insolvent insurer would have had if such sums had been paid by the insolvent insurer and except as provided in paragraph II. In the case of an insolvent insurer operating on a plan with assessment liability, payments of claims of the association shall not operate to reduce the liability of the insureds to the receiver, liquidator, or statutory successor for unpaid assessments.

II. The association shall have the right to recover from the following persons the amount of any covered claim paid, whether for defense, indemnity, or otherwise, on behalf of such person pursuant to this chapter:

(a) Any insured whose net worth on December 31 of the year immediately preceding the date the insurer becomes an insolvent insurer exceeds $25 million, provided the insured's net worth shall be deemed to include the net worth of the insured and all of its affiliates on a consolidated basis; and

(b) Any person who is an affiliate of the insolvent insurer and whose liability obligations to other persons are satisfied in whole or in part by payments made under this chapter.

III. The association and any association similar to the association in another state shall be recognized as claimants in the liquidation of an insolvent insurer for any amounts paid by them on covered claim obligations as determined under this chapter or similar laws in other states and shall receive dividends and any other distributions at the priority set forth in RSA 402-C. The receiver, liquidator, or statutory successor of an insolvent insurer shall be bound by determinations of covered claims eligibility under this chapter and by settlements of claims made by the association or a similar organization in another state and shall grant such claims priority equal to that which the claimant would have been entitled in the absence of this chapter against the assets of the insolvent insurer. The expenses of the association or similar organization in handling claims shall be accorded the same priority as the liquidator's expenses.

IV. The association shall periodically file with the receiver or liquidator of the insolvent insurer statements of the covered claims paid by the association and estimates of anticipated claims on the association which shall preserve the rights of the association against the assets of the insolvent insurer.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:12 Exhaustion of Other Coverage. 

I. Any person having a claim against an insurer under any provision in an insurance policy other than a policy of an insolvent insurer, including but not limited to the provisions of uninsured motorist coverage of any policy, shall be required to exhaust first his or her right under such policy. Any amount payable on a covered claim under this chapter shall be reduced by the amount of any recovery under such insurance policy.

II. Any person having a claim which may be recovered under more than one insurance guaranty association or its equivalent shall seek recovery first from the association of the place of residence of the insured except that if it is a first party claim for damage to property with a permanent location, he or she shall seek recovery first from the association of the location of the property, and if it is a workers' compensation claim, he or she shall seek recovery first from the association of the residence of the claimant. Any amount payable as a covered claim under this chapter shall be reduced by the amount of recovery from any other insurance guaranty association or its equivalent.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:13 Prevention of Insolvencies. 

To aid in the detection and prevention of insurer insolvencies:

I. The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation, or conservation of any member insurer. Such reports and recommendations shall not be considered public documents.

II. The board of directors may, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report on the history and causes of such insolvency, based on the information available to the association, and submit such report to the commissioner.

III. The board of directors may, upon majority vote, make recommendations to the commissioner on matters generally related to improving or enhancing regulation for solvency.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:14 Examination of the Association. 

The association shall be subject to examination and regulation by the commissioner. The board of directors shall submit, not later than March 30 of each year, a financial report for the preceding calendar year in a form approved by the commissioner.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:15 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 or personal property.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:16 Recognition of Assessments in Rates. 

I. The rates and premiums charged for insurance policies to which this chapter applies may include amounts sufficient to recoup a sum equal to the amounts paid to the association by the member insurer less any amounts returned to the member insurer by the association. Such rates may not be deemed excessive because they contain an amount reasonably calculated to recoup assessments paid by the member insurer. Alternatively, the member insurer may recoup assessments by collecting a surcharge on premiums charged for insurance policies to which this chapter applies instead of recouping the assessments through its rates and premiums.

II. The amount of any surcharge may be separately stated on either a billing or policy declaration sent to an insured.

III. Member insurers who collect surcharges in excess of assessments owed for an insolvent insurer shall remit the excess to the association as an additional assessment within 30 days after the association has determined the amount of the excess recoupment and given notice to the member of that amount. The excess shall be applied to reduce future assessment charges in the appropriate accounts.

IV. A member insurer may omit collection of the surcharge from its insureds when the expense of collecting the surcharge would exceed the amount of the surcharge. However, nothing in this section shall relieve the member insurer of its obligation to remit the amount of surcharge otherwise collectible.

V. Amounts recouped through surcharge shall be considered premiums for all purposes, including the computation of gross premium tax.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:17 Immunity. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer, the association or its agents or employees, the board of directors, or any person serving as a representative of any director, or the commissioner or his or her representatives for any action taken or any failure to act by them in the performance of their powers and duties under this chapter.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:18 Stay of Proceedings. 

All proceedings in which the insolvent insurer is a party or is obligated to defend a party in any court in this state shall, subject to waiver by the association in specific cases, be stayed for 6 months and such additional time thereafter as may be determined by the court from the date the insolvency is determined or an ancillary proceeding is instituted in this state, whichever is later.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:19 Termination of the Association. 

The commissioner may by order terminate the operation of the association as to any kind of insurance with respect to which the commissioner has found, after notice and hearing, that there is in effect a statutory plan of the United States government to avoid excessive delay or financial loss to claimants or policyholders because of insurer insolvency. Such order for termination shall continue the operation of this chapter with respect to prior insurer insolvencies not covered by such plan. The order shall also provide for a proportionate distribution of the assets of the association to insurers which will cease to be members of the association on the effective date of the order.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:2 Purpose. 

The purpose of this chapter is to provide a mechanism for the payment of covered claims under certain insurance policies to avoid excessive delay in payment and to the extent provided in this chapter minimize financial loss to claimants or policyholders because of the insolvency of an insurer, and to permit an association to assess the cost of such protection among insurers.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:20 Advertising. 

No person shall make, publish or circulate, or cause to be made, published or circulated, any statement which uses the existence of the association for the purpose of sale, solicitation or inducement to purchase any form of insurance within the scope of this chapter, provided this section shall not apply to the distribution of any publication approved by the commissioner and describing the general purposes and current limitations of this chapter.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:3 Scope. 

This chapter shall apply to insurers with orders of liquidation with findings of insolvency that are first entered after the effective date of this chapter and shall apply to all kinds of direct insurance, but shall not be applicable to the following:

I. Life, annuity, health, or disability insurance;

II. Mortgage guaranty, financial guaranty, or other forms of insurance offering protection against investment risks;

III. Fidelity or surety bonds, or any other bonding obligations;

IV. Credit insurance, vendors' single interest insurance, or collateral protection insurance or other forms of any similar insurance protecting the interests of a creditor arising out of a creditor-debtor transaction;

V. Insurance of warranties or service contracts including insurance that provides for the repair, replacement, or service of goods or property, indemnification for repair, replacement or service for the operational or structural failure of goods or property due to a defect of materials, workmanship, or normal wear and tear, or provides reimbursement for the liability incurred by the issuer of agreements or service contracts that provide such benefits;

VI. Title insurance;

VII. Ocean marine insurance;

VIII. Any transaction or combination of transactions between a person, including affiliates of such person, and an insurer, including affiliates of such insurer, which involves the transfer of investment or credit risk unaccompanied by transfer of insurance risk; or

IX. Any insurance provided by or guaranteed by government.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:4 Construction. 

This chapter shall be liberally construed to effect the purpose under RSA 404-H:2 which shall constitute an aid and guide to interpretation.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:5 Definitions. 

In this chapter:

I. "
Account
" means any one of the 3 accounts created by RSA 404-H:6.

II. "
Affiliate
" means a person who directly or indirectly, through one or more intermediaries, controls, is controlled by, or is under common control with another person.

III. "
Affiliate of the insolvent insurer
" means a person who directly, or indirectly, through one or more intermediaries, controls, is controlled by, or is under common control with an insolvent insurer on December 31 of the year preceding the date the insurer becomes an insolvent insurer.

IV. "
Association
" means the New Hampshire Insurance Guaranty Association created under RSA 404-H:6.

V. "
Authority
" means the business finance authority established in RSA 162-A.

VI. "
Claimant
" means any insured making a claim or any person instituting a liability claim, including a workers' compensation claim, provided that no person who is an affiliate of the insolvent insurer at the time the policy was issued or at the time of the insured event may be a claimant.

VII. "
Commissioner
" means the commissioner of insurance of this state.

VIII. "
Control
" means the possession, direct or indirect, or the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is a result of an official position with or corporate office held by the person. Control shall be presumed to exist if a person, directly or indirectly, owns, controls, holds with the power to vote, or holds proxies representing, 10 percent or more of the voting securities of any other person. This presumption may be rebutted by a showing that control does not exist in fact.

IX. (a) "
Covered claim
" means an unpaid claim, including one for unearned premiums submitted by a claimant, which arises out of and is within the coverage and is subject to the applicable limits of an insurance policy to which this chapter applies issued by an insurer, if such insurer after the effective date of this chapter becomes an insolvent insurer, and:

(1) The claimant or insured is a resident of this state at the time of the insured event; provided that for entities other than an individual, the residence of a claimant or insured is the state in which its principal place of business is located at the time of the insured event; or

(2) The claim is a first party claim for damage to property with a permanent location in this state.

(b) "
Covered claim
" includes obligations that arose through the issuance of an insurance policy by a member insurer, which are later allocated, transferred, assumed by, or otherwise made the sole responsibility of a member or non-member insurer if:

(1) There are no remaining obligations of the original member insurer after the transfer; and

(2) The insurer that assumed the member's coverage obligations becomes insolvent and goes into liquidation proceedings.

(c) "Covered claim" shall not include:

(1) Any amount awarded as punitive or exemplary damages;

(2) Any amount sought as a return of premium under any retrospective rating plan; 

(3) Any claim by or for the benefit of any reinsurer, insurer, insurance pool, or underwriting association, as subrogation recoveries, reinsurance recoveries, contribution, indemnification or otherwise. No claim for any amount by or for the benefit of any reinsurer, insurer, insurance pool, or underwriting association may be asserted against a person insured under a policy issued by an insolvent insurer other than to the extent such claim exceeds the limitations on the association's obligations set forth in RSA 404-H:8, I(a)(1)(B) of this chapter; or

(4) Any claim arising out of an insurance policy issued by a non-member insurer and later allocated, transferred, assumed by, or otherwise made the sole responsibility of a member insurer.

X. "
Insolvent insurer
" means an insurer licensed to transact insurance in this state, either at the time the policy was issued or when the insured event occurred, and against whom a final order of liquidation has been entered after the effective date of this chapter with a finding of insolvency by a court of competent jurisdiction in the insurer's state of domicile.

XI. "
Member insurer
" means any person who:

(a) Writes any kind of insurance to which this chapter applies under RSA 404-H:3, including the exchange of reciprocal or inter-insurance contracts; and

(b) Is licensed to transact insurance in this state, except mutual insurance companies that operate on an assessment plan and require as a condition for granting insurance the signing of a premium deposit note by the insurer, which note is given for the purpose of establishing a limit of liability to assessment, while their total receipts from policyholders is less than $10,000 per year.

XII. "
Net direct written premiums
" means direct gross premiums written in this state on insurance policies to which this chapter applies, less return premiums thereon and dividends paid or credited to policyholders on such direct business. "
Net direct written premiums
" does not include premiums on contracts between insurers or reinsurers.

XIII. "
Person
" means any individual or legal entity, including governmental entities.


Source. 2004, 197:1, eff. Aug. 6, 2004. 2022, 211:1, eff. Aug. 16, 2022.

    404-H:6 Creation of the Association. 

There is created a nonprofit unincorporated legal entity to be known as the New Hampshire Insurance Guaranty Association, that shall be the same association created under RSA 404-B:6. All insurers defined as member insurers in RSA 404-H:5, XI shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under a plan of operation established and approved under RSA 404-H:9 and shall exercise its powers through a board of directors established under RSA 404-H:7. For purposes of administration and assessment, the association shall be divided into 3 separate accounts:

I. The workers' compensation insurance account;

II. The automobile insurance account; and

III. The account of all other insurance to which this chapter applies.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:7 Board of Directors. 

I. The board of directors of the association shall consist of not less than 5 nor more than 9 persons serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term by a majority vote of the remaining board members subject to the approval of the commissioner
. If no members are selected within 60 days after the effective date of this chapter, the commissioner may appoint the initial members of the board of directors.

II. In approving selections to the board, the commissioner shall consider among other things whether all member insurers are fairly represented.

III. Members of the board may be reimbursed from the assets of the association for expenses incurred by them as members of the board of directors.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:8 Powers and Duties of the Association. 

I. The association shall:

(a) (1) Be obligated to pay covered claims existing prior to the order of liquidation and arising within 30 days after the order of liquidation, or before the policy expiration date if less than 30 days after the order of liquidation, or before the insured replaces the policy or causes its cancellation, if he or she does so within 30 days of the order of liquidation. Such obligation shall be satisfied by paying to the claimant an amount as follows:

(A) The full amount of a covered claim for benefits under workers' compensation insurance coverage.

(B) An amount not exceeding $300,000 for other covered claims. Payment by the association of an amount satisfying the obligations of the association to a person instituting a liability claim shall satisfy the association's obligations to pay the insured.

(2) In no event shall the association be obligated to pay an amount in excess of the obligation of the insolvent insurer under the policy or coverage from which the claim arises.

(3) Any obligation of the association to defend an insured on a covered claim shall cease upon the association's:

(A) Payment, by settlement releasing the insured or on a judgment, of an amount equal to the lesser of the association's covered claim obligation limit or the applicable policy limit; or

(B) Tender of such amount.

(4) Notwithstanding any other provisions of this chapter, except in the case of a claim for benefits under workers' compensation coverage, a covered claim shall not include a claim filed with the association after the earlier of:

(A) Thirty six months after the date of the order of liquidation; or

(B) The final date set by the court for the filing of claims against the liquidator or receiver of an insolvent insurer and shall not include any claim filed with the association or a liquidator for protection afforded under the insured's policy for incurred-but-not-reported losses.

(5) If the association determines that there may be more than one claimant having a covered claim against the association under the policy or policies of any one insolvent insurer, the association may establish a plan to allocate amounts payable by the association in such manner as the association in its discretion deems equitable.

(b) Be deemed the insurer only to the extent of the association's obligation on the covered claims and to such extent, subject to the limitations provided in this chapter, shall have all rights, duties, and obligations of the insolvent insurer as if the insurer had not become insolvent, including but not limited to the right to pursue and retain salvage and subrogation recoverables on paid covered claims obligations. The association shall not be deemed the insolvent insurer for any purpose relating to the issue of whether the association is amenable to the personal jurisdiction of the courts of any jurisdiction.

(c) Allocate claims paid and expenses incurred among the 3 accounts separately, and assess member insurers separately for each account amounts necessary to pay the obligations of the association under subparagraph I(a) subsequent to an insolvency, the expenses of handling covered claims subsequent to an insolvency, and other expenses authorized by this chapter. The assessments of each member insurer shall be in the proportion that the net direct written premiums of the member insurer for the calendar year preceding the assessment on the kinds of insurance in the account bears to the net direct written premiums of all member insurers for the calendar year preceding the assessment on the kinds of insurance in the account. Each member insurer shall be notified of the assessment not later than 30 days before it is due. No member insurer may be assessed in any one year on any account an amount greater than 2 percent of that member insurer's net direct written premiums for the calendar year preceding the assessment on the kinds of insurance in the account. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in any account an amount sufficient to make all necessary payments from that account, the funds available shall be prorated and the unpaid portion shall be paid as soon thereafter as funds become available. The association shall pay claims in any order that it deems reasonable, including the payment of claims as such are received from the claimants or in groups or categories of claims. The association may exempt or defer, in whole or in part, the assessment of any member insurer, if the assessment would cause the member insurer's financial statement to reflect amounts of capital or surplus less than the minimum amounts required for a certificate of authority by any jurisdiction in which the member insurer is authorized to transact insurance; provided however that, during the period of deferment, no dividends shall be paid to shareholders or policyholders. Deferred assessments shall be paid when such payment will not reduce capital or surplus below required minimums. Such payments shall be refunded to those companies receiving larger assessments by virtue of such deferment, or at the election of any such company, credited against future assessments.

(d) Investigate claims brought against the association and adjust, compromise, settle, and pay covered claims to the extent of the association's obligation and deny all other claims.

(e) Not be bound by any settlement, release, compromise, waiver or judgment executed or entered within 12 months prior to an order of liquidation and shall have the right to assert all defenses available to the association including, but not limited to, defenses applicable to determining and enforcing its statutory rights and obligations to any such claim. The association shall be bound by any settlement, release, compromise, waiver or judgment executed or entered into more than one year prior to an order of liquidation; provided, however, such claim is a covered claim and such settlement or judgment was not a result of fraud, collusion, default or failure to defend. Further, as to any covered claims arising from a judgment under any decision, verdict or finding based on the default of the insolvent insurer or its failure to defend, the association either on its own behalf or on behalf of an insured may apply to have such judgment, order, decision, verdict or finding set aside by the same court or administrator that made such judgment, order, decision, verdict or finding and shall be permitted to defend such claim on the merits.

(f) Handle claims through its employees or through one or more insurers or other persons designated as servicing facilities. Designation of a servicing facility is subject to the approval of the commissioner, but such designation may be declined by a member insurer.

(g) Reimburse each servicing facility for obligations of the association paid by the facility and for expenses incurred by the facility while handling claims on behalf of the association and shall pay the other expenses of the association authorized by this chapter.

(h) Notwithstanding any of the powers of the commissioner as liquidator as provided for in RSA 402-C, the association shall have the final authority with respect to the processing and settlement of covered claims for which it becomes responsible pursuant to this chapter, including authority for the use of records of the insolvent insurer directly related to covered claims. At the conclusion of the association's responsibility with respect to any insolvent insurer, any original records of said insolvent insurer then in the possession of the association shall be turned over to the liquidator for ultimate disposal in accordance with RSA 402-C. The association shall cooperate with any agent to the extent possible in identifying policyholders of the agent and the insolvent insurer.

II. The association may:

(a) Employ or retain such persons as are necessary to handle claims and perform other duties of the association.

(b) Borrow funds necessary to effect the purposes of this chapter in accordance with the plan of operation.

(c) Sue or be sued, including the power and right to petition to intervene as a party before any court that has jurisdiction over an insolvent insurer as defined by this chapter, and in any administrative proceeding if the result of such administrative proceeding might in the future impose obligations on the association should one or more of the insurer parties to the proceeding become insolvent.

(d) Negotiate and become a party to such contracts as are necessary to carry out the purposes of this chapter.

(e) Perform such other acts as are necessary or proper to effectuate the purposes of this chapter.

(f) Refund to the member insurers in proportion to the contribution of each member insurer to that account that amount by which the assets of the account exceed the liabilities, if, at the end of any calendar year, the board of directors finds that the assets of the association in any account exceed the liabilities of that account as estimated by the board of directors for the coming year.

III. In any suit involving the association:

(a) Except for actions by member insurers aggrieved by final actions or decisions of the association pursuant to RSA 404-H:9, IV(h) of this chapter, all actions relating to or arising out of this chapter shall be brought in the courts in the state. Such courts shall have exclusive jurisdiction over all actions relating to or arising out of this chapter against the association.

(b) Exclusive venue in any action by or against the association is the superior court for the county of Merrimack, state of New Hampshire. The association may, at the option of the association, waive such venue as to specific actions.

IV. In the event of an insolvency resulting in covered claims payable by the association in excess of its capacity to pay from assessments collected under RSA 404-H:8, I(c), the association may borrow funds pursuant to RSA 404-H:8, II(b) from any domestic insurer willing and able to enter into an agreement to provide that funding, or a portion thereof, with the approval of the commissioner.


Source. 2004, 197:1, eff. Aug. 6, 2004.

    404-H:9 Plan of Operation. 

I. The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon approval in writing by the commissioner.

II. If the association fails to submit a suitable plan of operation within 90 days following the effective date of this chapter, the commissioner shall, after notice and hearing, adopt and promulgate such reasonable rules as are necessary or advisable to effectuate the provisions of this chapter. Such rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner.

III. All member insurers shall comply with the plan of operation.

IV. The plan of operation shall:

(a) Establish the procedures whereby all the powers and duties of the association under RSA 404-H:8 will be performed.

(b) Establish procedures for handling assets of the association.

(c) Establish the method of reimbursing members of the board of directors under RSA 404-H:7.

(d) Establish procedures by which claims may be filed with the association.

(e) Provide that notice of claims to the receiver or liquidator of the insolvent insurer shall be deemed notice to and filing with the association or its agent and a list of such claims shall be periodically submitted to the association or similar organization in another state by the receiver or liquidator.

(f) Establish regular places and times for meetings of the board of directors.

(g) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors.

(h) Provide that any member insurer aggrieved by any final action or decision of the association may appeal to the commissioner within 30 days after the action or decision.

(i) Establish the procedures whereby selections for the board of directors will be submitted to the commissioner.

(j) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

V. The plan of operation may provide that any or all powers and duties of the association, except those under RSA 404-H:8, II(b) and IV are delegated to a corporation, association, or other organization which performs or will perform functions similar to those of this association, or its equivalent, in 2 or more states. Such a corporation, association or organization shall be reimbursed as a servicing facility would be reimbursed and shall be paid for its performance of any other functions of the association. A delegation under this paragraph shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.


Source. 2004, 197:1, eff. Aug. 6, 2004.

[RSA 404-J:1 repealed by 2019, 346:422, I effective December 1, 2024.]
    404-J:1 Commission Established. 

I. There is hereby established a commission on the status of health coverage markets for individuals and small employers.

(a) The members of the commission shall be as follows:

(1) Three members of the senate, one of whom shall be a member of the minority party, appointed by the president of the senate.

(2) Three members of the house of representatives, one of whom shall be a member of the minority party, appointed by the speaker of the house of representatives.

(3) The insurance commissioner, or designee.

(4) Three persons representing health carriers, appointed by the insurance commissioner, as follows:

(A) One person representing a health carrier with a significant presence in the individual market;

(B) One person representing a health carrier with a significant presence in the small employer market; and

(C) One person representing a health carrier with an interest in providing or administering health coverage in the pathway II association market.

(5) Two producers, appointed by the insurance commissioner, one of whom shall be a producer with a significant clientele in the individual market and the other a producer with a significant clientele in the small employer market.

(6) A public member from an academic institution or charitable foundation who has health care and health insurance expertise, appointed by the senate president.

(7) A public member who shall represent the interests of persons who obtain their coverage through that market, appointed by the speaker of the house of representatives.

(8) A public member who shall represent the interests of persons who obtain their coverage through the individual market, appointed by the president of the senate.

(9) Two public members from organizations that represent the interests of the medically underserved, persons with pre-existing conditions, or persons with chronic health conditions, including mental health or substance use disorders, appointed by the governor.

(10) A public member who shall represent the interests of small employers sponsoring health coverage for their employees, appointed by the governor.

(11) A public member from the Business and Industry Association of New Hampshire or a New Hampshire chamber of commerce, appointed by the governor.

(12) A public member from a national organization with a New Hampshire chapter that is interested in qualifying as a bone fide pathway II association, as defined in RSA 415-E:1, III, appointed by the governor.

(b) Of the commission members listed under subparagraph (a), only the 6 legislative members shall be voting members. All other members shall serve in an advisory capacity only.

(c) Legislative members of the commission shall receive mileage at the legislative rate when attending to the duties of the commission.

(d) The commission shall be a public body subject to RSA 91-A, and its meetings shall be considered public proceedings.

II. (a) The commission shall evaluate the status of health coverage markets for individuals and small employers. This shall include the individual market, the small employer market, and alternative sources of coverage that may be available to individuals and small employers, including pathway II association coverage, transitional coverage, and short-term limited duration coverage. These markets shall be evaluated in terms of their performance in making available to individuals and small employers affordable coverage that provides access to medically necessary care on affordable terms. Consideration shall be given to market competitiveness, price, choice of plans, market size, market segmentation, the risk profile of the covered population in each market, adverse selection against specific markets, migration between markets, the rate of growth or diminution in the overall number of covered lives, and other similar factors that may affect the coverage available to individuals and small employers. Specifically, the commission shall evaluate markets and make recommendations on the following:

(1) The performance and effectiveness of the small group market in itself and in conjunction with other markets that may be available to small employers and their employees, including, if applicable, pathway II association coverage. This shall include consideration of coverage for pre-existing conditions and essential health benefits, premium rates and product offerings, impact on premiums, the availability and choice of plans, the number of covered lives, and the overall impact on the availability and affordability of coverage for higher risk individuals and small employer groups. Based on this evaluation, the commission shall make recommendations in its annual report for future program or legislative modifications, including, if applicable, modifications to the risk adjustment program authorized under RSA 420-K, as well as a final recommendation as to whether the general court should allow the continuation or should phase out the market for pathway II association coverage.

(2) The performance and effectiveness of the individual market in itself and in conjunction with other markets that may be available to individuals and sole proprietors, including, if applicable, pathway II association coverage. This shall include consideration of the migration of sole proprietors to the pathway II market and the effectiveness of screening procedures in validating sole proprietorship status, the price and availability of coverage for individuals who do not qualify for an advanced premium tax credit or cost sharing reduction assistance through the marketplace exchange, and the design and effectiveness of the risk sharing mechanism and 1332 waiver for the individual market authorized under RSA 420-N:6-a. Based on this evaluation, the commission shall make recommendations concerning the individual market risk sharing mechanism under the 1332 waiver, any changes that are needed to screening and monitoring procedures for compliance with the hourly work standard to qualify as a sole proprietor under pathway II association coverage, and any other legislative or regulatory measures that would promote market stability and growth in the individual market.

(b) The commission shall not make any recommendation that includes the use of new general funds.

(c) The commission shall solicit information from any person or entity the commission deems relevant to its study.

III. The insurance commissioner shall provide information and reports to the commission on a biannual basis concerning the status of the individual, small employer and, if applicable, pathway II association markets as necessary to allow the commission to carry out its duties. The commission shall have the authority, at any time, upon a finding that pathway II association coverage is having an adverse impact on the availability and choice of coverage in the individual or small employer markets or is causing average premiums for individuals or small groups to increase at a rate that is significantly higher than the trend in claims costs, to recommend that the commissioner limit pathway II associations to the writing of existing business only or adjust the risk score differential amount in RSA 420-K:4, I(d), and the commissioner shall have authority to implement this recommendation by order pursuant to RSA 400-A:14 and this paragraph.

IV. The members of the commission shall elect a chairperson from among the members. The first meeting of the commission shall be called by the first-named senate member. The first meeting of the commission shall be held within 45 days of the effective date of this section. Four of the 6 voting members of the commission shall constitute a quorum.

V. The commission shall submit an annual report on or before November 1 of each year with its findings and any recommendations for proposed legislation, and a final report on December 1, 2024 to the president of the senate, the speaker of the house of representatives, the senate clerk, the house clerk, the governor, and the state library. If applicable, the commission's reports shall contain the commission's recommendation regarding whether the market for pathway II association coverage should continue or be phased out.


Source. 2019, 346:419, eff. Dec. 1, 2021.

    405-A:1 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner of New Hampshire or the commissioner, director or superintendent of insurance in any other state.

II. "Completed operations liability" means liability arising out of the installation, maintenance, or repair of any product at a site which is not owned or controlled by:

(a) any person who performs that work; or

(b) any person who hires an independent contractor to perform that work;

and shall include liability for activities which are completed or abandoned before the date of the occurrence giving rise to the liability.

III. "Domicile" for purposes of determining the state in which a purchasing group is domiciled, means:

(a) for a corporation, the state in which the purchasing group is incorporated; and

(b) for an unincorporated entity, the state of its principal place of business.

IV. "Hazardous financial condition" means that based on its present or reasonably anticipated financial condition, a risk retention group, although not yet financially impaired or insolvent, is unlikely to be able to:

(a) meet obligations to policyholders with respect to known claims and reasonably anticipated claims; or

(b) pay other obligations in the normal course of business.

V. "Insurance" means primary insurance, excess insurance, reinsurance, surplus lines insurance, and any other arrangement for shifting and distributing risk which is determined to be insurance under the laws of this state.

VI. "Liability" means the legal liability for damages, including costs of defense, legal costs and fees, and other claims expenses, because of injuries to other persons, damage to their property, or other damage or loss to such other persons resulting from or arising out of:

(a) any business (whether profit or nonprofit), trade, product, services (including professional services), premises or operations; or

(b) any activity of any state or local government, or any agency or political subdivision thereof; which does not include personal risk liability and an employer's liability with respect to its employees other than legal liability under the Federal Employer's Liability Act (45 U.S.C. section 51 et seq.).

VII. "Located", for purposes of determining the state in which a purchasing group is located, means any state in which the purchasing group has a member or risk resident located.

VIII. "Personal risk liability" means liability for damages because of injury to any person, damage to property, or other loss or damage resulting from any personal, familial, or household responsibilities or activities, rather than from responsibilities or activities referred to in paragraph VI.

IX. "Plan of operation or a feasibility study" means an analysis which presents the expected activities and results of a risk retention group including, at a minimum:

(a) information sufficient to verify that its members are engaged in businesses or activities similar or related with respect to the liability to which such members are exposed by virtue of any related, similar, or common business, trade, product, services, premises or operations;

(b) for each state in which it intends to operate, the coverages, deductibles, coverage limits, rates, and rating classification systems for each line of insurance the group intends to offer;

(c) historical and expected loss experience of the proposed members and national experience of similar exposures to the extent that this experience is reasonably available;

(d) pro forma financial statements and projections;

(e) appropriate opinions by a qualified, independent casualty actuary, including a determination of minimum premium or participation levels required to commence operations and to prevent a hazardous financial condition;

(f) identification of management, underwriting and claims procedures, marketing methods, managerial oversight methods, investment policies, and reinsurance agreements;

(g) disclosure of each state in which the risk retention group has obtained, or sought to obtain, a charter or license, and a description of its status in each state; and

(h) such other matters as may be prescribed by the commissioner of the state in which the risk retention group is chartered for liability insurance companies authorized by the insurance laws of that state.

X. "Product liability" means liability for damages because of any personal injury, death, emotional harm, consequential economic damage, or property damage (including damages resulting from the loss of use of property) arising out of the manufacture, design, importation, distribution, packaging, labeling, lease, or sale of a product, but does not include the liability of any person for those damages if the product involved was in the possession of such a person when the incident giving rise to the claim occurred.

XI. "Purchasing group" means any group which:

(a) has as one of its purposes the purchase of liability insurance on a group basis;

(b) purchases such insurance only for its group members and only to cover their similar or related liability exposure, as described in subparagraph (c);

(c) is composed of members whose businesses or activities are similar or related with respect to the liability to which members are exposed by virtue of any related, similar, or common business, trade, product, services, premises, or operations; and

(d) is domiciled in any state.

XII. "Risk retention group" means any corporation or other limited liability association:

(a) whose primary activity consists of assuming and spreading all, or any portion of, the liability exposure of its group members; and

(b) which is organized for the primary purpose of conducting the activity described under subparagraph (a); and

(c) which:

(1) is chartered and licensed as a liability insurance company and authorized to engage in the business of insurance under the laws of any state; or

(2) before January 1, 1985, was chartered or licensed and authorized to engage in the business of insurance under the laws of Bermuda or the Cayman Islands and, before such date, had certified to the insurance commissioner of at least one state that it satisfied the capitalization requirements of such state, except that any such group shall be considered to be a risk retention group only if it has been engaged in business continuously since such date and only for the purpose of continuing to provide insurance to cover product liability or completed operations liability (as such terms were defined in the Product Liability Risk Retention Act of 1981 before the date of the enactment of the Liability Risk Retention Act of 1986); and

(d) which does not exclude any person from membership in the group solely to provide for members of such a group a competitive advantage over such a person; and

(e) which:

(1) has as its owners only persons who comprise the membership of the risk retention group and who are provided insurance by such group; or

(2) has as its sole owner an organization which has as:

(A) its members only persons who comprise one membership of the risk retention group; and

(B) its owners only persons who comprise the membership of the risk retention group and who are provided insurance by such group; and

(f) whose members are engaged in businesses or activities similar or related with respect to the liability of which such members are exposed by virtue of any related, similar, or common business trade, product, services, premises, or operations; and

(g) whose activities do not include the provision of insurance other than:

(1) liability insurance for assuming and spreading all or any portion of the liability of its group members; and

(2) reinsurance with respect to the liability of any other risk retention group (or any members of such other group) which is engaged in businesses or activities so that such group or member meets the requirement described in subparagraph (f) from membership in the risk retention group which provides such reinsurance; and

(h) the name of which includes the phrase "Risk Retention Group."

XIII. "State" means any state of the United States or the District of Columbia.


Source. 1988, 133:2. 1992, 288:18, eff. Jan. 1, 1993.

    405-A:10 Administrative and Procedural Authority Regarding Risk Retention Groups and Purchasing Groups. 

The commissioner is authorized to make use of any of the powers established under the insurance laws of this state to enforce the laws of this state with regard to risk retention groups and purchasing groups so long as those powers are not specifically preempted by the Product Liability Risk Retention Act of 1986, including the commissioner's administrative authority to investigate, issue subpoenas, conduct depositions and hearings, issue orders, impose penalties and seek injunctive relief. With regard to any investigation, administrative proceedings, or litigation, the commissioner may rely on the procedural laws of this state. The injunctive authority of the commissioner in regard to risk retention groups is restricted by the requirement that any injunction be issued by a court of competent jurisdiction.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:11 Duty of Agents or Brokers to Obtain License. 

I. 
Risk Retention Groups. No person, firm, association or corporation shall act or aid in any manner in soliciting, negotiating or procuring liability insurance in this state from a risk retention group unless such person, firm, association or corporation is licensed as an insurance agent or broker in accordance with this title.

II. 
Purchasing Groups.

(a) No person, firm, association or corporation shall act or aid in any manner in soliciting, negotiating or procuring liability insurance in this state for a purchasing group from an authorized insurer or a risk retention group chartered in a state unless such person, firm, association or corporation is licensed as an insurance agent or broker in accordance with this title.

(b) No person, firm, association or corporation shall act or aid in any manner in soliciting, negotiating or procuring liability insurance coverage in this state for any member of a purchasing group under a purchasing group's policy unless such person, firm, association or corporation is licensed as an insurance agent or broker in accordance with this title.

(c) No person, firm, association or corporation shall act or aid in any manner in soliciting, negotiating or procuring liability insurance from an insurer not authorized to do business in this state on behalf of a purchasing group located in this state unless such person, firm, association or corporation is licensed as a surplus lines agent or excess line broker in accordance with this title.

III. For purposes of acting as an agent or broker for a risk retention group or purchasing group pursuant to paragraphs I and II of this section, the requirement of residence in this state shall not apply.

IV. Every person, firm, association, or corporation licensed pursuant to the provisions of this title, on business placed with risk retention groups or written through a purchasing group, shall inform each prospective insured of the provisions of the notice required by RSA 405-A:3, VII, in the case of a risk retention group, and RSA 405-A:8, II, in the case of a purchasing group.


Source. 1988, 133:2. 1992, 288:20, eff. Jan. 1, 1993.

    405-A:12 Binding Effect of Orders Issued in United States District Court. 

An order issued by any district court of the United States enjoining a risk retention group from soliciting or selling insurance, or operating in any state (or in all states or in any territory or possession of the United States) upon a finding that such a group is in hazardous financial or financially impaired condition shall be enforceable in the courts of this state.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:13 Rules. 

The commissioner may adopt, pursuant to RSA 541-A, such rules relating to risk retention groups or purchasing groups, as may be necessary or desirable to carry out the provisions of this chapter.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:2 Risk Retention Groups Chartered in This State. 

I. A risk retention group shall, pursuant to the provisions of title XXXVII, be chartered and licensed to write only liability insurance pursuant to this chapter, and, except as provided elsewhere in this chapter, shall comply with all of the laws, rules, regulations and requirements applicable to such insurers chartered and licensed in this state and with RSA 405-A:3 to the extent such requirements are not a limitation on laws, rules, regulations or requirements of this state.

II. Before it may offer insurance in any state, each risk retention group shall submit for approval to the insurance commissioner of this state a plan of operation or a feasibility study. The risk retention group shall submit an appropriate revision in the event of any subsequent material change in any item of the plan of operation or feasibility study within 10 days of any such change. The group shall not offer any additional kinds of liability insurance in this state or in any other state until a revision of such plan or study is approved by the commissioner.

III. At the time of filing its application for charter, the risk retention group shall provide to the commissioner in summary form the following information: the identity of the initial members of the group; the identity of those individuals who organized the group or who will provide administrative services or otherwise influence or control the activities of the group; the amount and nature of initial capitalization; the coverages to be afforded; and the states in which the group intends to operate. Upon receipt of the information, the commissioner shall forward such information to the National Association of Insurance Commissioners. Providing notification to the National Association of Insurance Commissioners is in addition to and shall not be sufficient to satisfy the requirements of RSA 405-A:3 or any other section of this chapter.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:3 Risk Retention Groups Not Chartered in This State. 

Risk retention groups chartered and licensed in states other than this state and seeking to do business as a risk retention group in this state shall comply with the laws of this state as follows:

I. 
Notice of Operations and Designation of Commissioner as Agent. Before offering insurance in this state, a risk retention group shall submit to the commissioner:

(a) a statement identifying the state or states in which the risk retention group is chartered and licensed as a liability insurance company, its charter date, its principal place of business, and such other information, including information on its membership, as the commissioner of this state may require to verify that the risk retention group is qualified under RSA 405-A:1, XII.

(b) a copy of its plan of operations or feasibility study and revisions of such plan or study submitted to the state in which the risk retention group is chartered and licensed; provided, however, that the provision relating to the submission of plan of operation or feasibility study shall not apply with respect to any line or classification of liability insurance which:

(1) was defined in the Product Liability Risk Retention Act of 1981 before October 27, 1986; and

(2) was offered before such date by any risk retention group which had been chartered and operating for not less than 3 years before such date.

(c) the risk retention group shall submit a copy of any revision to its plan of operation or feasibility study required by subparagraph I(b) at the same time that such revision is submitted to the commissioner of its chartering state.

(d) a statement of registration for which a filing fee shall be determined by the commissioner which designates the commissioner as its agent for the purpose of receiving service of legal documents or process.

II. 
Financial Condition. Any risk retention group doing business in this state shall submit to the commissioner:

(a) a copy of the group's financial statement submitted to the state in which the risk retention group is chartered and licensed which shall be certified by an independent public accountant and contain a statement of opinion on loss and loss adjustment expense reserves made by a member of the American Academy of Actuaries or a qualified loss reserve specialist (under criteria established by the National Association of Insurance Commissioners);

(b) a copy of each examination of the risk retention group as certified by the commissioner or public official conducting the examination;

(c) upon request by the commissioner, a copy of any information or document pertaining to an outside audit performed with respect to the risk retention group; and

(d) such information as may be required to verify its continuing qualification as a risk retention group under RSA 405-A:1, XII.

III. 
Taxation.

(a) Each risk retention group shall be liable for the payment of premium taxes and taxes on premiums of direct business for risks resident or located within this state, and shall report to the commissioner the net premiums written for risks resident or located within this state. Such risk retention group shall be subject to taxation, and any applicable fines and penalties related thereto, on the same basis as a foreign admitted insurer. A risk retention group failing to remit the proper tax within the time period for filing shall pay a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

(b) To the extent licensed agents or brokers are utilized pursuant to RSA 405-A:11, they shall report to the commissioner the premiums for direct business for risks resident or located within this state which such licensees have placed with or on behalf of a risk retention group not chartered in this state.

(c) To the extent that insurance agents or brokers are utilized pursuant to RSA 405-A:11, such agent or broker shall keep a complete and separate record of all policies procured from each such risk retention group, which record shall be open to examination by the commissioner as provided in RSA 400-A:37. These records shall, for each policy and each kind of insurance provided thereunder, include the following:

(1) the limit of liability;

(2) the time period covered;

(3) the effective date;

(4) the name of the risk retention group which issued the policy;

(5) the gross premium charged; and

(6) the amount of return premiums, if any.

IV. 
Compliance With Unfair Claims Settlement Practices Law. Any risk retention group and its agents and representatives, shall comply with RSA 417, which regulates unfair trade practices, and any rules adopted under RSA 417.

V. 
Deceptive, False or Fraudulent Practices. Any risk retention group shall comply with the laws of this state regarding deceptive, false or fraudulent acts or practices. However, if the commissioner seeks an injunction regarding such conduct, the injunction must be obtained from a court of competent jurisdiction.

VI. 
Examination Regarding Financial Condition. Any risk retention group shall submit to an examination by the commissioner to determine its financial condition if the commissioner of the jurisdiction in which the group is chartered and licensed has not initiated an examination or does not initiate an examination within 60 days after a request by the commissioner of this state. Any such examination shall be coordinated to avoid unjustified repetition and conducted in an expeditious manner and in accordance with the National Association of Insurance Commissioners' Examiner Handbook.

VII. 
Notice to Purchasers. Every application form for insurance from a risk retention group, and every policy (on its front and declaration pages) issued by a risk retention group, shall contain in 10 point type the following notice:

NOTICE

This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. State insurance insolvency guaranty funds are not available for your risk retention group.

VIII. 
Prohibited Acts Regarding Solicitation or Sale. The following acts by a risk retention group are hereby prohibited:

(a) the solicitation or sale of insurance by a risk retention group to any person who is not eligible for membership in such group; and

(b) the solicitation or sale of insurance by, or operation of, a risk retention group that is in hazardous financial condition or financially impaired.

IX. 
Prohibition on Ownership by an Insurance Company. No risk retention group shall be allowed to do business in this state if an insurance company is directly or indirectly a member or owner of such risk retention group, other than in the case of a risk retention group all of whose members are insurance companies.

X. 
Prohibited Coverage. The terms of any insurance policy issued by any risk retention group shall not provide, or be construed to provide, coverage prohibited generally by statute of this state or declared unlawful by the highest court of this state whose law applies to such policy.

XI. 
Delinquency Proceedings. A risk retention group not chartered in this state and doing business in this state shall comply with a lawful order issued in a voluntary dissolution proceeding or in a delinquency proceeding commenced by a state insurance commissioner if there has been a finding of financial impairment after an examination under RSA 405-A:3, VI.

XII. 
Penalties. A risk retention group that violates any provision of this chapter shall be subject to fines and penalties including revocation of its right to do business in this state, applicable to licensed insurers generally.

XIII. 
Operation Prior to Enactment of This Chapter. In addition to complying with the requirements of this section, any risk retention group operating in this state prior to enactment of this chapter shall, within 30 days after the effective date of this chapter, comply with the provisions of paragraph I of this section.


Source. 1988, 133:2. 1994, 120:1, 2, eff. July 10, 1994. 2019, 179:4, eff. Jan. 1, 2020.

    405-A:4 Compulsory Associations. 

I. No risk retention group shall be required or permitted to join or contribute financially to any insurance insolvency guaranty fund, or similar mechanism, in this state, nor shall any risk retention group, or its insureds or claimants against its insureds, receive any benefit from any such fund for claims arising under the insurance policies issued by such risk retention group.

II. When a purchasing group obtains insurance covering its members' risks from an insurer not authorized in this state or a risk retention group, no such risks, wherever resident or located, shall be covered by any insurance guaranty fund or similar mechanism in this state.

III. When a purchasing group obtains insurance covering its members' risks from an authorized insurer, only risks resident or located in this state shall be covered by the fund administered by the New Hampshire Insurance Guaranty Association established in RSA 404-B.

IV. A risk retention group shall participate in this state's joint underwriting associations and mandatory liability pools as authorized by RSA 404-C.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:5 Repealed by 2010, 212:14, eff. Jan. 1, 2011. 

    405-A:6 Purchasing Groups;  Exemption From Certain Laws. 

A purchasing group and its insurer or insurers shall be subject to all applicable laws of this state, except that a purchasing group and its insurer or insurers shall be exempt, in regard to liability insurance for the purchasing group, from any law that would:

I. Prohibit the establishment of a purchasing group;

II. Make it unlawful for an insurer to provide or offer to provide insurance on a basis providing, to a purchasing group or its members, advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages or other matters;

III. Prohibit a purchasing group or its members from purchasing insurance on a group basis described in paragraph II of this section;

IV. Prohibit a purchasing group from obtaining insurance on a group basis because the group has not been in existence for a minimum period of time or because any member has not belonged to the group for a minimum period of time;

V. Require that a purchasing group must have a minimum number of members, common ownership or affiliation, or certain legal form;

VI. Require that a certain percentage of a purchasing group must obtain insurance on a group basis; or

VII. Otherwise discriminate against a purchasing group or any of its members.


Source. 1988, 133:2. 2010, 212:10, eff. Jan. 1, 2011.

    405-A:7 Notice and Registration Requirements of Purchasing Groups. 

I. A purchasing group which intends to do business in this state shall, prior to doing business, furnish notice to the commissioner which shall:

(a) identify the state in which the group is domiciled;

(b) identify all other states in which the group intends to do business;

(c) specify the lines and classifications of liability insurance which the purchasing group intends to purchase;

(d) identify the insurance company or companies from which the group intends to purchase its insurance and the domicile of such company;

(e) specify the method by which, and the person or persons, if any, through whom insurance will be offered to its members whose risks are resident or located in this state;

(f) identify the principal place of business of the group; and

(g) provide such other information as may be required by the commissioner to verify that the purchasing group is qualified under RSA 405-A:3.

II. A purchasing group shall, within 10 days, notify the commissioner of any changes in any of the items set forth in paragraph I.

III. The purchasing group shall register with and designate the commissioner as its agent solely for the purpose of receiving service of legal documents or process, for which a filing fee shall be determined by the commissioner, except that such requirement shall not apply in the case of a purchasing group which only purchases insurance that was authorized under the federal Product Liability Risk Retention Act of 1981; and:

(a) which in any state of the United States:

(1) was domiciled before April 1, 1986; and

(2) is domiciled on or after October 27, 1986;

(b) which:

(1) before October 27, 1986 purchased insurance from an insurance carrier licensed in any state; and

(2) since October 27, 1986, purchased its insurance from an insurance carrier licensed in any state; or

(c) which was a purchasing group under the requirements of the Product Liability Risk Retention Act of 1981 before October 27, 1986.

IV. Each purchasing group that is required to give notice pursuant to paragraph I of this section shall also furnish such information as may be required by the commissioner to:

(a) verify that the entity qualifies as a purchasing group;

(b) determine where the purchasing group is located; and

(c) determine appropriate tax treatment.

V. Any purchasing group which was doing business in this state prior to the enactment of this chapter shall, within 30 days after the effective date of the chapter, furnish notice to the commissioner pursuant to the provisions of paragraph I of this section and furnish such information as may be required pursuant to paragraphs III and IV of this section.


Source. 1988, 133:2. 1992, 288:19, eff. Jan. 1, 1993.

    405-A:8 Restrictions on Insurance Purchased by Purchasing Groups. 

I. A purchasing group may not purchase insurance on behalf of its New Hampshire members from a risk retention group that is not chartered in a state or from an insurer not admitted in this state, unless the purchase is effected through a licensed agent or broker acting pursuant to the surplus lines laws and regulations of this state.

II. A purchasing group which obtains liability insurance from an insurer not admitted in this state or a risk retention group shall inform each of the members of such group which have a risk resident or located in this state that such risk is not protected by an insurance insolvency guaranty fund in this state, and that such risk retention group or such insurer may not be subject to all insurance laws and rules of this state.

III. No purchasing group may purchase insurance providing for a deductible or self-insured retention applicable to the group as a whole; however, coverage may provide for a deductible or self-insured retention applicable to individual members.

IV. Purchases of insurance by purchasing groups are subject to the same standards regarding aggregate limits which are applicable to all purchases of group insurance.


Source. 1988, 133:2, eff. April 20, 1988.

    405-A:9 Purchasing Group Taxation. 

Premium taxes and taxes on premiums paid for coverage of risks resident or located in this state by a purchasing group or any members of the purchasing groups shall be:

I. Imposed at the same rate and subject to the same interest, fines and penalties as are applicable to premium taxes and taxes on premiums paid for similar coverage from a similar insurance source by other insureds; and

II. Paid first by such insurance source, and if not by such source by the agent or broker for the purchasing group, and if not by such agent or broker, then by the purchasing group, and if not by such purchasing group, then by each of its members.


Source. 1988, 133:2, eff. April 20, 1988.

    405-B:1 Purpose. 

The purpose of this chapter is to enable the collection and disbursement of premium taxes for nonadmitted insurance, including surplus lines insurance, necessitated by the passage of the Nonadmitted and Reinsurance Reform Act of 2010 (NRRA), which was incorporated intact into the Dodd-Frank Wall Street Reform and Consumer Protection Act, H.R. 4173.


Source. 2011, 191:5, eff. Aug. 13, 2011.

    405-B:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Home state
" means, except as provided in subparagraph (b), with respect to an insured:

(a) The state in which an insured maintains its principal place of business or, in the case of an individual, the individual's principal residence; or

(b) If 100 percent of the insured risk is located out of the state referred to in subparagraph (a), the state to which the greatest percentage of the insured's taxable premium for that insurance contract is allocated.

III. "
Multi-state risk
" means a risk covered by a nonadmitted insurer with insured exposures in more than one state.


Source. 2011, 191:5, eff. Aug. 13, 2011.

    405-B:3 Cooperative or Reciprocal Agreements. 

For the purposes of carrying out the provisions of the Nonadmitted and Reinsurance Reform Act of 2010, the commissioner is authorized to enter into a cooperative or reciprocal agreement, or compact with another state in order to facilitate the collection, allocation, and disbursement of premium taxes attributable to the placement of nonadmitted insurance, provide for uniform methods of allocation and reporting among nonadmitted insurance risk classifications, and share information among states relating to nonadmitted insurance premium taxes.


Source. 2011, 191:5, eff. Aug. 13, 2011.

    405-B:4 Single Home State Rate;  Surplus Lines. 

I. Every person who procures or causes to be procured or continues or renews insurance with a surplus lines company shall collect and pay to the commissioner a sum based on the total gross premiums charged, less any return premiums, for surplus insurance provided by the licensee pursuant to the license.

II. Where the insurance covers properties, risks, or exposures located or to be performed both in and out of this state, the sum payable shall be computed based on:

(a) An amount equal to 3 percent on that portion of the gross premiums allocated to this state, plus

(b) An amount equal to 3 percent on the portion of the premiums allocated to other states or territories, less

(c) The amount of gross premiums allocated to this state and returned to the insured.


Source. 2011, 191:5, eff. Aug. 13, 2011. 2019, 141:1, eff. Jan. 1, 2020.

    405-B:5 Single Home State Rate;  Independently Procured Under RSA 406-B:16. 

I. Every insured who procures or causes to be procured or continues or renews insurance with any unlicensed insurer pursuant to RSA 406-B:16 shall collect and pay to the commissioner a sum based on the total gross premiums charged, less any return premiums, for independently procured insurance.

II. Where the insurance covers properties, risks, or exposures located or to be performed both in and out of this state, the sum payable shall be computed based on:

(a) An amount equal to 3 percent on the portion of the gross premiums allocated to this state, plus

(b) An amount equal to 3 percent on the portion of the premiums allocated to other states or territories, less

(c) The amount of gross premiums allocated to this state and returned to the insured.


Source. 2011, 191:5, eff. Aug. 13, 2011. 2019, 141:2, eff. Jan. 1, 2020.

    405-B:6 Single Home State Rate;  Independently Procured Under RSA 406-B:17. 

I. Every insured who procures or causes to be procured or continues or renews insurance with any unlicensed insurer pursuant to RSA 406-B:17 shall collect and pay to the commissioner a sum based on the total gross premiums charged, less any return premiums, for independently procured insurance.

II. Where the insurance covers properties, risks, or exposures located or to be performed both in and out of this state, the sum payable shall be computed based on:

(a) An amount equal to 4 percent on such insurance other than marine insurance and a premium tax of 2 percent of gross premium charged for such marine insurance, the portion of the gross premiums allocated to this state, plus

(b) An amount equal to 4 percent on the portion of the premiums allocated to other states or territories, less

(c) The amount of gross premiums allocated to this state and returned to the insured.


Source. 2011, 191:5, eff. Aug. 13, 2011. 2019, 141:3, eff. Jan. 1, 2020.

    405-B:7 Clearinghouse Participation. 

The commissioner is authorized to participate in the clearinghouse established through the agreement or compact for the purpose of collecting and disbursing to reciprocal states any funds collected pursuant to RSA 405-B:4, RSA 405-B:5, and RSA 405-B:6 on properties, risks or exposures located or to be performed outside of this state. To the extent that other states where portions of the properties, risks or exposures reside have failed to enter into an agreement, compact or reciprocal allocation procedure with this state, the net premium tax collected shall be retained by this state.


Source. 2011, 191:5, eff. Aug. 13, 2011.

    405-B:8 Allocation Schedule. 

The commissioner is authorized to utilize or adopt the allocation schedule included in the agreement or compact for the purpose of allocating risk and computing the tax due on the portion of premium attributable to each risk classification and to each state where properties, risks or exposures are located.


Source. 2011, 191:5, eff. Aug. 13, 2011.

    405:1 Requirement. 

No insurance company not organized under the laws of this state shall do insurance business within the state unless it has obtained a license from the insurance commissioner authorizing it to do so.


Source. GL 174:22. 1889, 86:1. PS 169:1. PL 275:1. RL 325:1.

    405:10 Service of Process Through Insurance Commissioner. 

No such joint stock or mutual insurance company, nor its agents, shall do business in this state until it has filed with the commissioner a written stipulation, agreeing that legal process affecting the company, served on the commissioner for the time being, shall have the same effect as if served personally on the company within the state. Service of such process shall be made by leaving a copy of the process in the hands of the commissioner or in his office and paying to the commissioner a fee as prescribed by RSA 400-A:29.


Source. 1870, 1:1. 1875, 38:1. 1876, 11:1. GL 174:1. PS 169:4. PL 275:9. 1933, 32:1. RL 325:10. RSA 405:10. 1971, 244:2, eff. Aug. 17, 1971.

    405:11-a Prohibitions. 

I. No foreign insurer which is directly or indirectly owned or controlled in whole or in substantial part by any government or governmental agency shall be authorized to transact insurance in this state. Membership in a mutual insurer or subscribership in a reciprocal insurer or ownership of stock in an insurer by the alien property custodian or similar official of the United States or ownership of stock or other security which does not have voting rights with respect to the management of the insurer or supervision of an insurer by public authority shall not be deemed to be an ownership or control of the insurer for the purposes of this section.

II. The commissioner shall not grant or continue authority to transact insurance in this state as to any insurer or proposed insurer that management of which is found by the commissioner after investigation or upon reliable information to be incompetent or dishonest or untrustworthy or of unfavorable business repute or so lacking in insurance company managerial experience in operations of the kind proposed in this state as to make such operation, currently or prospectively, hazardous to or contrary to the best interests of, the insurance-buying or investing public of this state, or which the commissioner has good reason to believe is affiliated directly or indirectly through ownership, control, reinsurance transactions, or other business relations with any person or persons of unfavorable business repute or whose business operations are or have been marked, to the injury of insurers, stockholders, policyholders, creditors, or the public, by illegality, or by manipulation of assets or of accounts or of reinsurance or by bad faith.


Source. 2008, 18:13, eff. July 11, 2008.

    405:11 Preliminary Statements. 

Before a license is granted to a company it shall file with the commissioner a certified copy of its charter and by-laws and a full statement, under oath, of its president and secretary, showing the financial standing and condition of the company, in accordance with blanks furnished by the commissioner, except in cases where the company has already filed such papers, and shall otherwise comply with all laws relating to such companies.


Source. GL 174:2. 1889, 86:1. PS 169:5. PL 275:10. RL 325:11.

    405:12 Licenses. 

I. If the foregoing provisions are complied with and the commissioner is satisfied that the company (a) has the requisite capital and assets; (b) is a safe, reliable company, entitled to confidence; and (c) is consistent with the NAIC's Uniform Certificate of Authority Application process and standards, the commissioner shall grant a license to it to do insurance business by authorized agents within the state, subject to the laws of the state, until June 14 thereafter. Annually thereafter, on June 14, such license may be renewed so long as the company shall comply with the requirements of the law, NAIC guidelines, and the commissioner shall regard it as safe, reliable and entitled to confidence, and so long as the company continues to conduct a meaningful insurance business, as determined by the commissioner, within New Hampshire.

II. Every insurance company shall conduct its business in the legal name of the insurer as it appears on the insurer's application filed with the NAIC for a company code number. If an insurer is part of a group of affiliated insurers, the group name may appear in addition to the name of the individual insuring company, but the group name shall not be used in lieu of the legal name of the individual company.

(a) All insurance policies and contracts, and any endorsements or amendments separately issued and intended to be attached to such policies or contracts, shall identify the legal name, as set forth in paragraph II, of the insurer that is directly assuming the obligations under the policy or contract. Inclusion of the legal name of the insurer in a policy jacket, declaration, or other similar cover page issued with the policy, contract, or endorsement shall be deemed to be in compliance with this requirement.

(b) Identification of the insuring company on any advertisement or promotional materials shall be governed by the laws or rules related to the advertisements, misrepresentations in sale of insurance, and misrepresentation in insurance transactions.


Source. GL 174:2. 1889, 86:1. PS 169:6. PL 275:11. RL 325:12. RSA 405:12. 1973, 74:3. 1977, 232:5. 1983, 371:3. 2009, 215:2, eff. Jan. 1, 2010. 2021, 207:2, Pt. VI, Sec. 2, eff. Oct. 9, 2021.

    405:13 Revocation or Restriction of License. 

Such license may be revoked or restricted at any time by the commissioner for the causes and in the manner prescribed by law.


Source. GL 174:2. 1889, 86:1. PS 169:6. PL 275:12. RL 325:13. RSA 405:13. 1975, 229:2, eff. Aug. 2, 1975.

    405:14-a New License Required for Changed Conditions. 

The commissioner shall require a company licensed under this chapter to apply for a license in accordance with this chapter, if after notifying the company and after holding a hearing if requested, the commissioner finds that the company has undergone a substantial change in finances or managerial control since its last application for a license. The current license shall expire upon approval of the new application of the company or 30 days after the decision of the commissioner that a substantial change has occurred, whichever is sooner.


Source. 1975, 313:2, eff. Aug. 6, 1975.

    405:14 Notice of Revocation. 

If, in the opinion of the commissioner, the affairs of a foreign company so licensed are in an unsound or failing condition he shall revoke its license and all licenses that have been granted to its agents, by giving written notice of the revocation to the company and publishing a like notice in the newspaper published in Concord having the largest circulation in the state, and in the like newspaper published in Manchester.


Source. 1870, 1:5. GL 171:6. PS 169:6. PL 275:13. RL 325:14.

    405:15 Definition;  Agent. 

An insurance producer license to act as an agent shall be issued to any eligible person or business entity pursuant to the provisions of RSA 402-J.


Source. 1915, 32:1. 1919, 18:1. PL 275:17. RL 325:18. 2000, 315:10, eff. Jan. 1, 2001.

    405:16 Repealed by 2000, 315:26, XII, eff. Jan. 1, 2001. 

    405:17-a Repealed by 2000, 315:26, XIV, eff. Jan. 1, 2001. 

    405:17-b Insuring Through Producers. 

I. Foreign insurance or surety companies, although authorized to transact business within this state, shall only make, write, place, or cause to be made, written, or placed, policies or contracts of insurance or suretyship which are to be effective within this state through producers who are licensed and properly appointed to transact business in this state pursuant to RSA 402-J.

II. Foreign insurance or surety companies shall maintain books, records, and documents sufficient to demonstrate compliance with the provisions of paragraph I as provided in RSA 400-B.


Source. 1985, 179:4. 2000, 315:11. 2001, 95:4. 2009, 178:4, eff. Sept. 11, 2009.

    405:17-c Insurance Referrals. 

 Notwithstanding other provisions of this title, a person who has not complied with all applicable state insurance licensing and appointment laws and regulations may refer a party to a person who has complied with all applicable state insurance licensing and appointment laws and regulations, if the person making such referral is compensated for such referral in an amount that does not exceed a nominal amount and such amount is not based on or related to the party's purchase of insurance.


Source. 2000, 313:2, eff. Aug. 20, 2000.

    405:17 Repealed by 2000, 315:26, XIII, eff. Jan. 1, 2001. 

    405:18 Repealed by 1981, 4:1, eff. March 6, 1981. 

    405:19 Repealed by 1981, 4:2, eff. March 6, 1981. 

    405:2 Stock Company. 

No such stock insurance company shall be licensed to do business in the state unless it shall possess a paid-up capital of $800,000, invested in securities readily convertible into cash, 
1/2 at least of which are not loans secured by real estate; nor unless it shall possess, in addition to such capital, assets equal in amount to all its outstanding liabilities, estimating 50 percent of premiums received on unexpired fire risks running one year or less from date of policy, and a pro rata amount of all premiums received on unexpired risks running more than one year from date of policy, and on marine risks 50 percent of the amount of premiums written on policies upon yearly risks, and upon risks covering more than one passage not terminated, and the full amount of premiums written on policies of all other marine risks not terminated as a liability.


Source. 1870, 1:1. 1875, 38:1. 1876, 11:1. GL 174:1. PS 169:2. 1907, 10:1; 37:1. 1921, 128:1. PL 275:2. RL 325:2. 1947, 182:5. RSA 405:2. 1969, 283:5, eff. June 25, 1969.

    405:20, 405:21 Repealed by 1967, 237:3, eff. Aug. 22, 1967. 

    405:22 Repealed by 1981, 4:3, eff. March 6, 1981. 

    405:23 Repealed by 1981, 4:4, eff. March 6, 1981. 

    405:24-a Definitions. 

In this subdivision:

I. "
Admitted insurer
" means an insurer licensed to do an insurance business in this state.

II. "
Alien insurer
" means an insurance company formed according to the laws of a foreign country.

III. "
Capital
," as used in the financial requirements of RSA 405:24, means funds paid in for stock or other evidence of ownership.

IV. "
Eligible surplus lines insurer
" means an unadmitted insurer with which a surplus lines licensee may place surplus lines insurance pursuant to RSA 405:24.

V. "
Foreign insurer
" means an insurance company selling policies in a state other than the state in which they are incorporated or domiciled.

VI. "
Insurer
" means any person, corporation, association, partnership, and reciprocal exchange, interinsurer, Lloyds insurer, insurance exchange syndicate, and any other legal entity engaged in the of business of insurance.

VII. "
Nonadmitted
" or "
unadmitted
" means an insurer not licensed to do business in this state.

VIII. "
Person
" means any natural person or other entity, including, but not limited to, individuals, partnerships, associations, trusts, or corporations.

IX. "
Policy
" or "
contract
" means any contract of insurance, including but not limited to indemnity, fidelity, or suretyship.

X. "
Surplus
," as used in the financial requirements of RSA 405:24, means funds over and above liabilities and capital of the company for the protection of policyholders.

XI. "
Surplus lines insurance
" means property and casualty insurance in this state on properties, risks or exposures, located or performed in this state, permitted to be placed through a surplus lines licensee with an unadmitted insurer eligible to accept such insurance, pursuant to RSA 405:24.

XII. "
Surplus lines licensee
" means an individual, firm, or corporation licensed under RSA 405:24 to place insurance on properties, risks, or exposures located or to be performed in this state with unadmitted insurers eligible to accept such insurance.

XIII. "
Type of insurance
" means coverage afforded under the particular policy that is being placed.


Source. 2019, 14:1, eff. July 9, 2019.

    405:24 Applicability;  Issue. 

I. Foreign unlicensed companies that satisfy the provisions of RSA 405:26 and are approved by the commissioner as unadmitted surplus lines companies are not subject to any statutory or regulatory provision unless the statute or regulation specifically references unadmitted surplus lines companies; provided however, unadmitted surplus lines companies shall be subject to RSA 417:1 through RSA 417:22.

II. (a) Surplus lines insurance may be placed by a surplus lines licensee if the insurer is authorized to write the type of insurance in its domiciliary jurisdiction, and either meets the criteria established through a multi-state agreement pursuant to RSA 405-B:3 or meets one of the following criteria:

(b) The insurer has capital and surplus or its equivalent under the laws of its domiciliary jurisdiction which equals the greater of:

(1) The minimum capital and surplus requirements under RSA 401:4 or RSA 402:13;

(2) Fifteen million dollars; or

(3) The insurer is a nonadmitted insurer domiciled outside the United States that is listed on the Quarterly Listing of Alien Insurers maintained by the International Insurers Department of the National Association of Insurance Commissioners.

III. The commissioner, pursuant to RSA 402-J, may issue a producer license to a resident of the state permitting the producer named therein to procure insurance policies and contracts of insurance or suretyship to be effective in this state in foreign insurance companies not authorized to transact business in this state, but which are duly authorized to do business in some state having an insurance commissioner, or in a domestic insurer authorized to do business in accordance with paragraph IV. Such insurance or suretyship placed with an unadmitted surplus lines company shall be for such amount as the producer cannot place with an admitted company, and shall not be placed until the producer has first satisfied the insurance commissioner that the producer cannot procure such an insurance in an admitted company. For purposes of this paragraph, an insurer authorized to do business in accordance with paragraph IV shall not be deemed to be authorized or admitted. Before delivering to the insured a policy or binder of insurance written under the provisions of this section, every producer shall have stamped in a form approved by the commissioner on the face of the binder or policy the following: "The company issuing this policy is an eligible surplus lines insurer in the state of New Hampshire and the rates charged and policy forms used have not been approved by the commissioner of insurance. If the company issuing this policy becomes insolvent, the New Hampshire insurance guaranty fund shall not be liable for any claims made against the policy."

IV. A domestic insurer possessing policyholder surplus of at least $15,000,000 may, pursuant to a resolution by its board of directors, and with the approval of the commissioner, be designated as a domestic surplus lines insurer. The authority of a domestic surplus lines insurer in this state shall be limited to providing insurance covering risks procured from a surplus lines producer in accordance with this section. A domestic surplus lines insurer is not subject to the provisions of Title XXXVII, except that it shall be subject to any statute or regulation which specifically references unadmitted surplus lines companies and to the provisions of RSA 400-A:37, RSA 400-A:39, RSA 404-F, and RSA 417:1 through 417:31.


Source. 1911, 168:1. PL 275:20. RL 325:25. 1947, 173:1. RSA 405:24. 1959, 206:1. 1969, 366:6. 1983, 473:12. 1986, 59:1. 2000, 315:12. 2001, 95:5. 2008, 255:2. 2011, 191:6, eff. Aug. 13, 2011.

    405:25 Monthly Statements. 

Every such licensee shall, on or before the tenth day of each month, execute and file with the commissioner, a statement under oath covering all insurance policies and contracts of insurance or suretyship procured by him under his said license during the calendar month next preceding, giving the name of the company issuing each of said policies, the name and residence of the insured and the amount, term and premium of each policy and contract and the kind of property or risk insured thereby, and that he was unable to procure in companies admitted to do business in the state the amount of insurance necessary to protect said property or risk.


Source. 1911, 168:2. PL 275:21. RL 325:26. 1947, 173:2, eff. June 4, 1947.

    405:26 Companies Excluded. 

Such licensee shall not offer any portion of such insurance to any company which has not been approved by the insurance commissioner and does not possess and maintain a surplus to policyholders of at least $500,000 or to any company which has within the preceding 24 months been in an impaired condition.


Source. 1911, 168:2. PL 275:22. RL 325:27. RSA 405:26. 1969, 283:8, eff. June 25, 1969.

    405:27 Unlicensed Persons. 

No person, unless he shall be so licensed, shall act or aid in any manner in placing policies and contracts of insurance or suretyship to be effective in this state, or other than his own, in any company which is not duly authorized to transact business in this state. No foreign insurance company or other insurer shall issue any policy for which the requirements of this subdivision are not met.


Source. 1911, 168:2. PL 275:23. RL 325:28. 1947, 173:3. RSA 405:27. 1983, 473:13, eff. Sept. 3, 1983.

    405:28 Accounts;  Reports. 

Each person so licensed shall keep a separate account of the business done under the license, a certified copy of which account he shall forthwith file with the commissioner, showing the exact amount of such insurance placed for any person, firm or corporation, the gross premium charged thereon, the companies in which the same is placed, the date of the policies and the term thereof; and he shall also file a report in the same detail of all such policies cancelled and the gross return premium thereon.


Source. 1911, 168:3. PL 275:24. RL 325:29.

    405:29-a Annual Statement;  Tax;  Insurance Transactions on Multi-State Risks. 

For each licensed producer of unlicensed surplus lines companies reporting multi-state transactions, the provisions of RSA 405-B shall apply.


Source. 2011, 191:1, eff. Aug. 13, 2011.

    405:29 Annual Statement;  Tax. 

I. Each licensed producer shall file with the commissioner, not later than January 31st of each year, a sworn statement of the gross premiums charged for insurance procured or placed and the gross return premiums on such insurance cancelled under such license during the year ending on December 31 next preceding, and at the time of filing such statement shall pay to the state treasurer a sum equal to 3 percent of such gross premiums less such return premiums reported.

II. Any producer failing to file the report or failing to remit the proper tax within the time period for filing shall pay a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

III. Each producer filing under this section shall be subject to the provisions of RSA 400-A:32-a.


Source. 1911, 168:4. PL 275:25. RL 325:30. 2008, 154:2. 2010, 13:4, eff. July 1, 2010. 2019, 179:3, eff. Jan. 1, 2020.

    405:3 Life Insurance Company. 

If it is a life insurance company the premium reserve on life risks, based on the actuaries' table of mortality, with interest at 4 percent, shall be treated as a liability.


Source. 1870, 1:1. 1875, 38:1. 1876, 11:1. GL 174:1. PS 169:2. PL 275:3. RL 325:3.

    405:30 Investigation. 

The commissioner shall have authority at all times to investigate any alleged violations of this subdivision, and should he find any to exist he shall report the same to the attorney-general, who shall take proceedings to collect all fees and taxes which may be due from said licensee.


Source. 1911, 168:5. PL 275:26. RL 325:31.

    405:31 Penalty. 

Any person who violates or fails to comply with any of the provisions of this subdivision shall be subject to a fine not more than $2,500 or have any license suspended or revoked or shall both be fined and have any license suspended or revoked.


Source. 1911, 168:5. PL 275:27. RL 325:32. RSA 405:31. 1973, 530:55. 1983, 473:14, eff. Sept. 3, 1983.

    405:32 Repealed by 2000, 315:26, XV, eff. Jan. 1, 2001. 

    405:33 Repealed by 2000, 315:26, XVI, eff. Jan. 1, 2001. 

    405:34 Brokers;  Producer License. 

 An insurance producer license to act as a broker shall be issued to any eligible person or business entity pursuant to the provisions of RSA 402-J.


Source. 1915, 63:4. 1917, 23:1. PL 275:29. RL 325:35. 2000, 315:13, eff. Jan. 1, 2001.

    405:35 Repealed by 2000, 315:26, XVII, eff. Jan. 1, 2001. 

    405:36 Repealed by 2000, 315:26, XVIII, eff. Jan. 1, 2001. 

    405:37-a Repealed by 2000, 315:26, XX, eff. Jan. 1, 2001. 

    405:37 Repealed by 2000, 315:26, XIX, eff. Jan. 1, 2001. 

    405:38 Repealed by 1963, 310:2, eff. Sept. 1, 1963. 

    405:39 Repealed by 2000, 315:26, XXI, eff. Jan. 1, 2001. 

    405:4 Mutual Insurance Company. 

No such mutual insurance company shall be licensed to do business in the state unless it shall possess $800,000 of surplus to policyholders invested as provided in RSA 405:2, nor unless its assets equal its outstanding liabilities, including reinsurance, to be estimated as in the case of joint stock insurance companies, and including also the amount of its guaranteed capital.


Source. 1870, 1:1. 1875, 38:1. 1876, 11:1. GL 174:1. PS 169:3. PL 275:4. RL 325:4. RSA 405:4. 1969, 283:6, eff. June 25, 1969.

    405:40 Repealed by 2000, 315:26, XXII, eff. Jan. 1, 2001. 

    405:41 Repealed by 2000, 315:26, XXIII, eff. Jan. 1, 2001. 

    405:42 Repealed by 2000, 315:26, XXIV, eff. Jan. 1, 2001. 

    405:43 Effect of Broker's Knowledge. 

Companies issuing policies through their agents on applications from brokers shall be charged with the broker's knowledge of facts to the same extent as if he were their agent.


Source. 1915, 63:3. PL 275:38. RL 325:43.

    405:44-a Consultants;  Producer;  License Required. 

I. No person, corporation, partnership or association shall engage in any of the following acts without holding a valid producer license pursuant to RSA 402-J and complying with the provisions of RSA 405:44-a through RSA 405:44-g:

(a) Place on any advertisements, cards, signs, circulars or letterheads, or elsewhere, or in any other way or manner by which public announcements are made, use the title "insurance consultant," "insurance adviser," "insurance specialist," "insurance counselor," "insurance analyst," "policyholders' advisor," "policyholders' counselor," or any other similar title, or any title, word or combination of words indicating that the person, corporation, partnership or association gives, or is engaged in the business of giving, advice, counsel, recommendation or information to holders of policies of insurance or annuity or pure endowment contracts; or

(b) For a fee received or to be received, offer to examine, or examine or aid in examining, any policy of insurance for any annuity or pure endowment contract for the purpose of giving, or give or offer to give, any advice, counsel, recommendation or information in respect to the terms, conditions, benefits, coverage or premium of any such policy or contract, or in respect to the expediency or advisability of altering, changing, exchanging, converting, replacing, surrendering, continuing, renewing or rejecting any such policy or contract, or of accepting or procuring any such policy or contract from any company.

II. The term "
fee
" as used in this section means compensation paid by a person served by any person required to be licensed under RSA 402-J. Fee shall not be construed to mean the commission paid to a licensed insurance producer by an insurer.


Source. 1986, 58:1. 2000, 315:14. 2001, 95:3. 2008, 212:2, eff. June 16, 2008.

    405:44-b Consultants;  Application for License;  Standards;  Fee;  Revocation;  Suspension;  Hearing. 

I. The commissioner may, upon receipt of a fee pursuant to RSA 400-A:29, issue to any person who has attained the age of 18 or to any corporation, partnership or association a producer's license to act as an insurance consultant. The applicant for the license shall apply for such license pursuant to the provisions of RSA 402-J.

II, III. [Repealed.]

IV. The commissioner may at any time, for cause shown and after a hearing, due notice of which has been given, revoke the license or suspend it for a period not exceeding the unexpired term of the license. The commissioner may, for cause shown and after a hearing, due notice of which has been given, revoke the license while so suspended, and shall notify the licensee in writing of such revocation or suspension, and shall publish a notice of such revocation or suspension in such manner as he may deem necessary for the protection of the public.

V. The commissioner may at any time require such information as he deems necessary as to the business methods, policies and transactions of a licensee under this section. Any person, corporation, partnership or association who fails or refuses to furnish the commissioner, in such form as he may require, any such information within 10 days after receiving a written request therefor shall be subject to suspension or revocation of his license or an administrative fine of not more than $2,500, or both a fine and suspension or revocation.


Source. 1986, 58:1. 2000, 315:15, 26, XXVI. 2008, 18:15, eff. July 11, 2008.

    405:44-c Appeal. 

Any person, corporation, partnership or association aggrieved by the action of the commissioner in revoking, suspending or refusing to grant or reissue a license may file an appeal in accordance with the provisions of RSA 541.


Source. 1986, 58:1, eff. July 1, 1986.

    405:44-d Unenforceable Contracts or Agreements. 

Any contract or agreement with an insurance consultant shall not be enforceable by him unless it is in writing and executed, in duplicate, by the person to be charged or by his legal representative, or unless one of such duplicates is delivered to, or retained by, such person when it is signed by him, or unless it plainly specifies the amount of the fee paid or payable by such person and the services to be rendered by such insurance consultant, or unless it is in a form currently approved by the commissioner.


Source. 1986, 58:1, eff. July 1, 1986.

    405:44-e Required Acknowledgments. 

An insurance consultant who furnishes any advice or counsel as such consultant, makes any recommendation or gives any information except under the terms of a previously executed written contract conforming to RSA 405:44-d and in full force and effect shall, in every case, give to the recipient a statement in writing, signed by him, in a form currently approved by the commissioner, specifying the advice, counsel, recommendation or information given, and a receipt, in a form currently approved by the commissioner, for the fee paid to him or a statement, in a form currently approved by the commissioner, of the fee to be received by him. Any person, corporation, partnership or association who violates any provision of this section shall be subject to suspension or revocation of his or its license or an administrative fine of not more than $2,500, or both a fine and suspension or revocation.


Source. 1986, 58:1, eff. July 1, 1986.

    405:44-f Disclosure Statement. 

I. In addition to those records and reports which the commissioner may require pursuant to title XXXVII, any person, corporation, partnership or association subject to the provisions of this subdivision shall provide to current and prospective clients a written disclosure statement containing information relative to his or its background and business practices. The written disclosure statement shall include information concerning all of the following:

(a) The types of clients serviced by the insurance consultant.

(b) The nature and cost of services provided.

(c) The methods of analysis, sources of information and investment strategies utilized.

(d) The educational background of the insurance consultant and his employees or associates and the business standards to which he adheres.

(e) Any other business activities or professions in which the insurance consultant is engaged.

(f) Any ownership interest the insurance consultant may have in entities offering products which may be recommended by the insurance consultant.

(g) Whether there are any sales fees and commissions which the insurance consultant may receive for recommending particular insurance products to clients.

(h) Any other information relative to the insurance consultant's background and business practices which the commissioner deems appropriate.

II. The written disclosure statement shall be delivered to clients or prospective clients not less than 48 hours prior to the establishment of a written contract, or at the time the parties enter into the contract, if the client is afforded the right to terminate the contract, without penalty, within 5 business days after entering into it.


Source. 1986, 58:1, eff. July 1, 1986.

    405:44-g Penalty for Acting Without a License. 

Any person, corporation, partnership, or association who acts as an insurance consultant without such license or during a suspension of his or its license shall be subject to an administrative fine not to exceed $2,500 for each such act.


Source. 1986, 58:1, eff. July 1, 1986.

    405:44 Repealed by 2000, 315:26, XXV, eff. Jan. 1, 2001. 

    405:45 Purpose. 

The purpose of this subdivision is to protect the interest of insureds, claimants, ceding insurers, assuming insurers, and the public generally. The general court hereby declares its intent is to ensure adequate regulation of insurers and reinsurers and adequate protection for those to whom they owe obligations. In furtherance of that state interest, the general court hereby provides a mandate that upon the insolvency of a non-U.S. insurer or reinsurer that provides security to fund its United States obligations in accordance with this subdivision, the assets representing the security shall be maintained in the United States and claims shall be filed with and valued by the state insurance commissioner with regulatory oversight, and the assets shall be distributed, in accordance with the insurance laws of the state in which the trust is domiciled that are applicable to the liquidation of domestic United States insurance companies. The general court declares that the matters contained in this subdivision are fundamental to the business of insurance in accordance with 15 U.S.C. sections 1011-1012.


Source. 2004, 186:1. 2013, 235:1, eff. Sept. 13, 2013.

    405:46 Definitions. 

In this subdivision:

I. "
NAIC
" means the National Association of Insurance Commissioners.

II. A "
qualified U.S. financial institution
" means an institution that:

(a) Is organized or, in the case of a U.S. office of a foreign banking organization, licensed, under the laws of the United States or any state thereof;

(b) Is regulated, supervised, and examined by U.S. federal or state authorities having regulatory authority over banks and trust companies; and

(c) Has been determined by either the commissioner or the Securities Valuation Office of the National Association of Insurance Commissioners to meet such standards of financial condition and standing as are considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the commissioner.

III. A "
qualified U.S. financial institution
" means, for purposes of those provisions of this subdivision specifying those institutions that are eligible to act as a fiduciary of a trust, an institution that:

(a) Is organized, or, in the case of a U.S. branch or agency office of a foreign banking organization, licensed, under the laws of the United States or any state thereof and has been granted authority to operate with fiduciary powers; and

(b) Is regulated, supervised, and examined by federal or state authorities having regulatory authority over banks and trust companies.


Source. 2004, 186:1. 2013, 235:2, eff. Sept. 13, 2013.

    405:47 Credit Allowed a Domestic Ceding Insurer. 

Credit for reinsurance shall be allowed a domestic ceding insurer as either an asset or a reduction from liability on account of reinsurance ceded only when the reinsurer meets the requirements of paragraphs I, II, III, IV, or V; provided that the commissioner may adopt by rule, pursuant to RSA 541-A, specific additional requirements relating to or setting forth the valuation of assets or reserve credits, the amount and forms of security supporting reinsurance arrangements described in RSA 405:51, and the circumstances pursuant to which credit shall be reduced or eliminated. Credit shall be allowed under paragraphs I, II, or III only as respects cessions of those kinds or classes of business which the assuming insurer is licensed or otherwise permitted to write or assume in its state of domicile or, in the case of a U.S. branch of an alien assuming insurer, in the state through which it is entered and licensed to transact insurance or reinsurance. Credit shall be allowed under paragraphs III or IV only if the applicable requirements of paragraph VI have been satisfied.

I. Credit shall be allowed when the reinsurance is ceded to an assuming insurer that is licensed to transact insurance or reinsurance in this state.

II. Credit shall be allowed when the reinsurance is ceded to an assuming insurer that is accredited by the commissioner as a reinsurer in this state. To be eligible for accreditation a reinsurer shall:

(a) File with the commissioner evidence of its submission to this state's jurisdiction.

(b) Submit to this state's authority to examine its books and records.

(c) Be licensed to transact insurance or reinsurance in at least one state, or, in the case of a U.S. branch of an alien assuming insurer, is entered through and licensed to transact insurance or reinsurance in at least one state.

(d) File annually with the commissioner a copy of its annual statement filed with the insurance department of its state of domicile and a copy of its most recent audited financial statement.

(e) Demonstrate to the satisfaction of the commissioner that it has adequate financial capacity to meet its reinsurance obligations and is otherwise qualified to assume reinsurance from domestic insurers. An assuming insurer is deemed to meet the requirements as of the time of its application if it maintains a surplus as regards policyholders in an amount not less than $20,000,000 and its accreditation has not been denied by the commissioner within 90 days after submission of its application. 

III. (a) Credit shall be allowed when the reinsurance is ceded to an assuming insurer that is domiciled in, or, in the case of a U.S. branch of an alien assuming insurer, is entered through, a state that employs standards regarding credit for reinsurance substantially similar to those applicable under this subdivision and the assuming insurer or U.S. branch of an alien assuming insurer:

(1) Maintains a surplus as regards policyholders in an amount not less than $20,000,000; and

(2) Submits to the authority of this state to examine its books and records.

(b) Subparagraph (a)(1) does not apply to reinsurance ceded and assumed pursuant to pooling arrangements among insurers in the same holding company system.

IV. (a) Credit shall be allowed when the reinsurance is ceded to an assuming insurer that maintains a trust fund in a qualified United States financial institution, as defined in RSA 405:46 for the payment of the valid claims of its United States ceding insurers, their assigns and successors in interest. To enable the commissioner to determine the sufficiency of the trust fund, the assuming insurer shall report annually to the commissioner information substantially the same as that required to be reported on the NAIC Annual Statement form by licensed insurers. The assuming insurer shall submit to examination of its books and records by the commissioner and bear the expense of examination.

(b)(1) Credit for reinsurance shall not be granted under this section unless the form of the trust and any amendments to the trust have been approved by:

(A) The commissioner of the state where the trust is domiciled; or

(B) The commissioner of another state who, pursuant to the terms of the trust instrument, has accepted principal regulatory oversight of the trust.

(2) The form of the trust and any trust amendments also shall be filed with the commissioner of every state in which the ceding insurer beneficiaries of the trust are domiciled. The trust instrument shall provide that contested claims shall be valid and enforceable upon the final order of any court of competent jurisdiction of the United States. The trust shall vest legal title to its assets in its trustees for the benefit of the assuming insurer's U.S. ceding insurers, their assigns and successors in interest. The trust and the assuming insurer shall be subject to examination as determined by the commissioner.

(3) The trust shall remain in effect for as long as the assuming insurer has outstanding obligations due under the reinsurance agreements subject to the trust. No later than February 28 of each year, the trustee of the trust shall report to the commissioner in writing the balance of the trust and listing the trust's investments at the preceding year end and shall certify the date of termination of the trust, if so planned, or certify that the trust will not expire prior to the following December 31.

(c) The following requirements apply to the following categories of assuming insurers:

(1) The trust fund for a single assuming insurer shall consist of funds in trust in an amount not less than the assuming insurer's liabilities attributable to reinsurance ceded by U.S. ceding insurers, and, in addition, the assuming insurer shall maintain a trusteed surplus of not less than $20,000,000, except as provided in subparagraph (2).

(2) At any time after the assuming insurer has permanently discontinued underwriting new business secured by the trust for at least 3 full years, the commissioner with principal regulatory oversight of the trust may authorize a reduction in the required trusteed surplus, but only after a finding, based on an assessment of the risk, that the new required surplus level is adequate for the protection of U.S. ceding insurers, policyholders and claimants in light of reasonably foreseeable adverse loss development. The risk assessment may involve an actuarial review, including an independent analysis of reserves and cash flows, and shall consider all material risk factors, including when applicable the lines of business involved, the stability of the incurred loss estimates and the effect of the surplus requirements on the assuming insurer's liquidity or solvency. The minimum required trusteed surplus shall not be reduced to an amount less than 30 percent of the assuming insurer's liabilities attributable to reinsurance ceded by U.S. ceding insurers covered by the trust.

(3) In the case of a group including incorporated and individual unincorporated underwriters:

(A) For reinsurance ceded under reinsurance agreements with an inception, amendment, or renewal date on or after August 1, 1995, the trust shall consist of a trusteed account in an amount not less than the respective underwriters' several liabilities attributable to business ceded by U.S. domiciled ceding insurers to any underwriter of the group;

(B) For reinsurance ceded under reinsurance agreements with an inception date on or before July 31, 1995, and not amended or renewed after that date, notwithstanding the other provisions of this chapter, the trust shall consist of a trusteed account in an amount not less than the respective underwriters' several insurance and reinsurance liabilities attributable to business written in the United States; and

(C) In addition to these trusts, the group shall maintain in trust a trusteed surplus of which $100,000,000 shall be held jointly for the benefit of the U.S. domiciled ceding insurers of any member of the group for all years of account; and

(4) The incorporated members of the group shall not be engaged in any business other than underwriting as a member of the group and shall be subject to the same level of regulation and solvency control by the group's domiciliary regulator as are the unincorporated members.

(5) Within 90 days after its financial statements are due to be filed with the group's domiciliary regulator, the group shall provide to the commissioner an annual certification by the group's domiciliary regulator of the solvency of each underwriter member; or if a certification is unavailable, financial statements, prepared by independent public accountants, of each underwriter member of the group.

(d) In the case of a group of incorporated underwriters under common administration, the group shall:

(1) Have continuously transacted an insurance business outside the United States for at least 3 years immediately prior to making application for accreditation;

(2) Maintain aggregate policyholders' surplus of at least $10,000,000,000;

(3) Maintain a trust fund in an amount not less than the group's several liabilities attributable to business ceded by U.S. domiciled ceding insurers to any member of the group pursuant to reinsurance contracts issued in the name of the group;

(4) In addition, maintain a joint trusteed surplus of which $100,000,000 shall be held jointly for the benefit of U.S. domiciled ceding insurers of any member of the group as additional security for these liabilities; and

(5) Within 90 days after its financial statements are due to be filed with the group's domiciliary regulator, make available to the commissioner an annual certification of each underwriter member's solvency by the member's domiciliary regulator and financial statements of each underwriter member of the group prepared by its independent public accountant.

IV-a. Credit shall be allowed when the reinsurance is ceded to an assuming insurer that has been certified by the commissioner as a reinsurer in this state and secures its obligations in accordance with the requirements of this paragraph.

(a) To be eligible for certification, the assuming insurer shall meet the following requirements:

(1) Be domiciled and licensed to transact insurance or reinsurance in a qualified jurisdiction, as determined by the commissioner pursuant to subparagraph (c);

(2) Maintain minimum capital and surplus, or its equivalent, in an amount to be determined by the commissioner pursuant to rule;

(3) Maintain financial strength ratings from 2 or more rating agencies deemed acceptable to the commissioner pursuant to rule;

(4) Agree to submit to the jurisdiction of this state, appoint the commissioner as its agent for service of process in this state, and agree to provide security for 100 percent of the assuming insurer's liabilities attributable to reinsurance ceded by U.S. ceding insurers if it resists enforcement of a final U.S. judgment;

(5) Agree to meet applicable information filing requirements as determined by the commissioner, both with respect to an initial application for certification and on an ongoing basis; and

(6) Satisfy any other requirements for certification deemed relevant by the commissioner.

(b) An association including incorporated and individual unincorporated underwriters may be a certified reinsurer. To be eligible for certification, in addition to satisfying the requirements of subparagraph (a):

(1) The association shall satisfy its minimum capital and surplus requirements through the capital and surplus equivalents (net of liabilities) of the association and its members, which shall include a joint central fund that may be applied to any unsatisfied obligation of the association or any of its members, in an amount determined by the commissioner to provide adequate protection.

(2) The incorporated members of the association shall not be engaged in any business other than underwriting as a member of the association and shall be subject to the same level of regulation and solvency control by the association's domiciliary regulator as are the unincorporated members; and

(3) Within 90 days after its financial statements are due to be filed with the association's domiciliary regulator, the association shall provide to the commissioner an annual certification by the association's domiciliary regulator of the solvency of each underwriter member; or if a certification is unavailable, financial statements, prepared by independent public accountants, of each underwriter member of the association.

(c) The commissioner shall create and publish a list of qualified jurisdictions, under which an assuming insurer licensed and domiciled in such jurisdiction is eligible to be considered for certification by the commissioner as a certified reinsurer.

(1) To determine whether the domiciliary jurisdiction of a non-U.S. assuming insurer is eligible to be recognized as a qualified jurisdiction, the commissioner shall evaluate the appropriateness and effectiveness of the reinsurance supervisory system of the jurisdiction, both initially and on an ongoing basis, and consider the rights, benefits and the extent of reciprocal recognition afforded by the non-U.S. jurisdiction to reinsurers licensed and domiciled in the U.S. A qualified jurisdiction shall agree to share information and cooperate with the commissioner with respect to all certified reinsurance domiciled within that jurisdiction. A jurisdiction shall not be recognized as a qualified jurisdiction if the commissioner has determined that the jurisdiction does not adequately and promptly enforce final U.S. judgments and arbitration awards. Additional factors may be considered in the discretion of the commissioner.

(2) A list of qualified jurisdictions shall be published through the NAIC committee process. The commissioner shall consider this list in determining qualified jurisdictions. If the commissioner approves a jurisdiction as qualified that does not appear on the list of qualified jurisdictions, the commissioner shall provide thoroughly documented justification in accordance with criteria to be developed under regulation.

(3) U.S. jurisdictions that meet the requirement for accreditation under the NAIC financial standards and accreditation program shall be recognized as qualified jurisdictions.

(4) If a certified reinsurer's domiciliary jurisdiction ceases to be a qualified jurisdiction, the commissioner has the discretion to suspend the reinsurer's certification indefinitely, in lieu of revocation.

(d) The commissioner shall assign a rating to each certified reinsurer, giving due consideration to the financial strength ratings that have been assigned by rating agencies deemed acceptable to the commissioner pursuant to rule. The commissioner shall publish a list of all certified reinsurers and their ratings.

(e) A certified reinsurer shall secure obligations assumed from U.S. ceding insurers under this subparagraph at a level consistent with its rating, as specified in rules accepted by the commissioner.

(1) In order for a domestic ceding insurer to qualify for full financial statement credit for reinsurance ceded to a certified reinsurer, the certified reinsurer shall maintain security in a form acceptable to the commissioner and consistent with the provisions of RSA 405:50, or in a multi-beneficiary trust in accordance with RSA 405:47, IV, except as otherwise provided in this subparagraph.

(2) If a certified reinsurer maintains a trust to fully secure its obligations subject to RSA 405:47, IV, and chooses to secure its obligations incurred as a certified reinsurer in the form of a multi-beneficiary trust, the certified reinsurer shall maintain separate trust accounts for its obligations incurred under reinsurance agreements issued or renewed as a certified reinsurer with reduced security as permitted by this subparagraph or comparable laws of other U.S. jurisdictions and for its obligations subject to RSA 405:47, IV. It shall be a condition to the grant of certification under RSA 405:47, IV-a that the certified reinsurer shall have bound itself, by the language of the trust and agreement with the commissioner with principal regulatory oversight of each such trust account, to fund, upon termination of any such trust account, out of the remaining surplus of such trust any deficiency of any other such trust account.

(3) The minimum trusteed surplus requirements provided in RSA 405:47, IV are not applicable with respect to a multi-beneficiary trust maintained by a certified reinsurer for the purpose of securing obligations incurred under this paragraph, except that such trust shall maintain a minimum trusteed surplus of $10,000,000.

(4) With respect to obligations incurred by a certified reinsurer under this subparagraph, if the security is insufficient, the commissioner shall reduce the allowable credit by an amount proportionate to the deficiency, and has the discretion to impose further reductions in allowable credit upon finding that there is a material risk that the certified reinsurer's obligations will not be paid in full when due.

(5) For purposes of this subparagraph, a certified reinsurer whose certification has been terminated for any reason shall be treated as a certified reinsurer required to secure 100 percent of its obligations.

(A) In this subparagraph, "
terminated
" means revocation, suspension, voluntary surrender and inactive status.

(B) If the commissioner continues to assign a higher rating as permitted by other provisions of this section, this requirement does not apply to a certified reinsurer in inactive status or to a reinsurer whose certification has been suspended.

(f) If an applicant for certification has been certified as a reinsurer in an NAIC accredited jurisdiction, the commissioner has the discretion to defer to that jurisdiction's certification, and has the discretion to defer to the rating assigned by that jurisdiction, and such assuming insurer shall be considered to be a certified reinsurer in this state.

(g) A certified reinsurer that ceases to assume new business in this state may request to maintain its certification in inactive status in order to continue to qualify for a reduction in security for its in-force business. An inactive certified reinsurer shall continue to comply with all applicable requirements of this paragraph, and the commissioner shall assign a rating that takes into account, if relevant, the reasons why the reinsurer is not assuming new business.

IV-b. (a) Credit shall be allowed when the reinsurance is ceded to an assuming insurer meeting each of the conditions set forth in this paragraph.

(1) The assuming insurer must have its head office or be domiciled in, as applicable, and be licensed in a reciprocal jurisdiction. A "reciprocal jurisdiction" is a jurisdiction that meets one of the following:

(A) A non-U.S. jurisdiction that is subject to an in-force covered agreement with the United States, each within its legal authority, or, in the case of a covered agreement between the United States and European Union, is a member state of the European Union. For purposes of this subparagraph, a "covered agreement" is an agreement entered into pursuant to Dodd-Frank Wall Street Reform and Consumer Protection Act, 31 U.S.C. sections 313 and 314, that is currently in effect or in a period of provisional application and addresses the elimination, under specified conditions, of collateral requirements as a condition for entering into any reinsurance agreement with a ceding insurer domiciled in this state or for allowing the ceding insurer to recognize credit for reinsurance;

(B) A U.S. jurisdiction that meets the requirements for accreditation under the NAIC financial standards and accreditation program; or

(C) A qualified jurisdiction, as determined by the commissioner pursuant to RSA 405:47, IV-a(c), which is not otherwise described in subparagraph (A) or (B) and which meets certain additional requirements, consistent with the terms and conditions of in-force covered agreements, as specified by the commissioner in rules.

(2) The assuming insurer must have and maintain, on an ongoing basis, minimum capital and surplus, or its equivalent, calculated according to the methodology of its domiciliary jurisdiction, in an amount to be set forth in rules. If the assuming insurer is an association, including incorporated and individual unincorporated underwriters, it must have and maintain, on an ongoing basis, minimum capital and surplus equivalents (net of liabilities), calculated according to the methodology applicable in its domiciliary jurisdiction, and a central fund containing a balance in amounts to be set forth in rules.

(3) The assuming insurer must have and maintain, on an ongoing basis, a minimum solvency or capital ratio, as applicable, which will be set forth in rules. If the assuming insurer is an association, including incorporated and individual unincorporated underwriters, it must have and maintain, on an ongoing basis, a minimum solvency or capital ratio in the reciprocal jurisdiction where the assuming insurer has its head office or is domiciled, as applicable, and is also licensed.

(4) The assuming insurer must agree and provide adequate assurance to the commissioner, in a form specified by the commissioner pursuant to rules, as follows:

(A) The assuming insurer must provide prompt written notice and explanation to the commissioner if it falls below the minimum requirements set forth in subparagraphs (a)(2) or (3), or if any regulatory action is taken against it for serious noncompliance with applicable law;

(B) The assuming insurer must consent in writing to the jurisdiction of the courts of this state and to the appointment of the commissioner as agent for service of process. The commissioner may require that consent for service of process be provided to the commissioner and included in each reinsurance agreement. Nothing in this provision shall limit, or in any way alter, the capacity of parties to a reinsurance agreement to agree to alternative dispute resolution mechanisms, except to the extent such agreements are unenforceable under applicable insolvency or delinquency laws;

(C) The assuming insurer must consent in writing to pay all final judgments, wherever enforcement is sought, obtained by a ceding insurer or its legal successor, that have been declared enforceable in the jurisdiction where the judgment was obtained;

(D) Each reinsurance agreement must include a provision requiring the assuming insurer to provide security in an amount equal to 100 percent of the assuming insurer's liabilities attributable to reinsurance ceded pursuant to that agreement if the assuming insurer resists enforcement of a final judgment that is enforceable under the law of the jurisdiction in which it was obtained or a properly enforceable arbitration award, whether obtained by the ceding insurer or by its legal successor on behalf of its resolution estate; and

(E) The assuming insurer must confirm that it is not presently participating in any solvent scheme of arrangement which involves this state's ceding insurers, and agree to notify the ceding insurer and the commissioner and to provide security in an amount equal to 100 percent of the assuming insurer's liabilities to the ceding insurer, should the assuming insurer enter into such a solvent scheme of arrangement. Such security shall be in a form consistent with the provisions of paragraph IV-a and RSA 405:50 and as specified by the commissioner in rules.

(5) The assuming insurer or its legal successor must provide, if requested by the commissioner, on behalf of itself and any legal predecessors, certain documentation to the commissioner, as specified by the commissioner in rules.

(6) The assuming insurer must maintain a practice of prompt payment of claims under reinsurance agreements, pursuant to criteria set forth in rules.

(7) The assuming insurer's supervisory authority must confirm to the commissioner on an annual basis, as of the preceding December 31 or at the annual date otherwise statutorily reported to the reciprocal jurisdiction, that the assuming insurer complies with the requirements set forth in subparagraphs (a)(2) and (3).

(8) Nothing in this paragraph precludes an assuming insurer from providing the commissioner with information on a voluntary basis.

(b) The commissioner shall timely create and publish a list of reciprocal jurisdictions.

(1) A list of reciprocal jurisdictions is published through the NAIC committee process. The commissioner's list shall include any reciprocal jurisdiction as defined under subparagraphs (a)(1)(A) and (B), and shall consider any other reciprocal jurisdiction included on the NAIC list. The commissioner may approve a jurisdiction that does not appear on the NAIC list of reciprocal jurisdictions in accordance with criteria to be developed under rules adopted by the commissioner.

(2) The commissioner may remove a jurisdiction from the list of reciprocal jurisdictions upon a determination that the jurisdiction no longer meets the requirements of a reciprocal jurisdiction, in accordance with a process set forth in rules adopted by the commissioner, except that the commissioner shall not remove from the list a reciprocal jurisdiction as defined under subparagraph (a)(1)(A) and (B). Upon removal of a reciprocal jurisdiction from this list credit for reinsurance ceded to an assuming insurer which has its home office or is domiciled in that jurisdiction shall be allowed, if otherwise allowed pursuant to RSA 405:47.

(c) The commissioner shall timely create and publish a list of assuming insurers that have satisfied the conditions set forth in this paragraph and to which cessions shall be granted credit in accordance with this subparagraph. The commissioner may add an assuming insurer to such list if an NAIC accredited jurisdiction has added such assuming insurer to a list of such assuming insurers or if, upon initial eligibility, the assuming insurer submits the information to the commissioner as required under subparagraph (a)(4) and complies with any additional requirements that the commissioner may impose by rules, except to the extent that they conflict with an applicable covered agreement.

(d) If the commissioner determines that an assuming insurer no longer meets one or more of the requirements under this subparagraph, the commissioner may revoke or suspend the eligibility of the assuming insurer for recognition under this subparagraph in accordance with procedures set forth in rules.

(1) While an assuming insurer's eligibility is suspended, no reinsurance agreement issued, amended or renewed after the effective date of the suspension qualifies for credit except to the extent that the assuming insurer's obligations under the contract are secured in accordance with RSA 405:50.

(2) If an assuming insurer's eligibility is revoked, no credit for reinsurance may be granted after the effective date of the revocation with respect to any reinsurance agreements entered into by the assuming insurer, including reinsurance agreements entered into prior to the date of revocation, except to the extent that the assuming insurer's obligations under the contract are secured in a form acceptable to the commissioner and consistent with the provisions of RSA 405:50.

(e) If subject to a legal process of rehabilitation, liquidation, or conservation, as applicable, the ceding insurer, or its representative, may seek and, if determined appropriate by the court in which the proceedings are pending, may obtain an order requiring that the assuming insurer post security for all outstanding ceded liabilities.

(f) Nothing in this paragraph shall limit or in any way alter the capacity of parties to a reinsurance agreement to agree on requirements for security or other terms in that reinsurance agreement, except as expressly prohibited by this section or other applicable law or rules.

(g) Credit may be taken under this subparagraph only for reinsurance agreements entered into, amended, or renewed on or after the effective date of this paragraph, and only with respect to losses incurred and reserves reported on or after the later of (1) the date on which the assuming insurer has met all eligibility requirements pursuant to subparagraph (a), and (2) the effective date of the new reinsurance agreement, amendment, or renewal.

(1) This paragraph does not alter or impair a ceding insurer's right to take credit for reinsurance, to the extent that credit is not available under this paragraph, as long as the reinsurance qualifies for credit under any other applicable provision of this section.

(2) Nothing in this paragraph shall authorize an assuming insurer to withdraw or reduce the security provided under any reinsurance agreement except as permitted by the terms of the agreement.

(3) Nothing in this paragraph shall limit, or in any way alter, the capacity of parties to any reinsurance agreement to renegotiate the agreement.

V. Credit shall be allowed when the reinsurance is ceded to an assuming insurer not meeting the requirements of paragraphs I, II, III IV, IV-a, or IV-b but only with respect to the insurance of risks located in the jurisdictions where the reinsurance is required by applicable law or regulation of that jurisdiction.

VI. If the assuming insurer is not licensed, accredited, or certified to transact insurance or reinsurance in this state, the credit permitted by paragraphs III and IV shall not be allowed unless the assuming insurer agrees in the reinsurance agreements:

(a) That in the event of the failure of the assuming insurer to perform its obligations under the terms of the reinsurance agreement, the assuming insurer, at the request of the ceding insurer:

(1) Shall submit to the jurisdiction of any court of competent jurisdiction in any state of the United States;

(2) Shall comply with all requirements necessary to give such court jurisdiction; and

(3) Shall abide by the final decision of such court or of any appellate court in the event of an appeal.

(b) To designate the commissioner or a designated attorney as its true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by or on behalf of the ceding insurer.

(c) This paragraph is not intended to conflict with or override the obligation of the parties to a reinsurance agreement to arbitrate their disputes, if this obligation is created in the agreement.

VII. (a) No credit under this section shall be allowed, as an admitted asset or deduction from liability, to any ceding insurer for reinsurance, unless the reinsurance contract provides, in substance, that in the event of the insolvency of the ceding insurer, the reinsurance shall be payable by the assuming insurer on the basis of the claims allowed against the ceding insurer in the insolvency proceedings, under contract or contracts reinsured, without diminution because of the insolvency of the ceding insurer directly to the ceding insurer or to its domiciliary liquidator or receiver except:

(1) Where the contract specifically provides another payee of such reinsurance in the event of the insolvency of the ceding insurer; or

(2) Where the assuming insurer with the consent of the direct insured or insured has assumed such policy obligations of the ceding insurer as direct obligations of the assuming insurer to the payees under such policies and in substitution for the obligations of the ceding insurer to such payees.

(b) A reinsurance contract may provide that the domiciliary liquidator or receiver of any insolvent ceding insurer shall, within a specified or reasonable time after the claim is filed in court or in the receivership, give written notice to the assuming insurer of all or part of any claims against the ceding insurer on the policy or bond reinsured. During the pendency of the claim, any assuming insurer may investigate the claim and, unless forbidden to do so by the reinsurance agreement, may intervene in the proceeding in which the claim is pending and interpose any defenses it considers available which have not been raised by the ceding insurer, its liquidator, or receiver. The expenses incurred by the assuming insurer in this type of action are payable up to the amount of the expenses or the amount of the benefit produced, whichever is less, as expenses of the receivership. If 2 or more assuming insurers have potential liability because of the same claim, the expenses shall be apportioned among them in proportion to the benefit received.


Source. 2004, 186:1. 2013, 235:3. 2016, 144:1, eff. July 26, 2016. 2018, 193:1, eff. Aug. 7, 2018. 2020, 37:36, 37, eff. Sept. 27, 2020.

    405:48 Nonlicensed or Accredited Insurer. 

If the assuming insurer does not meet the requirements of RSA 405:47, I-III, the credit permitted by RSA 405:47, IV and IV-a shall not be allowed unless the assuming insurer agrees in the trust agreements to the following conditions:

I. Notwithstanding any other provisions in the trust instrument, if the trust fund is inadequate because it contains an amount less than the amount required by RSA 405:47, IV(c), or if the grantor of the trust has been declared insolvent or placed into receivership, rehabilitation, liquidation or similar proceedings under the laws of its state or country of domicile, the trustee shall comply with an order of the commissioner with regulatory oversight over the trust or with an order of a court of competent jurisdiction directing the trustee to transfer to the commissioner with regulatory oversight all of the assets of the trust fund.

II. The assets shall be distributed by and claims shall be filed with and valued by the commissioner with regulatory oversight over the trust in accordance with the laws of the state in which the trust is domiciled that are applicable to the liquidation of domestic insurance companies.

III. If the commissioner with regulatory oversight determines that the assets of the trust fund or any part thereof are not necessary to satisfy the claims of the U.S. ceding insurers of the grantor of the trust, the assets or part thereof shall be returned by the commissioner with regulatory oversight to the trustee for distribution in accordance with the trust agreement.

IV. The grantor shall waive any right otherwise available to it under U.S. law that is inconsistent with this provision.


Source. 2004, 186:1. 2013, 235:4, 5, eff. Sept. 13, 2013.

    405:49 Suspension;  Concentration Risk. 

I. If an accredited or certified reinsurer ceases to meet the requirements for accreditation or certification, the commissioner may suspend or revoke the reinsurer's accreditation or certification.

(a) The commissioner shall give the reinsurer notice and opportunity for hearing. The suspension or revocation shall not take effect until after the commissioner's order on hearing, unless:

(1) The reinsurer waives its right to a hearing;

(2) The commissioner's order is based on regulatory action by the reinsurer's domiciliary jurisdiction or the voluntary surrender or termination of the reinsurer's eligibility to transact insurance or reinsurance business in its domiciliary jurisdiction or in the primary certifying state of the reinsurer under RSA 405:47, IV-a; or

(3) The commissioner finds that an emergency requires immediate action and a court of competent jurisdiction has not stayed the commissioner's action.

(b) While a reinsurer's accreditation or certification is suspended, no reinsurance contract issued or renewed after the effective date of the suspension qualified for credit except to the extent that the reinsurer's obligations under the contract are secured in accordance with RSA 405:50. If a reinsurer's accreditation or certification is revoked, no credit for reinsurance may be granted after the effective date of the revocation except to the extent that the reinsurer's obligations under the contract are secured in accordance with RSA 405:47, IV-a(e) and RSA 405:50.

II. (a) A ceding insurer shall take steps to manage its reinsurance recoverables proportionate to its own book of business. A domestic ceding insurer shall notify the commissioner within 30 days after reinsurance recoverables from any single assuming insurer, or group of affiliated assuming insurers, exceeds 50 percent of the domestic ceding insurer's last reported surplus to policyholders, or after it is determined that the reinsurance recoverables from any single assuming insurer, or group of affiliated assuming insurers, is likely to exceed this limit. The notification shall demonstrate that the exposure is safely managed by the domestic ceding insurer.

(b) A ceding insurer shall take steps to diversify its reinsurance program. A domestic ceding insurer shall notify the commissioner within 30 days after ceding to any single assuming insurer, or group of affiliated assuming insurers, more than 20 percent of the ceding insurer's gross written premium in the prior calendar year, or after it has determined that the reinsurance ceded to any single assuming insurer, or group of affiliated assuming insurers, is likely to exceed this limit. The notification shall demonstrate that the exposure is safely managed by the domestic ceding insurer.


Source. 2004, 186:1. 2013, 235:6, eff. Sept. 13, 2013.

    405:5 Repealed by 1969, 283:7, eff. June 25, 1969. 

    405:50-a Rulemaking for Reinsurance. 

The commissioner may adopt rules under RSA 541-A relative to reinsurance arrangements as follows:

I. Such rules shall apply only to reinsurance relating to:

(a) Life insurance policies with guaranteed nonlevel gross premiums or guaranteed nonlevel benefits.

(b) Universal life insurance policies with provisions resulting in the ability of a policyholder to keep a policy in force over a secondary guarantee period.

(c) Variable annuities with guaranteed death or living benefits.

(d) Long-term care insurance policies.

(e) Such other life and health insurance and annuity products as to which the NAIC adopts model regulatory requirements with respect to credit for reinsurance.

II. A rule adopted pursuant to subparagraph I(a) or I(b) may apply to any treaty containing policies issued on or after January 1, 2015, and policies issued prior to January 1, 2015, if risk pertaining to such pre-2015 policies is ceded in connection with the treaty, in whole or in part, on or after January 1, 2015.

III. A rule adopted under this section may require the ceding insurer, in calculating the amounts or forms of security required to be held, to use the Valuation Manual adopted by the NAIC under Section 11B(1) of the NAIC Standard Valuation Law, including all amendments adopted by the NAIC and in effect on the date as of which the calculation is made, to the extent applicable.

IV. A rule adopted pursuant to this section shall not apply to cessions to an assuming insurer that:

(a) Meets the conditions set forth in RSA 405:47, IV-b; or

(b) Is certified in this state; or

(c) Maintains at least $250,000,000 in capital and surplus when determined in accordance with the NAIC Accounting Practices and Procedures Manual, including all amendments thereto adopted by the NAIC, excluding the impact of any permitted or prescribed practices, and is:

(1) Licensed in at least 26 states; or

(2) Licensed in at least 10 states and licensed or accredited in a total of at least 35 states.


Source. 2018, 193:3, eff. Aug. 7, 2018. 2020, 37:39, eff. Sept. 27, 2020.

    405:50 Asset or Reduction From Liability for Reinsurance Ceded by a Domestic Insurer to an Assuming Insurer Not Meeting the Requirements of RSA 405:47. 

An asset or a reduction from liability for the reinsurance ceded by a domestic insurer to an assuming insurer not meeting the requirements of RSA 405:47 shall be allowed in an amount not exceeding the liabilities carried by the ceding insurer; provided that the commissioner may adopt by rule, pursuant to RSA 541-A, specific additional requirements relating to or setting forth the valuation of assets or reserve credits, the amount and forms of security supporting reinsurance arrangements described in RSA 405:50-a, and the circumstances pursuant to which credit shall be reduced or eliminated. The reduction shall be in the amount of funds held by or on behalf of the ceding insurer, including funds held in trust for the ceding insurer, under a reinsurance contract with the assuming insurer as security for the payment of obligations under such contract, if the security is held in the United States subject to withdrawal solely by, and under the exclusive control of, the ceding insurer; or, in the case of a trust, held in a qualified United States financial institution, as defined in RSA 405:46, III. This security may be in the form of:

I. Cash.

II. Securities listed by the Securities Valuation Office of the National Association of Insurance Commissioners, including those deemed exempt from filing as defined by the Purposes and Procedures Manual of the Securities Valuation Office, and qualifying as admitted assets.

III. (a) Clean, irrevocable, unconditional letters of credit, issued or confirmed by a qualified United States financial institution, as defined in RSA 405:46, II effective no later than December 31, of the year for which filing is being made, and in the possession of, or in trust for, the ceding insurer on or before the filing date of its annual statement;

(b) Letters of credit meeting applicable standards of issuer acceptability as of the dates of their issuance or confirmation shall, notwithstanding the issuing or confirming institution's subsequent failure to meet applicable standards of issuer acceptability, continue to be acceptable as security until their expiration, extension, renewal, modification, or amendment, whichever first occurs.

IV. Any other form of security acceptable to the commissioner.


Source. 2004, 186:1. 2013, 235:6, eff. Sept. 13, 2013. 2018, 193:2, eff. Aug. 7, 2018. 2020, 37:38, eff. Sept. 27, 2020.

    405:51 Rulemaking. 

The commissioner may adopt rules, pursuant to RSA 541-A, implementing the provisions of this subdivision.


Source. 2004, 186:1. 2013, 235:6, eff. Sept. 13, 2013.

    405:52 Reinsurance Agreements Affected. 

Credit for reinsurance ceded to a certified reinsurer is allowed only for reinsurance contracts entered into or renewed on or after the effective date of the certification of the assuming insurer by the insurance commissioner.


Source. 2004, 186:1. 2013, 235:6, eff. Sept. 13, 2013.

    405:53 Reciprocal Denial. 

If any state shall, by its laws, deny any insurance company or citizen of this state any rights or privileges which are granted to insurance companies and citizens of that state, this state shall in like manner deny to insurance companies and citizens of that state all such rights and privileges, and they shall be subject to all the restrictions and penalties prescribed by that state against insurance companies and citizens of this state.


Source. 1891, 54:1. PL 275:47. RL 325:52.

    405:54 Writing Insurance. 

If, by the laws of any state, the insurance commissioner or other official shall have the power to revoke the license of any company of this state or foreign state for writing insurance upon any person or property of that state, other than through or by a citizen of that state, the insurance commissioner of this state is empowered to revoke the license of any insurance company of that state, or any foreign insurance company licensed to do business in this state, that shall write for or through any agent of that state, directly or indirectly, upon any person or property of this state, except the same be written through a duly authorized agent, who shall be a citizen of this state.


Source. 1891, 54:1. PL 275:48. RL 325:53.

    405:55 Commissions, etc. 

If, by the laws of any other state, agents, brokers or companies of this state are prohibited from receiving commissions on policies of fire or casualty insurance written for them by agents or companies doing business in that state on persons or property residing or located therein the agents, brokers or companies resident in that state shall not be paid any commission, brokerage or other compensation upon any policy written for them by agents or companies doing business in this state.


Source. 1909, 85:1. PL 275:49. RL 325:54.

    405:56 Penalties. 

Any such agent or company of this state, who shall pay such commission, brokerage or other compensation upon any such policy so written for him or them upon persons or property in this state, shall be subject to the same penalties as are prescribed by the laws of that state for agents, brokers or companies of that state, who shall pay such commission, brokerage or other compensation to such agents, brokers or companies of this state.


Source. 1909, 85:1. PL 275:50. RL 325:55.

    405:57 Notice to Agents. 

It shall be the duty of the insurance commissioner, upon receiving information that, by the laws of any other state, agents, brokers or companies, residents of this state, are prohibited from receiving commissions on policies written for them by agents or companies of that state, to notify agents and companies doing business in this state of the existence of such a law and to enforce the same restrictions and penalties as prescribed by the laws of that state.


Source. 1909, 85:2. PL 275:51. RL 325:56.

    405:58 Exclusion of Companies. 

Whenever it shall appear to the commissioner of this state that any insurance company chartered by this state, and authorized by such commissioner in this state to engage in life, accident and health insurance business or any combination thereof, is refused permission to transact any such business or combination thereof within any state of the United States or within any foreign country, by the provisions of any law of such state or country which shall in terms prohibit, or shall be construed in such manner as to prohibit, such company from engaging in such business or combination thereof after such company has complied with all other laws of such state or foreign country the commissioner may cancel the authority of, or refuse a license to, every company organized by charter or under the laws of such other state or foreign country to do any of the kinds of business above mentioned in this state, and may refuse a certificate of authority to every such company thereafter applying to him for authority to do any such business in this state, so long as such New Hampshire company shall be refused permission to transact any such business or combination thereof in such other state or foreign country.


Source. 1915, 151:1. PL 275:52. RL 325:57.

    405:59 Repealed by 1971, 244:19, V, eff. Aug. 17, 1971. 

    405:6 Non-assessable Policies. 

Any mutual fire or casualty insurance company now or hereafter admitted to transact business in this state may issue non-assessable policies in compliance with the requirements of RSA 402:2, except that the deposit required by said section may be made in the home state of such admitted company in cash or securities legal for investments by such companies in such home state. Any deposit required for the purposes specified in this section shall be inclusive of any deposit required by any other state, provided that such deposit is for the benefit of all policyholders in the United States.


Source. 1941, 122:2. RL 325:6.

    405:60 Revocation of Licenses. 

If any such company shall refuse or neglect to pay any tax, fine, penalty, license, or fee imposed by the laws of this state, or fail to comply with any other requirement thereof, the commissioner may revoke its license.


Source. 1895, 100:1. 1921, 27:1. PL 275:54. RL 325:59.

    405:61 Request for Information. 

I. Any law enforcement investigator may request an insurance company licensed under this chapter to release any information in its possession relative to the disappearance, theft or loss of any motor vehicle, or other personal property. The insurance company shall release the information and cooperate with any official authorized to request such information pursuant to this section. The information may include but not be limited to:

(a) Any relevant insurance policy;

(b) Policy premium payment records;

(c) History of previous claims made by the insured for the theft, loss or disappearance of any motor vehicle or other personal property;

(d) Any other material relating to the investigation of the theft, loss or disappearance.

II. If an insurance company has reason to suspect that a theft, loss or disappearance of a motor vehicle or other personal property in the amount of $500 or more was caused by other than accidental means, the company shall notify the local or state law enforcement authorities and furnish them, either through a recognized bureau or organization of companies or through the secretary or other officer of the insurance company, with all relevant material acquired during its investigation of the theft, loss or disappearance of a motor vehicle or other personal property. The insurance company shall cooperate with and take such reasonable action as may be requested of it by any law enforcement agency, and permit any person so ordered by a court to inspect any of its records pertaining to the policy and the loss.

III. In the absence of fraud or malice, no public official or insurance company or person who furnishes information on behalf of the insurance company shall be liable for damages in a civil action or subject to criminal prosecution for any oral or written statement made or any other action taken that is necessary to supply information required pursuant to this section.

IV. The recipient of any information furnished pursuant to this section shall hold the information in confidence, and shall only release it to a law enforcement authority or agency or to the insurance department, until such time as its release is required pursuant to a criminal or civil proceeding.

V. An insurer or other person licensed by the insurance department who fails to comply with this section may be subject to administrative action to be taken by the insurance commissioner. The penalty imposed by the commissioner may include a fine not exceeding $2500 in the discretion of the insurance commissioner, or suspension or revocation of such insurer's license, or both.


Source. 1981, 502:5, eff. Aug. 28, 1981.

    405:62 Approval as a Domestic Insurer. 

Any insurer which is organized under the laws of any other state and is admitted to do business in this state for the purpose of writing insurance may become a domestic insurer upon the approval of the commissioner by amending its articles of incorporation or equivalent corporate charter to designate its change of domicile to this state, and by complying with all applicable requirements of Title XXXVII relative to the organization and licensing of a domestic insurer of the same type. Such domestic insurer shall be entitled to like certificates and licenses to transact business in this state, and shall be subject to the authority and jurisdiction of this state.


Source. 1991, 114:4. 2008, 255:4, eff. Aug. 25, 2008.

    405:63 Conversion of Foreign Insurer. 

Any domestic insurer may, upon the approval of the commissioner, transfer its domicile to any other state in which it is admitted to transact the business of insurance, and upon such a transfer shall cease to be a domestic insurer, and shall be admitted to this state if qualified as a foreign insurer.


Source. 1991, 114:4, eff. May 14, 1991.

    405:64 Effects of Redomestication. 

The certificate of authority, agents' appointments and licenses, rates, and other items which the commissioner allows, in his discretion, which are in existence at the time any insurer licensed to transact the business of insurance in this state transfers its corporate domicile to this or any other state by merger, consolidation or any other lawful method shall continue in full force and effect upon such transfer if such insurer remains duly qualified to transact the business of insurance in this state. All outstanding policies of any transferring insurer shall remain in full force and effect and need not be endorsed as to the new name of the company or its new location unless so ordered by the commissioner. Every transferring insurer shall file new policy forms with the commissioner on or before the effective date of the transfer, but may use existing policy forms with appropriate endorsements if allowed by, and under such conditions as approved by the commissioner. However, every such transferring insurer shall notify the commissioner of the details of the proposed transfer, and shall file promptly, any resulting amendments to corporate documents filed or required to be filed with the commissioner.


Source. 1991, 114:4, eff. May 14, 1991.

    405:65 Filing with Secretary of State. 

An insurer transferring its domicile to this state shall file the following documents with the secretary of state, together with applicable filing fees:

I. Restated articles of incorporation or equivalent, as amended pursuant to RSA 405:62; and

II. Executed order of the commissioner approving the redomestication.


Source. 2008, 255:5. 2015, 273:16, eff. Jan. 1, 2016.

    405:7 Net Assets. 

The term net assets, as used herein, shall be taken to mean the funds of an insurance company available for the payment of its obligations in this state, including, in the case of a mutual company, its deposit notes or other contingent funds, its subscription fund and premium notes absolutely due, and also including uncollected and deferred premiums not more than 3 months due, on policies actually in force, after deducting from such funds all unpaid losses and claims, and claims for losses, and all other debts and liabilities inclusive of policy liability and exclusive of capital.


Source. 1919, 23:1. PL 275:6. RL 325:7.

    405:8 Mill Mutuals. 

Mutual fire or mutual employer's liability insurance companies incorporated under the laws of other states, which insure only factories or mills or property connected with such factories or mills, may be admitted to this state upon complying with the conditions set forth herein, and shall comply with all the requirements hereof, except that, in lieu of all other taxation upon premiums in this state, such companies shall annually pay a tax at the rate of 2 percent on gross premiums in force on risks in this state after deducting the unabsorbed portion of such premium computed at the rate of return actually made on annual policies expiring during the year by said insurance companies.


Source. 1913, 90:1. PL 275:7. RL 325:8.

    405:9 Returns. 

Such companies shall, on or before March 1, make a return, under oath, to the commissioner, showing the gross premiums in force on risks in this state on December 31 previous and the unabsorbed portion of such premiums computed at the rate of return actually made on annual policies expiring during the year by said companies.


Source. 1913, 90:1. PL 275:8. 1929, 13:1. RL 325:9.

    406-A:1 Purpose of Chapter. 

I. The purpose of this chapter is to subject to the jurisdiction of the insurance commissioner of this state and to the jurisdiction of the courts of this state insurers not authorized to transact business in this state which place in or send into this state any false advertising designed to induce residents of this state to purchase insurance from insurers not authorized to transact business in this state. The legislature declares it is in the interest of the citizens of this state who purchase insurance from insurers which solicit insurance business in this state in the manner set forth in the preceding sentence that such insurers be subject to the provisions of this chapter. In furtherance of such state interest, the legislature herein provides a method of substituted service of process upon such insurers and declares that in so doing, it exercises its power to protect its residents and also exercises powers and privileges available to the state by virtue of Public Law 15, 79th Congress of the United States, Chapter 20, 1st Session, S. 340, which declares that the business of insurance and every person engaged therein shall be subject to the laws of the several states; the authority provided herein to be in addition to any existing powers of this state.

II. The provisions of this chapter shall be liberally construed.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:2 Definitions. 

When used in this chapter:

I. "The commissioner" shall mean the insurance commissioner of this state.

II. "Unfair trade practice act" shall mean Revised Statutes Annotated, chapter 417, entitled Unfair Insurance Trade Practices.

III. "Residents" shall mean and include person, partnership or corporation, domestic, alien or foreign.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:3 Notice to Domiciliary Supervisory Official. 

No unauthorized foreign or alien insurer of the kind described in RSA 406-A:1 shall make, issue, circulate or cause to be made, issued or circulated, to residents of this state any estimate, illustration, circular, pamphlet, or letter, or cause to be made in any newspaper, magazine or other publication or over any radio or television station, any announcement or statement to such residents misrepresenting its financial condition or the terms of any contracts issued or to be issued or the benefits or advantages promised thereby, or the dividends or share of the surplus to be received thereon in violation of the unfair trade practice act, and whenever the commissioner shall have reason to believe that any such insurer is engaging in such unlawful advertising, it shall be his duty to give notice of such fact by registered mail to such insurer and to the insurance supervisory official of the domiciliary state of such insurer. For the purpose of this section, the domiciliary state of an alien insurer shall be deemed to be the state of entry or the state of the principal office in the United States.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:4 Actions by Commissioner. 

If after 30 days following the giving of the notice mentioned in RSA 406-A:3 such insurer has failed to cease making, issuing, or circulating such false misrepresentations or causing the same to be made, issued or circulated in this state, and if the commissioner has reason to believe that a proceeding by him in respect to such matters would be to the interest of the public, and that such insurer is issuing or delivering contracts of insurance to residents of this state or collecting premiums on such contracts or doing any of the acts enumerated in RSA 406-A:5, he shall take action against such insurer under the unfair trade practice act.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:5 Service Upon Unauthorized Insurer. 

I. Any of the following acts in this state, effected by mail or otherwise, by any such unauthorized foreign or alien insurer: (1) the issuance or delivery of contracts of insurance to residents of this state, (2) the solicitation of applications for such contracts, (3) the collection of premiums, membership fees, assessments or other considerations for such contracts, or (4) any other transaction of insurance business, is equivalent to and shall constitute an appointment by such insurer of the insurance commissioner and his successor or successors in office, to be its true and lawful attorney, upon whom may be served all statements of charges, notices and lawful process in any proceeding instituted in respect to the misrepresentations set forth in RSA 406-A:3 hereof under the provisions of the unfair trade practice act, or in any action, suit or proceeding for the recovery of any penalty therein provided, and any such act shall be signification of its agreement that such service of statement of charges, notices or process is of the same legal force and validity as personal service of such statement of charges, notices or process in this state, upon such insurer.

II. Service of a statement of charges and notices under said unfair trade practice act shall be made by any deputy or employee of the department of insurance delivering to and leaving with the commissioner or some person in apparent charge of his office, 2 copies thereof. Service of process issued by any court in any action, suit or proceeding to collect any penalty under said act provided, shall be made by delivering and leaving with the commissioner, or some person in apparent charge of his office, 2 copies thereof. The commissioner shall forthwith cause to be mailed by registered mail one of the copies of such statement of charges, notices or process to the defendant at its last known principal place of business, and shall keep a record of all statements of charges, notices and process so served. Such service of statement of charges, notices or process shall be sufficient provided they shall have been so mailed and the defendant's receipt or receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter and the name and address of the person to whom the letter is addressed, and the affidavit of the person mailing such letter showing a compliance herewith are filed with the commissioner in the case of any statement of charges or notices, or with the clerk of the court in which such action is pending in the case of any process, on or before the date the defendant is required to appear or within such further time as may be allowed.

III. Service of statement of charges, notices or process in any such proceeding, action or suit shall in addition to the manner provided in paragraph II of this section be valid if served upon any person within this state who on behalf of such insurer is (1) soliciting insurance, or (2) making, issuing or delivering any contract of insurance, or (3) collecting or receiving in this state any premium for insurance; and a copy of such statement of charges, notices or process is sent within 10 days thereafter by registered mail by or on behalf of the commissioner or to the defendant at the last known principal place of business of the defendant, and the defendant's receipt, or the receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter, the name and address of the person to whom the letter is addressed, and the affidavit of the person mailing the same showing a compliance herewith, are filed with the commissioner in the case of any statement of charges or notices, or with the clerk of the court in which such action is pending in the case of any process, on or before the date the defendant is required to appear or within such further time as the court may allow.

IV. No cease or desist order or judgment by default under this section shall be entered until the expiration of 30 days from the date of the filing of the affidavit of compliance.

V. Service of process and notice under the provisions of this chapter shall be in addition to all other methods of service provided by law, and nothing in this chapter shall limit or prohibit the right to serve any statement of charges, notices or process upon any insurer in any other manner now or hereafter permitted by law.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:6 Constitutionality. 

If any provision of this chapter or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or application of the chapter which can be given effect without the invalid provision or application, and to this end the provisions of this chapter are declared to be severable.


Source. 1961, 48:1, eff. May 29, 1961.

    406-A:7 Short Title. 

This chapter may be cited as the Unauthorized Insurers False Advertising Process Act.


Source. 1961, 48:1, eff. May 29, 1961.

    406-B:1 Purpose. 

The purpose of this chapter is to subject certain persons and insurers to the jurisdiction of the commissioner, of proceedings before the commissioner, and of the courts of this state in suits by or on behalf of the state and insureds or beneficiaries under insurance contracts. The legislature declares that it is a subject of concern that many residents of this state hold policies of insurance issued by persons and insurers not authorized to do business in this state, thus presenting to such residents the often insuperable obstacle of asserting their legal rights under such policies in forums foreign to them under laws and rules of practice with which they are not familiar. The legislature declares that it is also concerned with the protection of residents of this state against acts by persons and insurers not authorized to do an insurance business in this state by the maintenance of fair and honest insurance markets, by protecting authorized persons and insurers, which are subject to strict regulation, from unfair competition by unauthorized persons and insurers by protecting against the evasion of the insurance regulatory laws of this state and to protect the premium tax revenues of this state. In furtherance of such state interest, the legislature herein provides methods for substituted service of process upon such persons or insurers in any proceeding, suit or action in any court and substitute service of any notice, order, pleading or process upon such persons or insurers in any proceeding before the commissioner to enforce or effect full compliance with the insurance and tax statutes of this state, and declares in so doing it exercises its power to protect residents of this state and to define what constitutes doing an insurance business in this state, and also exercises powers and privileges available to this state by virtue of P.L. 79-15 (1945), (chapter 20, 1st sess., S. 340), 59 Stat. 33, as amended, which declares that the business of insurance and every person engaged therein shall be subject to the laws of the several states.


Source. 1967, 237:1. 1969, 260:1, eff. June 20, 1969.

    406-B:10 Reporting of Unauthorized Insurance. 

I. Every person investigating or adjusting any loss or claim on a subject of insurance in this state shall immediately report to the commissioner every insurance policy or contract which has been entered into by any insurer not authorized to transact such insurance in this state.

II. This section does not apply to transactions in this state involving a policy lawfully solicited, written, and delivered outside of this state covering only subjects of insurance not resident, located or expressly to be performed in this state at the time of issuance, and which transactions are subsequent to the issuance of such policy.


Source. 1967, 237:1, eff. Aug. 22, 1967.

    406-B:11-a Unauthorized Insurance Premium Tax;  Insurance Transactions on Multi-State Risks. 

For lawfully procured insurance premiums in unlicensed insurance companies reporting multi-state risks, the provisions of RSA 405-B shall apply.


Source. 2011, 191:2, eff. Aug. 13, 2011.

    406-B:11 Unauthorized Insurance Premium Tax. 

I. Except as to premiums on lawfully procured surplus lines insurance pursuant to the surplus lines laws of this state, and premiums on unlicensed insurance procured by industrial insurers on which a tax has been paid pursuant to RSA 406-B:16, VI and premiums on independently procured insurance on which a tax has been paid pursuant to RSA 406-B:17, every unauthorized insurer shall pay to the commissioner before March 1 next succeeding the calendar year in which the insurance was so effectuated, continued or renewed a premium receipts tax of 4 percent of gross premiums charged for such insurance other than marine insurance and a premium receipts tax of 2 percent of gross premiums charged for such marine insurance on subjects resident, located or to be performed in this state. Such insurance on subjects resident, located or to be performed in this state procured through negotiations or an application, in whole or in part occurring or made within or from within or outside of this state, or for which premiums in whole or in part are remitted directly or indirectly from within or outside of this state, shall be deemed to be insurance procured, or continued or renewed in this state. The term "
premium
" includes all premiums, membership fees, assessments, dues, and any other consideration for insurance. Such tax shall be in lieu of all taxes and fire department dues. On default of any such unauthorized insurer in the payment of such tax the insured shall pay the tax. If the tax prescribed by this section is not paid within the time stated, the tax shall be increased by a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

II. If a policy covers risks or exposures only partially in this state, the tax payable shall be computed on the portions of the premium which are properly allocable to the risks or exposures located in this state. In determining the amount of premiums taxable in this state, all premiums written, procured, or received in this state and all premiums on policies negotiated in this state shall be deemed written on property or risks located or resident in this state, except such premiums as are properly allocated or apportioned and reported as taxable premiums of any other state or states.


Source. 1967, 237:1. 1971, 170:4. 2002, 207:39, eff. July 15, 2002. 2019, 179:5, eff. Jan. 1, 2020.

    406-B:12 Penalty for Unauthorized Insurance. 

Any unlicensed insurer who does any unauthorized act of an insurance business as set forth in RSA 406-B:2 shall be fined in accordance with RSA 400-A:15, III.


Source. 2002, 207:40, eff. July 15, 2002. 2020, 37:49, eff. Sept. 27, 2020.

    406-B:13 Reciprocal Judgment. 

I. 
Definition. In this section:

(a) "
Reciprocal state
" means any state or territory of the United States the laws of which contain procedures substantially similar to those specified in this section for the enforcement of decrees or orders in equity issued by courts located in other states or territories of the United States, against any insurer incorporated or authorized to do business in said state or territory.

(b) "
Foreign decree
" means any decree or order in equity of a court located in a "reciprocal state", including a court of the United States located therein, against any insurer incorporated or authorized to do business in this state.

(c) "
Qualified party
" means a state regulatory agency acting in its capacity to enforce the insurance laws of its state.

II. 
List of Reciprocal States. The insurance commissioner of this state shall determine which states and territories qualify as reciprocal states and shall maintain at all times an up-to-date list of such states.

III. 
Filing and Status of Foreign Decrees. A copy of any foreign decree authenticated in accordance with the statutes of this state may be filed in the office of the clerk of any superior court of this state. The clerk, upon verifying with the insurance commissioner that the decree or order qualifies as a "foreign decree" shall treat the foreign decree in the same manner as a decree of a superior court of this state. A foreign decree so filed has the same effect and shall be deemed as a decree of a superior court of this state, and is subject to the same procedures, defenses and proceedings for reopening, vacating, or staying as a decree of a superior court of this state and may be enforced or satisfied in like manner.

IV. 
Notice of Filing.

(a) At the time of the filing of the foreign decree, the attorney general shall make and file with the clerk of the court an affidavit setting forth the name and last known post office address of the defendant.

(b) Promptly upon the filing of the foreign decree and the affidavit, the clerk shall mail notice of the filing of the foreign decree to the defendant at the address given and to the insurance commissioner of this state and shall make a note of the mailing in the docket. In addition, the attorney general may mail a notice of the filing of the foreign decree to the defendant and to the insurance commissioner of this state and may file proof of mailing with the clerk. Lack of mailing notice of filing by the clerk shall not affect the enforcement proceedings if proof of mailing by the attorney general has been filed.

(c) No execution or other process for enforcement of a foreign decree filed hereunder shall issue until 30 days after the date the decree is filed.

V. 
Stay.

(a) If the defendant shows the superior court that an appeal from the foreign decree is pending or will be taken, or that a stay of execution has been granted, the court shall stay enforcement of the foreign decree until the appeal is concluded, the time for appeal expires, or the stay of execution expires or is vacated, upon proof that the defendant has furnished the security for the satisfaction of the decree required by the state in which it was rendered.

(b) If the defendant shows the superior court any ground upon which enforcement of a decree of any superior court of this state would be stayed, the court shall stay enforcement of the foreign decree for an appropriate period, upon requiring the same security for satisfaction of the decree which is required in this state.

VI. 
Fees. Any person filing a foreign decree shall pay to the clerk of court $10. Fees for docketing, transcription or other enforcement proceedings shall be as provided for decrees of the superior court.


Source. 2002, 207:40, eff. July 15, 2002.

    406-B:14 Short Title. 

This chapter may be cited as the "Uniform Unlicensed Insurers Act."


Source. 2002, 207:40, eff. July 15, 2002.

    406-B:15 Separability. 

If any provision of this chapter or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provision and to this end the provisions of this chapter are declared to be severable.


Source. 2002, 207:40, eff. July 15, 2002.

    406-B:16-a Lawfully Procured Insurance in Unlicensed Companies;  Insurance Transactions on Multi-State Risks. 

For premiums on unlicensed insurance procured by industrial insurers with tax liability for multi-state risks, the provisions of RSA 405-B shall apply.


Source. 2011, 191:3, eff. Aug. 13, 2011.

    406-B:16 Lawfully Procured Insurance in Unlicensed Companies;  Exceptions to Unauthorized Provisions. 

The unauthorized provisions of this chapter do not apply to:

I. The lawful transaction of surplus lines insurance.

II. The lawful transaction of reinsurance by insurers.

III. Transactions in this state involving a policy lawfully solicited, written, and delivered outside of this state covering only subjects of insurance not resident, located, or expressly to be performed in this state at the time of issuance, and which transactions are subsequent to the issuance of such policy.

IV. Transactions involving contracts of insurance independently procured through negotiations occurring entirely outside of this state which are reported and on which premium tax is paid in accordance with RSA 406-B:17.

V. Attorneys acting in the ordinary relation of attorney and client in the adjustment of claims or losses.

VI. (a) Any insurance company or underwriter issuing contracts of insurance to industrial insureds, nor to any contract of insurance issued to any one or more industrial insureds. Every industrial insured under a contract procured from an unlicensed insurer shall pay to the commissioner of insurance before March 1 next succeeding the calendar year in which the insurance was so effectuated, continued, or renewed a premium receipts tax of 3 percent of the gross premiums charged for such insurance. For the purposes of this section, an "industrial insured" is:

(1) An insured who procures the insurance of any risk or risks other than life and annuity contracts and health insurance contracts by use of the services of a full time employee acting as an insurance manager or buyer or the services of a regularly and continuously retained qualified insurance consultant; and

(2) An insured whose aggregate annual premiums for insurance on all risks total at least $15,000; and

(3) An insured having at least 25 full time employees.

(b) Any insured failing to file the report or failing to remit the proper tax within the time period for filing shall pay a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

(c) For the purposes of this section, each insured filing under this section shall be subject to the provisions of RSA 400-A:32-a.

VII. Transactions in this state involving any policy of insurance or annuity contract issued prior to the effective date of this section.

VIII. Transactions in this state relative to a policy issued or to be issued outside this state involving insurance on vessels, craft or hulls, cargos, marine builder's risk, marine protection and indemnity or other risk, including strikes and war risks commonly insured under ocean or wet marine forms of policy.

IX. This chapter shall not apply to any life insurance or annuity company organized and operated, without profit to any private shareholder or individual, exclusively for the purpose of aiding educational or scientific institutions organized and operated without profit to any private shareholder or individual, by issuing insurance and annuity contracts direct from the home office of the company and without agents or representatives in this state, only to or for the benefit of such institutions and individuals engaged in the service of such institutions; nor shall this chapter apply to any insurance or annuity contracts issued by any such life insurance or annuity company.

X. The provisions of this chapter, other than the provisions of RSA 406-B:2, 4, and 5, do not apply to ocean marine insurance.


Source. 2002, 207:40. 2005, 248:16. 2008, 154:3, eff. June 6, 2008. 2019, 179:6, eff. Jan. 1, 2020.

    406-B:17-a Independently Procured Insurance;  Insurance Transactions on Multi-State Risks. 

For premiums on unlicensed insurance independently procured with tax liability for multi-state risks, the provisions of RSA 405-B shall apply.


Source. 2011, 191:4, eff. Aug. 13, 2011.

    406-B:17 Independently Procured Insurance. 

I. Every insured who procures or causes to be procured or continues or renews insurance with any unlicensed insurer, or any insured or self-insurer who so procures or continues excess loss, catastrophe or other insurance, upon a subject of insurance resident, located or to be performed within this state, other than insurance procured through a surplus lines agent pursuant to the surplus lines law of this state shall within 60 days after the date such insurance was so procured, continued, or renewed, file a report of the same with the commissioner in writing and upon forms designated by the commissioner and furnished to such an insured upon request. The report shall show the name and address of the insured or insureds, name and address of the insurer, the subject of the insurance, a general description of the coverage, the amount of premium correctly charged therefor, and such additional pertinent information as is reasonably requested by the commissioner.

II. Any insurance in an unlicensed insurer of a subject of insurance resident, located or to be performed within this state procured through negotiations or an application, in whole or in part occurring or made within or from within or outside of this state, shall be deemed to be insurance procured, or continued or renewed in this state within the intent of paragraph I.

III. There is hereby levied upon the obligation, chose in action, or right represented by the premium charged for such insurance, a premium receipts tax of 4 percent of gross premiums charged for such insurance other than marine insurance and a premium receipts tax of 2 percent of gross premiums charged for such marine insurance. The term "
premium
" shall include all premiums, membership fees, assessments, dues, and any other consideration for insurance. Such tax shall be in lieu of all taxes and fire department dues. The insured shall, before March 1 next succeeding the calendar year in which the insurance was so procured, continued, or renewed, pay the amount of the tax to the commissioner. In the event of cancellation and rewriting of any such insurance contract, the additional premium for premium receipts tax purposes shall be the premium in excess of the unearned premium of the canceled insurance contract.

IV. If a policy covers risks or exposures only partially in this state, the tax payable shall be computed on the portions of the premium which are properly allocable to the risks or exposures located in this state. In determining the amount of premiums taxable in this state, all premiums written, procured, or received in this state and all premiums on policies negotiated in this state shall be deemed written on property or risks located or resident in this state, except such premiums as are properly allocated or apportioned and reported as taxable premiums of any other state or states.

V. If the insured fails to withhold from the premiums the amount of tax herein levied, the insured shall be liable for the amount thereof and shall pay the same to the commissioner within the time stated in paragraph III. If the tax prescribed by this section is not paid within the time stated in paragraph III, the tax shall be increased by a penalty contingent upon the number of days that have passed since the due date. For late payments received 1-30 days after the due date, the penalty fee shall be 3 percent of the amount of tax due. For late payments received 31-60 days after the due date, the penalty fee shall be 6 percent of the amount of tax due. For late payments received more than 60 days after the due date, the penalty fee shall be 12 percent of the amount of tax due.

VI. The attorney general, upon request of the commissioner, shall proceed in the courts of this or any other state or in any federal court or agency to recover such tax not paid within the time prescribed in this section.

VII. This section shall not be construed or deemed to abrogate or modify any provision of this chapter. This section does not apply to individual life or individual disability insurance.

VIII. Each insured filing under this section shall be subject to the provisions of RSA 400-A:32-a, I-III.


Source. 2002, 207:40. 2008, 154:4, eff. June 6, 2008. 2019, 179:7, eff. Jan. 1, 2020.

    406-B:2 Insurance Business Defined. 

Any of the following acts in this state effected by mail or otherwise by or on behalf of an unlicensed insurer is deemed to constitute the transaction or doing of an insurance business in this state. The venue of an act committed by mail is at the point where the matter transmitted by mail is delivered and takes effect. Unless otherwise indicated, the term "
insurer
" as used in this section includes all corporations, associations, partnerships and individuals, engaged as principals in the business of insurance and also includes interinsurance exchanges and mutual benefit societies. The word "
commissioner
" shall mean the insurance commissioner.

I. The making of or proposing to make, as an insurer, an insurance contract.

II. The making of or proposing to make, as guarantor or surety, any contract of guaranty or suretyship as a vocation and not merely incidental to any other legitimate business or activity of the guarantor or surety.

III. The taking or receiving of any application for insurance.

IV. The receiving or collection of any premium, commission, membership fees, assessments, dues or other consideration for any insurance or any part thereof.

V. The issuance or delivery of contracts or certificates of insurance to residents of this state or to persons authorized to do business in this state.

VI. Directly or indirectly acting as an agent for or otherwise representing or aiding on behalf of another any person or insurer in the solicitation, negotiation, procurement, or effectuation of insurance or renewals thereof, or in the dissemination of information as to coverage or rates, or forwarding of applications, or delivery of policies or contracts, or inspection of risks, a fixing of rates or investigation or adjustment of claims or losses or in the transaction of matters subsequent to effectuation of the contract and arising out of it, or in any other manner representing or assisting a person or insurer in the transaction of insurance with respect to subjects of insurance resident, located or to be performed in this state. The provisions of this section shall not operate to prohibit full-time salaried employees of a corporate insured from acting in the capacity of an insurance manager or buyer in placing insurance in behalf of such employer.

VII. The doing of any kind of insurance business specifically recognized as constituting the doing of an insurance business within the meaning of the statutes relating to insurance.

VIII. The doing or proposing to do any insurance business in substance equivalent to any of the foregoing in a manner designed to evade the provisions of the statutes.

IX. Any other transactions of business in this state by an insurer.


Source. 1967, 237:1. 1969, 260:2, 3. 1971, 170:1. 1985, 177:1, 3. 1986, 93:2, 4. 2002, 207:32, eff. July 15, 2002.

    406-B:3 Unauthorized Insurance Prohibited. 

No unlicensed person or insurer shall directly or indirectly do any of the acts of an insurance business set forth in RSA 406-B:2 except as provided by and in accordance with the specific authorization of statute. In respect to the insurance of subjects resident, located or to be performed within this state this section shall not prohibit the collection of premium or other acts performed outside of this state by persons or insurers authorized to do business in this state provided such transactions and insurance contracts otherwise comply with statute.


Source. 1967, 237:1. 1971, 170:2. 2002, 207:33, eff. July 15, 2002.

    406-B:4 Service of Process on Commissioner. 

I. Any act of doing an insurance business as set forth in RSA 406-B:2 by any unlicensed person or insurer is equivalent to and shall constitute an irrevocable appointment by such person or insurer, binding upon such person or insurer, his or her executor, administrator or personal representative, or successor in interest if a corporation, of the commissioner, his or her successor or successors in office to be the true and lawful attorney of such person or insurer upon whom may be served all legal process in any action, suit or proceeding in any court arising out of doing an insurance business in this state by such person or insurer, except in an action, suit or proceeding by the commissioner or by the state. Any act of doing an insurance business as set forth in RSA 460-B:2 by any unlicensed person or insurer shall be signification of its agreement that any such legal process so served shall be of the same legal force and validity as personal service of process in this state upon such person or insurer, or upon such person's or insurer's executor, administrator or personal representative, or its successor in interest if a corporation.

II. Such service of process shall be made by leaving 2 copies thereof in the hands or office of the commissioner and paying to him for the use of the state a fee as established by RSA 400-A:29 for each person or insurer. A certificate by the commissioner showing such service and attached to the original or third copy of such process presented to him for that purpose shall be sufficient evidence thereof. Service upon the commissioner as such attorney shall be service upon the principal.

III. The commissioner shall forthwith mail one copy of such process to the defendant at its last known principal place of business and shall keep a record of all process so served upon him which shall show the day and hour of service. Such service of process is sufficient, provided notice of such service and copy of the process are sent within 10 days thereafter by registered mail by plaintiff or plaintiff's attorney to the defendant at the last known principal place of business of the defendant and the defendant's receipt, or receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter and the name and address of the person or insurer to whom the letter is addressed, and the affidavit of the plaintiff or plaintiff's attorney showing compliance herewith are filed with the clerk of the court in which such action is pending on or before the date the defendant is required to appear, or within such further time as the court may allow.

IV. Service of process in any such action, suit or proceeding shall, in addition to the manner provided in paragraphs II and III, be valid if served upon any person within this state who on behalf of such unlicensed person or insurer is doing any act of an insurance business as set forth in RSA 406-B:2 and if a copy of such process is sent within 10 days thereafter by registered mail by plaintiff or plaintiff's attorney to the defendant at the last known principal place of business of the defendant and the defendant's receipt, or receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter and the name and address of the person or insurer to whom the letter is addressed and the affidavit of the plaintiff or plaintiff's attorney showing compliance herewith are filed with clerk of the court in which such action is pending on or before the date the defendant is required to appear, or within such further time as the court may allow.

V. No plaintiff or complainant shall be entitled to a judgment by default in any action, suit or proceeding in which the process is served under this section until the expiration of 45 days from the date of filing of the affidavit of compliance.

VI. Nothing contained in this section shall limit or abridge the right to serve any process, notice or demand upon any person or insurer in any other manner now or hereafter permitted by law.


Source. 1967, 237:1. 1983, 473:15. 2002, 207:34, 35, eff. July 15, 2002.

    406-B:5 Service of Process on Secretary of State. 

I. Any act of doing an insurance business as set forth in RSA 406-B:2 by any unlicensed person or insurer is equivalent to and shall constitute irrevocable appointment by such person or insurer, binding upon such persons or insurer, his or her executor, administrator or personal representative, or successor in interest if a corporation, of the secretary of state, his or her successor or successors in office to be the true and lawful attorney of such person or insurer upon whom may be served all legal process in any action, suit or proceeding in any court by the commissioner or by the state and upon whom may be served any notice, order, pleading or process in any proceeding before the commissioner and which arises out of doing an insurance business in this state by such person or insurer. Any act of doing an insurance business as set forth in RSA 406-B:2 by any unlicensed person or insurer shall be signification of its agreement that any such legal process in such court action, suit or proceeding and any such notice, order, pleading or process in such administrative proceeding before the commissioner so served shall be of the same legal force and validity as personal service of process in this state upon such person or insurer, or upon his or her executor, administrator or personal representative, or its successor in interest if a corporation.

II. Such service of process in such action, suit or proceeding in any court or such notice, order, pleading or process in such administrative proceeding authorized by paragraph I shall be made by leaving 2 copies thereof in the hands or office of the secretary of state. A certificate by the secretary of state showing such service and attached to the original or third copy of such process presented to him for that purpose shall be sufficient evidence thereof. Service upon the secretary of state as such attorney shall be service upon the principal.

III. The secretary of state shall forthwith mail one copy of such court process or such notice, order, pleading or process in proceedings before the commissioner to the defendant in such court proceeding or to whom the notice, order, pleading or process in such administrative proceeding is addressed or directed at its last known principal place of business and shall keep a record of all process so served on him which shall show the day and hour of service. Such service is sufficient, provided notice of such service and a copy of the court process or the notice, order, pleading or process in such administrative proceeding are sent within 10 days thereafter by registered mail by the plaintiff or the plaintiff's attorney in the court proceeding or by the commissioner in the administrative proceeding to the defendant in the court proceeding or by whom the notice, order, pleading or process in such administrative proceeding is addressed or directed at its last known principal place of business of the defendant in the court or administrative proceeding, and the defendant's receipt, or receipt issued by the post office with which the letter is registered, showing the name of the sender of the letter and the name and address of the person or insurer to whom the letter is addressed, and the affidavit of the plaintiff or plaintiff's attorney in court proceeding or of the commissioner in administrative proceeding, showing compliance herewith are filed with the clerk of the court in which such action, suit or proceeding is pending or with the commissioner in administrative proceedings, on or before the date the defendant in the court or administrative proceeding is required to appear or respond thereto, or within such further time as the court or commissioner may allow.

IV. No plaintiff or complainant shall be entitled to a judgment or determination by default in any court or administrative proceeding in which court process or notice, order, pleading, or process in proceedings before the commissioner is served under this section until the expiration of 45 days from the date of filing of the affidavit of compliance.

V. Nothing contained in this section shall limit or abridge the right to serve any process, notice, order, pleading or demand upon any person or insurer in any other manner now or hereafter permitted by law.

VI. The attorney general upon request of the commissioner is authorized to proceed in the courts of this or any other state or in any federal court or agency to enforce an order or decision in any court proceeding or in any administrative proceeding before the commissioner.


Source. 1967, 237:1. 2002, 207:36, eff. July 15, 2002.

    406-B:6 Unauthorized Person or Insurer Defense of Action. 

I. Before any unauthorized person or insurer files or causes to be filed any pleading in any court action, suit or proceeding or in any notice, order, pleading, or process in such administrative proceeding before the commissioner instituted against such person or insurer, by service made as provided in RSA 406-B:4 and 5, such person or insurer shall either:

(a) Deposit with the clerk of the court in which such action, suit or proceeding is pending, or with the commissioner in administrative proceedings before the commissioner, cash or securities or bond with good and sufficient sureties to be approved by the court, or the commissioner, in any amount to be fixed by the court or the commissioner sufficient to secure the payment of any final judgment which may be rendered in such court proceeding or in such administrative proceeding before the commissioner, provided that the court or the commissioner in administrative proceedings before the commissioner may in its or his discretion make an order dispensing with such deposit or bond where the insurer makes a showing satisfactory to such court or the commissioner that it maintains in a state of the United States funds or securities, in trust or otherwise, sufficient and available to satisfy any final judgment which may be entered in such court action, suit or proceeding or in such administrative proceeding before the commissioner; or

(b) Procure proper authorization to do an insurance business in this state.

II. The court in any action, suit or proceeding in which service has been made as provided in RSA 406-B:4 or the commissioner in any administrative proceeding before the commissioner in which service is made as provided in RSA 406-B:5 may, in his or its discretion, order such postponement as may be necessary to afford the defendant reasonable opportunity to comply with paragraph I and to defend such court action or administrative proceeding.

III. Nothing in paragraph I is to be construed to prevent an unlicensed person or insurer from filing a motion to quash a writ or to set aside service thereof made as provided in RSA 406-B:4 or 5 on the ground that such unlicensed person or insurer has not done any of the acts enumerated in RSA 406-B:2 or that the person on whom service was made pursuant to RSA 406-B:4 was not doing any of the acts therein enumerated.


Source. 1967, 237:1. 2002, 207:37, eff. July 15, 2002.

    406-B:7 Attorney Fees. 

In an action against an unauthorized person or insurer upon a contract of insurance issued or delivered in this state to a resident thereof or to a corporation authorized to do business therein, if the person or insurer has failed for 30 days after demand prior to the commencement of the action to make payment in accordance with the terms of the contract, and it appears to the court that such refusal was vexatious and without reasonable cause, the court may allow to the plaintiff a reasonable attorney fee and include such fee in any judgment that may be rendered in such action. Failure of the person or insurer to defend any such action shall be deemed prima facie evidence that its failure to make payment was vexatious and without reasonable cause.


Source. 1967, 237:1, eff. Aug. 22, 1967.

    406-B:8 Validity of Insurance Contracts. 

I. Except for lawfully procured surplus lines insurance pursuant to the surplus lines laws of this state, contracts of insurance independently procured, through negotiations occurring entirely outside of this state which are reported and on which premium tax is paid in accordance with RSA 406-B:17 and contracts of industrial insurance on which premium tax is paid pursuant to RSA 406-B:16, VI, any contract of insurance effective in this state and entered into by an unauthorized insurer is unenforceable by such insurer. In event of failure of any such unauthorized insurer to pay any claim or loss within the provisions of such insurance contract, any person who assisted or in any manner aided directly or indirectly in the development, marketing, or administration of such insurance contract shall be liable to the insured for the full amount thereof pursuant to the provisions of such insurance contract.

II. The failure of an insurer transacting insurance business in this state to obtain a certificate of authority shall not impair the validity of any act or contract of such insurer and shall not prevent such insurer from defending any action at law or suit in equity in any court of this state, but no insurer transacting insurance business in this state without a certificate of authority shall be permitted to maintain an action in any court of this state to enforce any right, claim or demand arising out of the transaction of such business until such insurer shall have obtained a certificate of authority.


Source. 1967, 237:1. 1969, 260:4. 1971, 170:3. 1991, 94:1. 2002, 207:38, eff. July 15, 2002.

    406-B:9 Investigation and Disclosure of Insurance Contracts. 

I. Whenever the commissioner has reason to believe that insurance has been effectuated by or for any person in this state with an unauthorized insurer, the commissioner shall in writing order such person to produce for examination all insurance contracts and other documents evidencing insurance with both authorized and unauthorized insurers and to disclose to the commissioner the amount of insurance, name and address of each insurer, gross amount of premium paid or to be paid and the name and address of the person or persons assisting or aiding in the solicitation, negotiation or effectuation of such insurance.

II. Every person who, for 30 days after such written order pursuant to paragraph I, neglects to comply with the requirements of such order or who willfully makes a disclosure that is untrue, deceptive, or misleading shall forfeit $50 and an additional $50 for each day of neglect after expiration of said 30 days.

III. Whenever the commissioner believes, from evidence satisfactory to him, that any insurer is violating or about to violate the provisions of this act, the commissioner may, with the assistance of the attorney general of this state, cause a complaint to be filed in the Merrimack county superior court to enjoin and restrain such insurer from continuing such violation or engaging therein or doing any act in furtherance thereof. The court shall have jurisdiction of the proceeding and shall have the power to make and enter an order or judgment awarding such preliminary or final injunctive relief as in its judgment is proper.


Source. 1967, 237:1. 1969, 260:5, eff. June 20, 1969.

    406-C:1 Purpose. 

The purpose of this chapter is to authorize and regulate the solicitation for purchase and the sale in this state of insurance by financial institutions and to maintain parity with respect to the insurance powers of state and federally chartered financial institutions.


Source. 1997, 223:3. 2000, 313:3, eff. Aug. 20, 2000.

    406-C:10 Prohibition on Tying of Banking and Insurance Products. 

I. The financial institution shall not require or imply that the purchase of an insurance product by a customer or prospective customer is required as a condition of, or is in any way related to, the lending of money or extension of credit or the provision of services related to any such activities. A written disclosure to this effect, or such other disclosure as the department may authorize through rulemaking, shall be expressly acknowledged by the customer and shall include notice that the customer is free to select another insurance provider and that the customer's choice of another insurance provider will not affect the financial institution's credit decisions or credit terms in any way. The written disclosure shall be acknowledged at the time that a customer applying for the lending of money or an extension of credit is first informed that insurance is available through the financial institution.

II. A financial institution that solicits, sells, advertises, or offers insurance, and any person who solicits, sells, advertises, or offers insurance on behalf of a financial institution or on the premises of a financial institution shall obtain written acknowledgment of the receipt of the disclosure from the customer at the time the customer receives the disclosure. If the solicitation is conducted by telephone, the person or financial institution shall obtain an oral acknowledgment of receipt of the disclosure, maintain sufficient documentation to show that the acknowledgment was given by the customer, and make reasonable efforts to obtain a written acknowledgment from the customer. If a customer affirmatively consents to receiving the disclosures electronically and if the disclosures are provided in a format that the customer may retain or obtain later, the person or financial institution, may provide the disclosure and obtain acknowledgment of the receipt of the disclosure from the customer using electronic media.

III. The completion of a loan transaction or other transactions involving the extension of credit shall not be delayed or impeded by an officer or employee of a financial institution for the purpose of influencing a customer's selection or purchase of insurance.


Source. 1997, 223:3. 2004, 46:2, eff. May 3, 2004.

    406-C:11 Prohibition on Discrimination Against Non-Affiliated Agents. 

I. The financial institution shall not condition the provision of any product or service to any customer upon the purchase of a policy or contract of insurance through a particular insurer, agent, or broker or reject any insurance policy required in connection with a loan or extension of credit solely because such policy has been issued or underwritten by any person who is not associated with such institution.

II. The financial institution shall not impose any discriminatory requirement on any insurance agent or broker who is not associated with the financial institution that is not imposed on any insurance agent who is associated with such institution.

III. Unless otherwise authorized by any applicable federal or state law, no financial institution shall require any debtor, insurer, broker, or agent to pay a separate charge in connection with the handling of insurance that is required under a contract.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:12 Prohibited Practices. 

I. An employee of a financial institution who is not licensed to sell insurance may refer a party to a person who is licensed to sell insurance, if the employee making such referral is compensated for such referral in an amount that does not exceed a nominal amount and such amount is not based on or related to the party's purchase of insurance.

II. The financial institution shall not offer, recommend, sponsor, or sell an insurance product which has not been properly approved for sale to New Hampshire residents.

III. An insurance product shall not be offered in a package with non-insurance products in a manner that constitutes unlawful tying activities, rebating, and unfair competition with respect to insurance sales.

IV. The payment for rental or lease of space by an unlicensed financial institution to an insurance agent or broker shall not be based directly or indirectly on the volume of premium written or insurance sold by the agent or broker.


Source. 1997, 223:3. 2000, 313:8, 9, eff. Aug. 20, 2000.

    406-C:13 Application of State and Federal Consumer Protection Provisions. 

Any financial institution which solicits or sells insurance products pursuant to RSA 383-B:3-301(d) and this chapter shall be subject to all applicable federal and state consumer protection laws, including the federal anti-tying provisions of 12 U.S.C. section 1972.


Source. 1997, 223:3. 2015, 272:33, eff. Oct. 1, 2015.

    406-C:14 Insurance Records. 

Books and records relating to the insurance transactions of a financial institution licensed to sell insurance, including all files relating to and reflecting customer complaints, shall be kept separate and apart from all records relating to other business transactions of such financial institution, and shall be made available to the insurance department for inspection upon reasonable notice.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:15 Examination Authority. 

The insurance activities of financial institutions pursuant to RSA 383-B:3-301(d) and this chapter shall be subject to examination by the commissioner and the commissioner is authorized to impose reasonable and customary assessments on the financial institution for such examination.


Source. 1997, 223:3. 2015, 272:34, eff. Oct. 1, 2015.

    406-C:16 Rulemaking Authority for Implementing Regulations. 

I. The commissioner may adopt rules to effectuate the purposes of this chapter, which are to protect the insurance buying public from potential coercion by financial institutions, to minimize the possibilities of unfair competitive practices by financial institutions that harm the public, and to maintain parity with respect to the insurance powers of state and federally chartered financial institutions.

II. The commissioner may also adopt rules which would vary the provisions of this chapter, if essential, and for the sole purpose of maintaining parity and eliminating competitive advantages enjoyed by federally chartered financial institutions, upon a determination by the commissioner that a specific federal law, regulation, or ruling creates a substantial disparity in the insurance agency powers of state and federal financial institutions in this state. Any rule adopted pursuant to this paragraph shall not diminish any consumer protection afforded under this chapter. The commissioner shall seek appropriate legislation amending any affected provisions of this chapter at the earliest legislative opportunity.

III. Rules adopted by the commissioner under this chapter shall be adopted pursuant to RSA 541-A. Notwithstanding RSA 541-A:17, I, or any other law to the contrary, any rule adopted under this chapter shall continue in force and effect until amended or repealed.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:17 Enforcement. 

Any person violating the provisions of this chapter shall be subject to any and all enforcement procedures within the authority of the insurance department including, but not limited to, the issuance of a cease and desist order requiring such person to cease all insurance sales and solicitation activities.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:18 Penalties. 

Any financial institution violating any of the provisions of this chapter or any rule adopted under this chapter may be subject to an administrative fine not to exceed $2,500 per violation. The commissioner may also suspend or revoke the license of any financial institution or other person or organization for any violation of this chapter or rule or for failure to comply with an order, including a cease and desist order, of the commissioner issued under this chapter.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:19 Provisions Severable. 

If any provision of this chapter or the application thereof to any person or circumstance is held to be invalid for any reason, such invalidity shall not affect any other provisions or applications of this chapter which can be given effect without the invalid provisions or applications, and to this end the provisions of this chapter are severable.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:2 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Customer" means a person with an investment, security, deposit, trust, or credit relationship with a financial institution.

III. "Insurance" means all products defined or regulated as insurance by the state of New Hampshire, except:

(a) Credit life, credit accident and health, credit property insurance, and credit involuntary unemployment insurance;

(b) Insurance purchased by a financial institution in connection with collateral pledged as security for a loan when the debtor breaches the contractual obligation to provide that insurance;

(c) Private mortgage insurance;

(d) Mortgage life and mortgage disability insurance; and

(e) Travel accident and baggage insurance.

IV. "
Financial institution
" means a bank, savings bank, savings and loan association, trust company, credit union, or any depository institution as defined by the Federal Deposit Insurance Act, as amended, 12 U.S.C. section 1813 (c)(1), which is authorized to take deposits and make loans from a place of business in the state. For the purpose of this chapter, the term financial institution shall also include any non-depository affiliate or subsidiary of a financial institution but only in the instances when the non-depository affiliate or subsidiary is soliciting the sale or purchase of insurance recommended or sponsored by, on the premises of, or in connection with a product offering of, the depository financial institution. Activities of employees and agents of a financial institution shall be deemed to be the activities of the financial institution. The term does not include an insurance company subject to regulation under title XXXVII.

V. "
Nonpublic customer information
" means personally identifiable financial information including any list, description, or other grouping of consumers, and publicly available information pertaining to them, that is derived using any personally identifiable financial information that is not publicly available. Nonpublic customer information also means nonpublic personal health information that identifies an individual who is the subject of the information; or with respect to which there is a reasonable basis to believe that the information could be used to identify an individual.

VI. [Repealed.]

VII. "
Personally identifiable financial information
" means any information a consumer provides to a licensee to obtain an insurance product or service from the licensee about a consumer resulting from a transaction involving an insurance product or service between a licensee and a consumer or the licensee otherwise obtains about a consumer in connection with providing an insurance product or service to that consumer.

VIII. "
Publicly available information
" means any information that a licensee has a reasonable basis to believe is lawfully made available to the general public from federal, state or local government records, widely distributed media or disclosures to the general public that are required to be made by federal, state, or local law.


Source. 1997, 223:3. 2000, 313:4, 5, 13. 2002, 207:24, 25. 2003, 144:6, eff. Jan. 1, 2004.

    406-C:3 License for Insurance Sales. 

A financial institution and the employees of a financial institution conducting insurance sales shall be required to obtain a producer's license authorizing the sale of insurance by complying with the licensing requirements of RSA 402-J.


Source. 1997, 223:3. 2000, 315:17, eff. Jan. 1, 2001.

    406-C:4 Prohibition on Underwriting. 

Neither this chapter, nor RSA 383-B:3-301(d) shall be construed to authorize any financial institution to engage in the underwriting of any insurance product or in any insurance underwriting activity requiring licensure under RSA 402 or RSA 405.


Source. 1997, 223:3. 2015, 272:32, eff. Oct. 1, 2015.

    406-C:5 Licensure Requirement. 

Solicitation for the purchase or sale of any insurance product by the financial institution shall be conducted only by persons who are licensed and have complied with all applicable state insurance licensing laws and rules, and are officers, directors, or employees of the financial institution.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:6 Authorized Carriers. 

A financial institution shall offer only insurance products of approved surplus lines carriers or approved products of insurance companies authorized to do insurance business in New Hampshire.


Source. 1997, 223:3, eff. Aug. 17, 1997.

    406-C:7 Separation of Activities. 

I. A financial institution shall, to the extent practicable, keep the area where the bank conducts transactions involving insurance products or annuities physically segregated from areas where retail deposits are routinely accepted from the general public, identify the areas where insurance product or annuity sales activities occur, and clearly delineate and distinguish those areas from the areas where the bank's retail deposit-taking activities occur.

II. Solicitation for the purchase or sale of insurance by a licensed employee who exercises authority over credit transactions shall be conducted in a manner which addresses the potential for customer confusion and coercion.

III. Signage, informational materials, and sales literature concerning the availability of insurance products through the financial institution shall be utilized and displayed in the manner required by this chapter.

IV. If the product name under which the insurance contract is marketed includes the name of a financial institution, then the marketing material must prominently identify the insurance company which issues and underwrites the insurance contract.


Source. 1997, 223:3. 2000, 313:6. 2002, 207:27. 2004, 46:1, eff. May 3, 2004.

    406-C:8 Disclosures. 

I. To avoid customer confusion and in addition to any other requisite disclosures, all advertising, promotional material, and solicitation, including telemarketing contacts in the case of life insurance and annuities, shall include a prominent disclosure that substantively states that a purchase of insurance:

(a) Is not a deposit;

(b) Is not insured by the Federal Deposit Insurance Corporation or any other agency or instrumentality of the federal government;

(c) Is not guaranteed by the financial institution or an affiliate, unless the insurance is guaranteed by such financial institution or its affiliate in which case the nature of the guarantee and identity of the guarantor shall be disclosed; and

(d) Where appropriate, involves investment risk, including potential loss of principal.

II. At the time of sale, the financial institution shall also provide written disclosure of how to complain to the insurance department about problems in the sale or solicitation of an insurance product. Other than disclosing how to complain to the insurance department, a financial institution that does not accept insured deposits is not required to disclose items I(a) through (c) of this section.


Source. 1997, 223:3. 2000, 313:7, eff. Aug. 20, 2000.

    406-C:9 Confidential Customer Information. 

The financial institution shall not disclose any nonpublic customer information, unless such disclosure is consistent with the provisions of the federal Gramm-Leach-Bliley Act and any applicable laws, or rules adopted pursuant to RSA 400-A:15, I.


Source. 1997, 223:3. 2002, 207:26, eff. July 15, 2002.

    407-B:1 Purpose. 

The purpose of this chapter is to permit the writing of motor vehicle insurance in this state on a group merchandising basis subject to the conditions stated herein, to avoid the application of any statute forbidding discrimination between insureds as to the type of business defined herein and to set forth the terms and conditions under which insurance on a group merchandising basis may be written.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-B:2 Definitions. 

The following words, as used in this chapter, unless the context otherwise requires or a different meaning is specifically prescribed, shall have the following meanings:

I. 
Group Motor Vehicle Insurance Defined. All motor vehicle insurance which is offered by a licensed insurer in this state on a group merchandising plan to an eligible group as herein defined shall be deemed group motor vehicle insurance.

II. 
Group Merchandising Defined. The marketing of group motor vehicle insurance by a licensed insurer otherwise engaged in insuring independent individual risks, to an eligible group on a guaranteed basis under a single insurance program, without individual underwriting selection or individual proof of insurability, shall be deemed group merchandising. This method of marketing insurance is generally referred to as "mass merchandising," "franchise merchandising," or "collective merchandising"; but for purposes of this section shall hereinafter be only referred to as "group merchandising" or the "group plan" as herein defined.

III. 
Eligible Group Defined. Any group to be eligible for group merchandising shall have been in existence for more than 5 years prior to the purchase of such insurance, and shall not have been organized solely for the purpose of purchasing insurance. Such group shall have a high degree of homogeneity and may include members of unincorporated and corporated associations, labor unions, employees of a common employer and similar principal agent relationships. No group will be eligible unless it consists of 500 or more members with at least 75 percent participation in the group plan. Where the group has national or other affiliates, only the members located in the state of New Hampshire shall be considered in determining the number and percentage of individuals necessary for establishing group eligibility.

IV. 
Eligible Members Defined. Eligible members shall include all members in good standing in the group provided employees shall be engaged in at least 24 hours employment per week, except as otherwise provided in RSA 407-B:4. Officers and directors of an eligible group and individual proprietors and partners shall be eligible for a group plan and as such may be considered as employees.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-B:3 General Conditions. 

Group motor vehicle insurance may be issued in this state provided the following conditions are complied with:

I. Mandatory participation in the group plan shall not be required as a condition of employment, nor shall any member not participating in the plan be coerced or discriminated against.

II. The insurer and the group insured must accept all members or employees who are eligible and wish to participate in the plan.

III. Such a group plan shall include a provision that any member of the group shall have the right to convert his group policy to an individual standard policy of insurance in the same company as offered by the insurer to the non-group insureds upon termination of his connection with the group extending to him the same limits of coverage.

IV. To qualify to write the group insurance herein defined, an insurer must also be engaged in the business of writing the type of coverage offered for insureds other than group and may not be organized solely for the purpose of furnishing coverage to such groups.

V. Each member of the group must be issued the same form of policy as approved for issue in this state varying only as to the amounts of insurance and limits of liability.

VI. Insurance must be provided by individual policies to each member of the group under an agreement whereby the premiums on such policies shall be paid to the insurer periodically by the group with or without payroll deductions.

VII. An insurer may not cancel the insurance of an individual member of the group except for the non-payment of premium by such member or unless the insurance for the entire group is cancelled. In such cases notice of cancellation as provided in like non-group policies shall be given to each member.

VIII. The plan shall provide that only those motor vehicles owned by members of the group or their spouses or children, jointly or severally, shall be eligible for coverage.

IX. All individuals considered "Eligible Members" as defined herein shall be provided with this motor vehicle group insurance plan if they wish it, provided one family member holds a valid license to operate a motor vehicle.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-B:4 Maintenance of Records. 

Every insurer writing insurance under this group merchandising plan shall keep and maintain separate experience data on this type of business including complete records of premium income, losses and expense so that the experience of each group may be fairly ascertained.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-B:5 Rates. 

Rates for this type of business shall be adequate but not excessive or unfairly discriminatory and shall be filed pursuant to the provisions of RSA 412 insofar as consistent with the provisions of this chapter.


Source. 1969, 288:1. 2003, 150:6, eff. Jan. 1, 2004.

    407-B:6 Experience Rating. 

No experience rating shall be applied to an individual group until after 3 years of operation and at that time shall be based on the experience of the preceding 3 calendar years. Thereafter, any experience rating shall be made annually using the last 3 calendar years. In case of merger of 2 or more companies, the 3-year minimum will apply to the oldest company in the newly-formed entity, not the new entity formed by the merger itself.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-B:7 Other Group Plans. 

The provisions of this chapter shall not apply to any group plans of group life insurance or group accident and sickness insurance but any existing plan of group motor vehicle insurance now in effect shall conform to the provisions of this chapter.


Source. 1969, 288:1, eff. Aug. 25, 1969.

    407-C:1 License Required. 

No individual, firm, association, or corporation shall perform, or offer to perform, in this state, for a stipulated fee covering a certain period, any form of road or other service relating to the repair, operation and care of automobiles or protection and assistance of automobile owners or drivers, other than by insurance, or to furnish or offer to furnish tourist service by selling or offering to sell to any proprietor of any so-called roadside house or camp furnishing or offering to furnish meals or lodging to the traveling public, any form of advertising to be published in so-called tourist guides or like publications, or any form of sign or other insignia indicating that said roadside house or camp has been approved by any individual, firm, association, or corporation, without being licensed therefor by the insurance commissioner.


Source. 1933, 113:1. 1939, 31:1. RL 335:1. RSA 269:1. 1981, 146:2, eff. Jan. 1, 1982.

    407-C:2 Issuance and Renewal. 

I. If the insurance commissioner is of the opinion that an applicant is reliable and entitled to confidence, such applicant shall be granted a license to perform such road or other service in this state until July 1 thereafter, and annually thereafter on July 1, such license may be renewed so long as the commissioner shall regard such licensee as reliable and entitled to confidence. Such application shall give such information as the commissioner may require, including, but not limited to, the most recent financial statement of the applicant prepared in accordance with generally accepted accounting principles and certified by a certified public accountant.

II. Individuals, firms, associations, or corporations established in this state shall file with the commissioner proof of minimum capital and surplus in an amount equal to or greater than $250,000, or shall file with the commissioner a surety bond or equivalent acceptable to the commissioner in the amount of $250,000.


Source. 1933, 113:2. RL 335:2. RSA 269:2. 1981, 146:2. 1985, 343:1. 2001, 224:4, eff. Sept. 9, 2001.

    407-C:3 Agents. 

No person, for himself or herself or in behalf of any individual, firm, association, or corporation, shall sell, or offer to sell, any such road or other service, without being licensed as a producer therefor by the insurance commissioner pursuant to the provisions of RSA 402-J. However, no producer license shall be required of a person employed by a licensed business entity pursuant to the provisions of RSA 402-J.


Source. 1933, 113:3. RL 335:3. RSA 269:3. 1981, 146:2. 2000, 315:18. 2002, 207:12, eff. July 15, 2002.

    407-C:4 Agents' Licenses. 

The insurance commissioner shall grant a producer license to sell such service in behalf of any individual firm, association, or corporation licensed therefor, to any applicant subject to the provisions of RSA 402-J.


Source. 1933, 113:4. RL 335:4. RSA 269:4. 1981, 146:2. 2002, 207:13, eff. July 15, 2002.

    407-C:5 Revocation of Licenses. 

The insurance commissioner may revoke a license at any time for cause, after hearing.


Source. 1933, 133:5. RL 335:5. RSA 269:5. 1981, 146:2, eff. Jan. 1, 1982.

    407-C:6 Fees for Licenses. 

The fees for each license issued under this chapter shall be in accordance with the provisions of RSA 400-A:29.


Source. 1933, 113:6. RL 335:6. RSA 269:6. 1969, 336:30. 1971, 244:16. 1981, 146:2, eff. Jan. 1, 1982.

    407-C:7 Penalty. 

Any individual, firm, association, or corporation violating any provision of this chapter, shall:

I. Be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person; and

II. Be subject to suspension or revocation of his license and a fine not to exceed $2,500 for each violation.


Source. 1933, 113:7. RL 335:7. RSA 269:7. 1973, 528:153. 1981, 146:2. 1991, 136:3, eff. Jan. 1, 1992.

    407-D:1 Definitions. 

In this chapter:

I. "Insurer" includes any person authorized to represent the insurer with respect to a claim who is acting within the scope of the person's authority.

II. "Non-original manufacturer" means any manufacturer other than the original manufacturer of the part.

III. "After market part" means sheet metal or plastic parts which generally constitute the exterior of a motor vehicle, including inner and outer panels.


Source. 1988, 176:2, eff. Jan. 1, 1989.

    407-D:2 Identification. 

All after market parts manufactured after January 1, 1989, shall carry sufficient permanent identification so as to identify its manufacturer. Such identification shall be accessible to the extent possible after installation.


Source. 1988, 176:2, eff. Jan. 1, 1989.

    407-D:3-a Limitation on the Use of After Market Parts. 

I. No insurer of private passenger automobiles shall require or specify the use of after market parts on:

(a) Vehicles that have been placed in service within the immediately preceding 2 years and that have 30,000 or fewer miles recorded on the odometer; or

(b) Leased vehicles if the lease provides that such parts will cause a diminution of the residual value of such vehicle.

II. In this section, "
specify
" includes writing repair estimates on the basis of the cost of after market parts or otherwise declining to pay for the cost of original equipment manufacturer replacement parts.


Source. 2016, 186:2, eff. Jan. 1, 2017.

    407-D:3 Like Kind and Quality. 

No insurer shall require the use of after market parts in the repair of an automobile unless the after market part is at least equal in like kind and quality to the original part in terms of fit, quality and performance. Insurers specifying the use of after market parts shall consider the cost of any modifications which may become necessary when making the repair.


Source. 1988, 176:2, eff. Jan. 1, 1989.

    407-D:4 Disclosure. 

I. The insurer shall disclose to the claimant in writing, either on the estimate or on a separate document attached to the estimate, the following information in no smaller print than 10 point type:

This estimate has been prepared based on the use of automobile parts not made by the original manufacturer. Parts used in the repair of your vehicle by other than the original manufacturer are required to be at least equal in like kind and quality in terms of fit, quality, and performance to the original manufacturer parts they are replacing.

II. All after market parts installed on the vehicle shall be clearly identified on the estimate of such repair.

III. Any insurer who fails to provide the precise statement in paragraph I shall be prohibited from requesting or requiring the use of after market parts.


Source. 1988, 176:2. 2016, 186:1, eff. Jan. 1, 2017.

    407-D:5 Enforcement. 

I. Any violation of this chapter by an insurer shall be deemed an unfair insurance trade practice under RSA 417. Insurers violating any provision of this chapter shall be subject to penalties under RSA 417:10.

II. Any violation of this chapter by a manufacturer shall be deemed an unfair or deceptive act or practice within the meaning of RSA 358-A:2 and may be enforced by the attorney general pursuant to RSA 358-A.


Source. 1988, 176:2, eff. Jan. 1, 1989.

    407:1 Form of Policy. 

The form of policy for fire insurance prescribed by this chapter shall be known and designated as the Standard Fire Insurance Policy for New Hampshire, hereinafter known as the Standard Fire Policy. There may be inserted before and after the words "New Hampshire" the state in which such form of policy is standard.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:10 Agent's Knowledge. 

If a company shall issue a policy upon an application prepared by a third person assuming to act as its agent or otherwise, it shall be charged with his knowledge of facts relating to the property insured as if they were stated in the application.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:11 Policy Value. 

I. If a building insured for a specified amount, whether under a separate policy or under a policy also covering other buildings, is totally destroyed by fire or lightning without criminal fault on the part of the insured or his assignee, the sum for which such building is insured shall be taken to be the value of the insured's interest therein unless overinsurance thereon was fraudulently obtained.

II. If an insured building is only partially destroyed by fire or lightning, the insured shall be entitled to the actual loss sustained not exceeding the sum insured.

III. Nothing contained in paragraphs I and II of this section shall be construed as prohibiting the use of coinsurance, or agreed amount.

IV. When a building is insured not for a specified amount but under a blanket form with one amount covering 2 or more buildings or one or more buildings and personal property, the provisions of paragraph I of this section shall not apply.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:12-a Payment of Incidental Costs. 

In the event that an insured sustains a loss covered under the policy with respect to payment of undisputed incidental costs, including but not limited to rent, the insurer shall make payment for such costs within 15 days after receipt of a valid proof of loss. The insured may commence an action after the expiration of the 15 days to recover such costs.


Source. 1992, 133:1, eff. May 4, 1992.

    407:12 Adjustment and Payment of Loss. 

The company shall begin the adjustment of the loss within 15 days after receipt of notice of loss. The amount of loss under a fire insurance policy shall be due and payable in 60 days after receipt by the insuring company of proof of loss, and the insured may commence an action after the expiration of that time to recover the same.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:13 Rebuilding. 

If the company decides to rebuild or repair the property destroyed or injured, it shall begin to do so within 20 days after adjusting the loss, and shall prosecute the work with reasonable diligence until it is completed.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:14 Neglect of Insurer. 

If the company neglects to adjust the loss within 15 days after receiving notice of it, or to begin to rebuild or repair the property destroyed or damaged within 20 days after the adjustment of the loss, the insured may proceed to rebuild or repair at the expense of the company, which shall be liable for the reasonable expenses incurred in so doing and for the loss sustained by its neglect, not exceeding the amount insured; or the insured may commence an action upon the policy.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:15 Notice to Insured. 

The insurer shall provide written notice to the insured of any denial of coverage. The notice shall inform the insured that any action based upon the denial shall be barred by law if not commenced within 12 months from the date of the written denial.


Source. 1959, 163:1. 2014, 31:6, eff. July 26, 2014.

    407:16 Judgment, etc. 

If, upon trial, the insured recovers more than the amount determined by the insurers, he shall have judgment and execution immediately therefor, with interest and costs. If he recovers no more than such amount, the court may allow interest thereon, and such costs to either party as may be just; but execution shall not issue against the company within 3 months, unless by special order of court.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:17 Suit Against Foreign Company. 

A person having a claim against an insurance company not organized under the laws of the state, arising from a transaction with an agent of the company in the state, may sue therefore in the courts of the state. Service of any process pertaining to such action upon the insurance commissioner shall have the same effect as if the company were a domestic corporation and the service were lawfully made within the state upon its officers.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:18 Non-payment of Judgment. 

If in such action the plaintiff shall recover a judgment, and the company does not pay it within 30 days after notice of it is given to the commissioner, he may suspend the authority of the company to do business in the state.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:19 Policies Written During Suspension. 

If the company or any of its agents shall issue a policy during such suspension, the company and agent shall each forfeit $200 for each policy so issued; but the policies shall be valid and binding, nevertheless.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:2-a Combination Coverages. 

Any policy or contract otherwise subject to RSA 407:2, which includes either on an unspecified basis as to the coverage or for a single premium coverage against the peril of fire and substantial coverage against other perils, need not comply with the provisions of RSA 407:2, provided:

I. Such policy or contract shall afford coverage, with respect to the peril of fire, not less than the coverage afforded by such New Hampshire Standard Fire Policy;

II. That such coverage as to the peril of fire shall be made subject without change to the same general provisions and stipulations as those of such Standard Fire Policy;

III. The provisions in relation to mortgagee interests and obligations in such Standard Fire Policy shall be incorporated therein without change;

IV. Such policy or contract is complete as to all of its terms without reference to the standard form of fire insurance policy or any other policy;

V. The insurance commissioner is satisfied that such policy or contract complies with the provisions hereof.


Source. 1981, 345:1, eff. Aug. 16, 1981.

    407:2 Use Required. 

No policy or contract of fire insurance, except for motor vehicle insurance, marine insurance, inland marine insurance, and policies used to effect reinsurance between insurers, shall be made, issued or delivered by any insurer or by any agent or representative thereof, on any property in this state unless it shall conform to all the provisions of the policy form prescribed herein. The insurance commissioner may, after hearing, revoke or suspend the license of any insurer using any other form of such policy.


Source. 1959, 163:1, eff. Jan. 1, 1960. 2020, 37:50, eff. Sept. 27, 2020.

    407:20 Action by Assignee. 

If a policy has been transferred or assigned by the insured to a person to hold absolutely or as collateral security, with the assent of the insurer, the assignee may bring an action thereon in his own name or in that of the assignor, and may recover the full amount due upon the policy for the benefit of whom it may concern.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:21 Chapter Controlling. 

Every provision and stipulation in a contract to which this chapter is applicable in conflict with this chapter shall be void and no waiver of any part thereof shall be set up by the insurer.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:22 New Form Adopted. 

The Standard Fire Policy (with permission to substitute for the word, company, a more accurate descriptive term for the type of insurer) shall be in the following form:


Standard Fire Insurance Policy for New Hampshire

No.
 
Type of Company
 Renewal of Number
 
 
 
Space for Company Name, Insignia and Location
 


Insured's Name and Mailing Address

 
 
 Space for
 
 
 Producer's
 
 
 Name and
 
 
 Mailing
 
 
 Address
 
 
........
Inception (Mo. Day Yr.)
 Expiration (Mo. Day Yr.)
 Years
 


It is important that the written portions of all policies covering the same property read exactly alike. If they do not, they should be made uniform at once.

Insurance is provided against only those perils and for only those coverages indicated below by a premium charge and against other perils and for other coverages only when endorsed hereon or added hereto.

Space for policy amounts, rates, premium, description and location of property covered.

Subject to Form No(s).
 
attached hereto.
 


Insert form number(s) and edition date(s)

Mortgage Clause: Subject to the provisions of the mortgage clause attached hereto, loss, if any, on building items, shall be payable to:

Insert name(s) of mortgagee(s) and mailing address(es)

Agency at
Countersignature Date.
 
.........................Agent
 


If any conditions of this form are construed to be more liberal than any other policy conditions relating to the perils of fire, lightning or removal, the conditions of this form shall apply.

In consideration of the provisions and stipulations herein or added hereto and of the premium above specified, this Company, for the term of years specified above from inception date shown above at 12:01 AM (Midnight, Standard Time) to expiration date shown above at 12:01 AM (Midnight, Standard Time) at location of property involved, to an amount not exceeding the amount(s) above specified, does insure the insured named above and legal representatives, to the extent of the actual cash value of the property at the time of loss, but not exceeding the amount which it would cost to repair or replace the property with material of like kind and quality within a reasonable time after such loss, without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law regulating construction or repair, and without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest of the insured, against all direct loss by fire, lightning and by removal from premises endangered by the perils insured against in this policy, except as hereinafter provided, to the property described herein while located or contained as described in this policy, or pro rata for 5 days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but not elsewhere. Assignment of this policy shall not be valid except with the written consent of this Company.

This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy.

Concealment, fraud.

Coverage under this policy shall be void for the insured who, whether before or after a loss, has intentionally concealed or misrepresented any material fact or circumstance; engaged in fraudulent conduct; or made false statements relating to this insurance.

Notice requirements.

In the event that a company or filing or rating organization eliminates or reduces coverages, conditions or definitions in its policies issued under this section other than at the request of a policyholder, the company must attach to the policy a printed notice in each such policy explaining clearly what coverages, conditions or definitions have been eliminated or reduced. If explanations of such reduced or eliminated coverages are not contained in the printed notice attached to its policies, then such coverages, conditions or definitions shall remain in full force and effect without such reductions or eliminations. The requirements of this section shall apply only to such policies renewed or endorsed with the same company.

Uninsurable and excepted property.

This policy shall not cover accounts, bills, currency, deeds, evidences of debt, money or securities; nor, unless specifically named hereon in writing, bullion or manuscripts.

Perils not included.

This Company shall not be liable for loss by fire or other perils insured against in this policy caused, directly or indirectly, by: (a) enemy attack by armed forces, including action taken by military, naval or air forces in resisting an actual or an immediately impending enemy attack; (b) invasion; (c) insurrection; (d) rebellion; (e) revolution; (f) civil war; (g) usurped power; (h) terrorism; (i) order of any civil authority except acts of destruction at the time of and for the purpose of preventing the spread of fire, provided that such fire did not originate from any of the perils excluded by this policy; (j) neglect of the insured to use all reasonable means to save and preserve the property at and after a loss, or when the property is endangered by fire in neighboring premises; (k) nor shall this Company be liable for loss by theft.

Other insurance.

Other insurance may be prohibited or the amount of insurance may be limited by endorsement attached hereto.

Conditions suspending or restricting insurance.

Unless otherwise provided in writing added hereto this Company shall not be liable for loss occurring (a) while the hazard is increased by any means within the control or knowledge of the insured; or (b) while a described building, whether intended for occupancy by owner or tenant, is vacant or unoccupied beyond a period of 60 consecutive days; or (c) as a result of explosion or riot, unless fire ensues, and in that event for loss by fire only.

Other perils or subjects.

Any other peril to be insured against or subject of insurance to be covered in this policy shall be by endorsement in writing hereon or added hereto.

Added provisions.

The extent of the application of insurance under this policy and of the contribution to be made by this Company in case of loss, and any other provision or agreement not inconsistent with the provisions of this policy, may be provided for in writing added hereto, but no provision may be waived except such as by the terms of this policy is subject to change.

Waiver provisions.

No permission affecting this insurance shall exist, or waiver of any provision be valid, unless granted herein or expressed in writing added hereto. No provision, stipulation or forfeiture shall be held to be waived by any requirement or proceeding on the part of this Company relating to appraisal or to any examination provided for herein.

Cancellation of policy.

This policy shall be cancelled at any time at the request of the insured, in which case this Company shall, upon demand and surrender of this policy, refund the excess of paid premium above the customary short rates for the expired time. This policy may be cancelled at any time by this Company by giving to the insured a 5 days' written notice of cancellation with or without tender of the excess of paid premium above the pro rata premium for the expired time, which excess, if not tendered, shall be refunded on demand. Notice of cancellation shall state that said excess premium (if not tendered) will be refunded on demand.

Mortgagee interests and obligations.

If loss hereunder is made payable, in whole or in part, to a designated mortgagee not named herein as the insured, such interest in this policy may be cancelled by giving to such mortgagee a 10 days' written notice of cancellation.

If the insured fails to render proof of loss such mortgagee, upon notice, shall render proof of loss in the form herein specified within 60 days thereafter and shall be subject to the provisions hereof relating to appraisal and time of payment and of bringing suit. If this Company shall claim that no liability existed as to the mortgagor or owner, it shall, to the extent of payment of loss to the mortgagee, be subrogated to all the mortgagee's rights of recovery, but without impairing mortgagee's right to sue; or it may pay off the mortgage debt and require an assignment thereof and of the mortgage. Other provisions relating to the interests and obligations of such mortgagee may be added hereto by agreement in writing.

Pro rata liability.

This Company shall not be liable for a greater proportion of any loss than the amount hereby insured shall bear to the whole insurance covering the property against the peril involved, whether collectible or not.

Requirements in case loss occurs.

The insured shall give immediate written notice to this Company of any loss, protect the property from further damage, forthwith separate the damaged and undamaged personal property, put it in the best possible order, furnish a complete inventory of the destroyed, damaged and undamaged property, showing in detail quantities, costs, actual cash value and amount of loss claimed; and within 60 days after the loss, unless such time is extended in writing by this Company, the insured shall render to this Company a proof of loss, signed and sworn to by the insured, stating the knowledge and belief of the insured as to the following: the time and origin of the loss, the interest of the insured and of all others in the property, the actual cash value of each item thereof and the amount of loss thereto, all encumbrances thereon, all other contracts of insurance, whether valid or not, covering any of said property, any changes in the title, use, occupation, location, possession or exposures of said property since the issuing of this policy, by whom and for what purpose any building herein described and the several parts thereof were occupied at the time of loss and whether or not it then stood on leased ground, and shall furnish a copy of all the descriptions and schedules in all policies and, if required, verified plans and specifications of any building, fixtures or machinery destroyed or damaged. The insured, as often as may be reasonably required, shall exhibit to any person designated by this Company all that remains of any property herein described, and submit to examinations under oath by any person named by this Company, and subscribe the same and, as often as may be reasonably required, shall produce for examination all books of account, bills, invoices and other vouchers, or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by this Company or its representative, and shall permit extracts and copies thereof to be made.

Appraisal.

In case the insured and this Company shall fail to agree as to the actual cash value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within 20 days of such demand. The appraisers shall first select a competent and disinterested umpire; and failing for 15 days to agree upon such umpire, then, on request of the insured or this Company, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any 2 when filed with this Company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting him and the expenses of appraisal and umpire shall be paid by the parties equally.

Company's options.

It shall be optional with this Company to take all, or any part, of the property at the agreed or appraised value, and also to repair, rebuild or replace the property destroyed or damaged with other of like kind and quality within a reasonable time, on giving notice of its intention so to do within 30 days after the receipt of the proof of loss herein required.

Abandonment.

There can be no abandonment to this Company of any property.

When loss payable.

The amount of loss for which this Company may be liable shall be payable 60 days after proof of loss, as herein provided, is received by this Company and ascertainment of the loss is made either by agreement between the insured and this Company expressed in writing or by the filing with this Company of an award as herein provided.

Suit.

No suit or action on this policy for the recovery of any claim shall be sustainable in any court of law or equity unless the requirements of this policy shall have been complied with, and unless commenced within 12 months next after inception of the loss.

Subrogation.

This Company may require from the insured an assignment of all right of recovery against any party for loss to the extent that payment therefor is made by this Company.

In Witness Whereof, this Company has executed and attested these presents; but this policy shall not be valid unless countersigned by the duly authorized Agent of this Company at the agency hereinbefore mentioned.
Insert signatures and



titles of proper officers



Source. 1959, 163:1. 1981, 349:1. 2000, 260:5. 2001, 224:3. 2003, 144:7. 2006, 196:5. 2009, 215:3, eff. Jan. 1, 2010.

    407:23-a Flood Damage;  Notice to Policyholder. 

I. Every insurer issuing a homeowner, condominium unit owner, residential tenant, and residential fire insurance policy that does not cover damage caused by flood shall notify the policyholder that the policy does not cover damage caused by flood. The notice shall also inform the policyholder how to contact the National Flood Insurance Program (NFIP) or the NFIP's agents. The notice may be included with other materials sent to the policyholder, as a separate document or included on the declarations page of the policy. The notice shall be provided:

(a) At the time the policy is issued; and

(b) At the time the policy is renewed.

II. The following statement, or language substantially similar, when combined with current information about how to contact the NFIP or its agent, satisfies the notice requirements of this section:

"This policy does not cover damage to your property caused by flooding. The federal government offers flood insurance through the National Flood Insurance Program to residents of communities that participate in its program. You can learn more about the National Flood Insurance Program at www.floodsmart.gov or by calling (888)379-9531."

III. The failure to comply with this section shall not invalidate a flood exclusion, or any other exclusion, in an insurance policy subject to this section.


Source. 2014, 52:1, eff. Jan. 1, 2015.

    407:23 Nuclear Perils. 

The Standard Fire Policy prescribed by this chapter is not intended to cover loss or damage caused by nuclear reaction or nuclear radiation or radioactive contamination, whether or not directly or indirectly resulting from an insured peril under said policy. Insurers issuing the Standard Policy pursuant to this chapter are authorized to affix thereto or include therein a written statement that the policy does not cover loss or damage caused by nuclear reaction or nuclear radiation or radioactive contamination, all whether directly or indirectly resulting from an insured peril under said policy. Provided, however, that nothing herein contained shall be construed to prohibit the attachment to any such policy of an endorsement or endorsements specifically assuming coverage for loss or damage caused by nuclear reaction or nuclear radiation or radioactive contamination.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:24 Conflicting Acts. 

Any act or parts of acts which may be construed as providing for a form different from the one herein prescribed are hereby repealed.


Source. 1959, 163:2, eff. Jan. 1, 1960.

    407:3 Other Material Required. 

I. There shall be printed at the head of said policy the name of the insurer or insurers issuing the policy, the location of the home office thereof, a statement whether said insurer or insurers are stock or mutual corporations or are Lloyd's underwriters; and the insurer or insurers may add thereto such device or devices as may be approved by the insurance commissioner.

II. If the policy is issued by a mutual or cooperative insurer having special regulations with respect to the payment by the policyholder of assessments, such regulations shall be printed upon the policy, and any such insurer may print upon the policy such regulations as may be appropriate to or required by its form of organization.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:4 Change of Arrangement. 

The insurance commissioner is authorized to change the shape, size and general arrangement of the Standard Fire Policy as he may think the public good requires.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:5 Combination Form. 

Two or more insurers authorized to do in this state the business of fire insurance, may, with the approval of the insurance commissioner, issue a combination standard form of fire policy which shall contain the following provisions:

I. A provision substantially to the effect that the insurers executing such policy shall be severally liable for the full amount of any loss or damage, according to the terms of the policy, or for specified percentages or amounts thereof, aggregating the full amount of such insurance under such policy.

II. A provision substantially to the effect that service of process, or of any notice or proof of loss required by such policy, upon any of the insurers executing such policy, shall be deemed to be service upon all such insurers.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:6 Temporary Insurance. 

Binders or other contracts for temporary insurance may be made, orally or in writing, and shall be deemed to include all the terms of such Standard Fire Policy and all such applicable endorsements as may be designated in such contract of temporary insurance; except that the cancellation clause of such Standard Fire Policy, and the clause thereof specifying the hour of the day at which the insurance shall commence, may be superseded by the express terms of such contract of temporary insurance.


Source. 1959, 163:1. 1986, 157:3, eff. May 28, 1986.

    407:7 Forms for Other Insurance. 

Appropriate forms of other contracts or endorsements, insuring against one or more of the perils incident to the ownership, use or occupancy of said property, other than fire and lightning, which the insurer is empowered to assume, may be used in connection with the Standard Fire Policy. Such forms of other contracts or endorsements attached or printed thereon may contain provisions and stipulations inconsistent with the Standard Fire Policy if applicable only to such other perils. The pages of the Standard Fire Policy may be renumbered and rearranged to provide space for the listing of rates and premiums for coverages.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:8 Use of Forms. 

A copy of the forms or endorsements providing coverage to be used with the Standard Fire Policy shall be filed with the insurance commissioner. The commissioner is given authority to disapprove any such form if he shall find it to be unfair or inequitable or if it does not comply with the requirements of law or conform to the filings made under the law relating to the regulation of rates.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    407:9 Descriptions Not Warranties. 

Descriptions of property and statements concerning its value and the title of the insured thereto in an application for insurance or in an insurance policy shall not be treated as warranties.


Source. 1959, 163:1, eff. Jan. 1, 1960.

    408-A:1 Purpose. 

The purpose of this chapter is to promote the public welfare by regulating credit life insurance and credit accident and health insurance. Nothing in this chapter is intended to prohibit or discourage reasonable competition. The provisions of this chapter shall be liberally construed.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:10 Claims. 

I. All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract.

II. All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to one specified.

III. No plan or arrangement shall be used whereby any person, firm or corporation other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; provided, that a group policyholder may, by arrangement with the group insurer, draw drafts or checks in payment of claims due to the group policyholder subject to audit and review by the insurer.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:11 Existing Insurance, Choice of Insurer. 

When credit life insurance or credit accident and health insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor, have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by him or of procuring and furnishing the required coverage through any insurer authorized to transact an insurance business within this state.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:12 Enforcement. 

The commissioner may, after notice and hearing, issue such rules and regulations as he deems appropriate for the supervision of this chapter. Whenever the commissioner finds that there has been a violation of this chapter or any rules or regulations issued pursuant thereto, and after written notice thereof and hearing given to the insurer or other person authorized or licensed by the commissioner, he shall set forth the details of his findings together with an order for compliance by a specified date. Such order shall be binding on the insurer and other person authorized or licensed by the commissioner on the date specified unless sooner withdrawn by the commissioner or a stay thereof has been ordered by a court of competent jurisdiction.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:13 Judicial Review. 

Any party to the proceeding affected by an order of the commissioner shall be entitled to a rehearing and appeal in accordance with the provisions of RSA 541.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:14 Penalties. 

In addition to any other penalty provided by law, any person who violates an order of the commissioner after it has become final, and while such order is in effect, shall, upon proof thereof to the satisfaction of the court, forfeit and pay to the state of New Hampshire a sum not to exceed $250 which may be recovered in a civil action, except that if such violation is found to be willful, the amount of such penalty shall be a sum not to exceed $1,000. The commissioner, in his discretion, may revoke or suspend the license or certificate of authority of the person guilty of such violation. Such order for suspension or revocation shall be upon notice and hearing, and shall be subject to judicial review as provided in RSA 408-A:13.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:15 Separability Provision. 

If any provision of this chapter, or the application of such provision of any person or circumstances, shall be held invalid, the remainder of the chapter, and the application of such provision to any person or circumstances other than those as to which it is held invalid, shall not be affected thereby.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:2 Scope and Definitions. 

I. This chapter may be cited as "The Model Act for the Regulation of Credit Life Insurance and Credit Accident and Health Insurance."

II. All life insurance and all accident and health insurance sold in connection with loans or other credit transactions shall be subject to the provisions of this chapter except such insurance sold in connection with:

(a) A loan or other credit transaction of more than 15 years' duration; or

(b) A first real estate mortgage; or

(c) A loan secured by a filing under the Uniform Commercial Code pursuant to RSA 477:44, IV.

III. For the purpose of this chapter:

(a) "Credit life insurance" means insurance on the life of a debtor pursuant to or in connection with a specific loan or other credit transaction;

(b) "Credit accident and health insurance" means insurance on a debtor to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor is disabled as defined in the policy;

(c) "Creditor" means the lender of money or vendor or lessor of goods, services, property, rights or privileges, for which payment is arranged through a credit transaction or any successor to the right, title or interest of any such lender, vendor, or lessor, and an affiliate, associate or subsidiary of any of them or any director, officer, or employee of any of them or any other person in any way associated with any of them;

(d) "Debtor" means a borrower of money or a purchaser or lessee of goods, services, property, rights or privileges for which payment is arranged through a credit transaction;

(e) "Indebtedness" means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction, except, with respect to credit life insurance issued in connection with a loan or other credit transaction with terms greater than 75 months, "indebtedness" shall mean only the amount necessary to liquidate the remaining debt of a debtor in a single lump sum payment, excluding any unearned interest, unearned finance charges, late charges, or past due amounts more than 2 months delinquent. This exception shall not apply to leases;

(f) "
Commissioner
" means the insurance commissioner of the state of New Hampshire;

(g) "
Credit unemployment insurance
" means insurance on a debtor to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor is unemployed or on leave as defined in the policy.


Source. 1959, 66:1. 1973, 585:2. 1977, 406:1. 1985, 259:1. 1998, 385:1. 2000, 243:1, 2, eff. Aug. 7, 2000.

    408-A:3 Forms of Credit Life Insurance and Credit Accident and Health Insurance. 

Credit life insurance and credit accident and health insurance shall be issued only in the following forms:

I. Individual policies of life insurance issued to debtors on the term plan;

II. Individual policies of accident and health insurance issued to debtors on a term plan or disability benefit provisions in individual policies of credit life insurance;

III. Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan;

IV. Group policies of accident and health insurance issued to creditors on a term plan insuring debtors or disability benefit provisions in group credit life insurance policies to provide such coverage.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:4 Amount of Credit Life Insurance and Credit Accident and Health Insurance. 

I. 
Credit Life Insurance. The amount of credit life insurance shall not exceed the initial indebtedness. Where an indebtedness repayable in substantially equal installments is secured by an individual policy of credit life insurance, the amount of insurance shall at no time exceed the scheduled amount of indebtedness, and where secured by a group policy of credit life insurance, shall at no time exceed the amount of unpaid indebtedness.

II. 
Credit Accident and Health Insurance. The total amount of indemnity payable by credit accident and health insurance in the event of disability, as defined in the policy, shall not exceed the aggregate of the periodic scheduled unpaid installments of the indebtedness; and the amount of each periodic indemnity payment shall not exceed the original indebtedness divided by the number of periodic installments.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:5-a Credit Unemployment Insurance. 

Credit unemployment insurance may be sold in connection with loans or other credit transactions, subject to the provisions of this chapter as applied to credit life insurance and credit accident and health insurance. Any insurer authorized to offer the coverage specified by this chapter may sell credit unemployment insurance pursuant to this chapter.


Source. 2000, 243:3, eff. Aug. 7, 2000.

    408-A:5 Term of Credit Life Insurance and Credit Accident and Health Insurance. 

The term of any credit life insurance or credit accident and health insurance shall, subject to acceptance by the insurer, commence on the date when the debtor becomes obligated to the creditor, or the date from which interest or finance charges accrue if later, except that, where a group policy provides coverage with respect to existing obligations, the insurance on a debtor with respect to such indebtedness shall commence on the effective date of the policy. Where evidence of insurability is required and such evidence is furnished more than 30 days after the date when the debtor becomes obligated to the creditor, the term of the insurance may commence on the date on which the insurance company determines the evidence to be satisfactory, and in such event there shall be an appropriate refund or adjustment of any charge to the debtor for insurance. The term of such insurance shall not extend more than 15 days beyond the scheduled maturity date of the indebtedness except when extended without additional cost to the debtor. If the indebtedness is discharged due to renewal or refinancing prior to the scheduled maturity date, the insurance in force shall be terminated before any new insurance may be issued in connection with the renewed or refinanced indebtedness. In all cases of termination prior to scheduled maturity, a refund shall be paid or credited as provided in RSA 408-A:8.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:6 Provisions of Policies and Certificates of Insurance;  Disclosure to Debtors. 

I. All credit life insurance and credit accident and health insurance sold shall be evidenced by an individual policy, or in the case of group insurance by a certificate of insurance, which individual policy or group certificate of insurance shall be delivered to the debtor.

II. Each individual policy or group certificate of credit life insurance, and/or credit accident and health insurance shall, in addition to other requirements of law, set forth the name and home office address of the insurer, and the identity by name or otherwise of the person or persons insured, the rate or amount of payment, if any, by the debtor separately for credit life insurance and credit accident and health insurance, a description of the amount, term and coverage including any exceptions, limitations or restrictions, and shall state that the benefit shall be paid to the creditor to reduce or extinguish the unpaid indebtedness and, wherever the amount of insurance may exceed the unpaid indebtedness, that any such excess shall be payable to a beneficiary, other than the creditor, named by the debtor or to his estate.

III. Said individual policy or group certificate of insurance shall be delivered to the insured debtor at the time the indebtedness is incurred except as hereinafter provided.

IV. If said individual policy or group certificate of insurance is not delivered to the debtor at the time the indebtedness is incurred, a copy of the application for such policy or a notice of proposed insurance, signed by the debtor and setting forth the name and home office address of the insurer, the identity by name or otherwise of the person or persons insured, the rate or amount of payment by the debtor, if any, separately for credit life insurance and credit accident and health insurance, a description of the amount, term and coverage provided, shall be delivered to the debtor at the time such indebtedness is incurred. The copy of the application for, or notice of proposed insurance, shall refer exclusively to insurance coverage, and shall be separate and apart from the loan, sale or other credit statement of account, instrument or agreement, unless the information required by this paragraph is prominently set forth therein. Upon acceptance of the insurance by the insurer and within 30 days of the date upon which the indebtedness is incurred, the insurer shall cause the individual policy or group certificate of insurance to be delivered to the debtor. Said application or notice of proposed insurance shall state that upon acceptance by the insurer, the insurance shall become effective as provided in RSA 408-A:5.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:7 Filing, Approval and Withdrawal of Forms. 

I. All policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders shall be filed with the commissioner of the state in which the policy is issued.

II. The commissioner shall within 30 days after the filing of any such policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders, disapprove any such form if the table of premium rates charged or to be charged appears by reasonable assumptions to be excessive in relation to benefits, or if it contains provisions which are unjust, unfair, inequitable, misleading, deceptive or encourage misrepresentation of the coverage, or are contrary to any provision of the insurance code or any rule or regulation promulgated thereunder.

III. If the commissioner notifies the insurer that the form is disapproved it is unlawful thereafter for such insurer to issue or use such form. In such notice, the commissioner shall specify the reason for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer. No such policy, certificate of insurance, notice of proposed insurance, nor any application, endorsement or rider, shall be issued or used until the expiration of 30 days after it has been so filed, unless the commissioner shall give his prior written approval thereto.

IV. The commissioner may, at any time after a hearing held not less than 20 days after written notice to the insurer, withdraw his approval of any such form on any ground set forth in paragraph II above. The written notice of such hearing shall state the reason for the proposed withdrawal.

V. It is not lawful for the insurer to issue such forms or use them after the effective date of such withdrawal.

VI. Any order or final determination of the commissioner under the provisions of this section shall be subject to judicial review.


Source. 1959, 66:1, eff. June 22, 1959.

    408-A:8 Premiums and Refunds. 

I. Each insurer issuing credit life insurance or credit accident and health insurance shall file with the commissioner its schedules of premium rates for use in connection with such insurance. Any insurer may revise such schedules from time to time, and shall file such revised schedules with the commissioner. No insurer shall issue any credit life insurance policy or credit accident and health insurance policy for which the premium rate exceeds that determined by the schedules of such insurer as then on file with the commissioner. The commissioner may require the filing of the schedule of premium rates for use in connection with and as a part of the specific policy filings as provided by RSA 408-A:7.

II. Each individual policy, group certificate or notice of proposed insurance shall provide that in the event of termination of the insurance prior to the scheduled maturity date of the indebtedness, any refund of an amount paid by the debtor for insurance shall be paid or credited promptly to the person entitled thereto within 30 days from the termination of the insurance; provided, however, that the commissioner shall prescribe a minimum refund and no refund which would be less than such minimum need be made. The formula to be used in computing such refund shall be filed with and approved by the commissioner. For any refund which is not paid within this 30-day period, the person to whom the premium is owed shall be entitled to interest beginning on day 31, at the legal rate.

II-a. [Repealed.]

II-b. [Repealed.]

III. If a creditor requires a debtor to make any payment for credit life insurance or credit accident and health insurance and an individual policy or group certificate of insurance is not issued, the creditor shall immediately give written notice to such debtor and shall promptly make an appropriate credit to the account.

IV. The amount charged to a debtor for credit life or credit health and accident insurance shall not exceed the premium charged by the insurer, as computed at the time the charge to the debtor is determined.


Source. 1959, 66:1. 1988, 221:2. 1989, 173:2, eff. July 1, 1989.

    408-A:9 Issuance of Policies. 

All policies of credit life insurance and credit accident and health insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business therein, and shall be issued only through holders of licenses or authorizations issued by the commissioner unless the sale is by a financial institution pursuant to RSA 406-C.


Source. 1959, 66:1, eff. June 22, 1959. 2022, 223:6, eff. Aug. 16, 2022.

    408-B:1 Title. 

This chapter shall be known and may be cited as the New Hampshire Life and Health Insurance Guaranty Association Act of 1996.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:10 Plan of Operation. 

I. (a) The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon the commissioner's written approval or unless the commissioner has not disapproved it within 30 days.

(b) If the association fails to submit a suitable plan of operation within 120 days after January 1, 1996, or if at any time thereafter the association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt such reasonable rules under RSA 541-A as are necessary or advisable to effectuate the provisions of this chapter. The rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner.

II. All member insurers shall comply with the plan of operation.

III. The plan of operation shall, in addition to requirements enumerated elsewhere in this chapter:

(a) Establish procedures for handling the assets of the association.

(b) Establish the amount and method of reimbursing members of the board of directors under RSA 408-B:7.

(c) Establish regular places and times for meetings including telephone conference calls of the board of directors.

(d) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors.

(e) Establish the procedures whereby selections for the board of directors will be made and submitted to the commissioner.

(f) Establish any additional procedure for assessments under RSA 408-B:9.

(g) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

IV. The plan of operation may provide that any or all powers and duties of the association, except those under RSA 408-B:8, XIII(c) and RSA 408-B:9, are delegated to a corporation, association or other organization which performs or will perform functions similar to those of this association, or its equivalent, in 2 or more states. Such a corporation, association, or organization shall be reimbursed for any payments made on behalf of the association and shall be paid for its performance of any function of the association. A delegation under this paragraph shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:11 Duties and Powers of the Commissioner. 

In addition to the duties and powers enumerated elsewhere in this chapter:

I. The commissioner shall:

(a) Upon request of the board of directors, provide the association with a statement of the premiums in this and any other appropriate states for each member insurer.

(b) When an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time; notice to the impaired insurer shall constitute notice to its shareholders, if any; the failure of the insurer to promptly comply with such demand shall not excuse the association from the performance of its powers and duties under this chapter.

(c) In any liquidation or rehabilitation proceeding involving a domestic insurer, be appointed as the liquidator or rehabilitator.

II. The commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. Such forfeiture shall not exceed 5 percent of the unpaid assessment per month, but no forfeiture shall be less than $100 per month.

III. Any action of the board of directors or the association may be appealed to the commissioner by any member insurer if the appeal is taken within 60 days of the final action being appealed. If a member company is appealing an assessment, the amount assessed shall be paid to the association and available to meet association obligations during the pendancy of an appeal. If the appeal on the assessment is upheld, the amount paid in error or excess shall be returned to the member company. Any final action or order of the commissioner shall be subject to judicial review in a court of competent jurisdiction.

IV. The liquidator, rehabilitator, or conservator of any impaired insurer may notify all interested persons of the effect of this chapter.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:12 Prevention of Insolvencies. 

To aid in the detection and prevention of insurer insolvencies or impairments:

I. It shall be the duty of the commissioner:

(a) To notify the commissioners of all the other states, territories of the United States, and the District of Columbia when the commissioner takes any of the following actions against a member insurer:

(1) Revocation of license;

(2) Suspension of license; or

(3) Makes any formal order that such company restrict its premium writing, obtain additional contributions to surplus, withdraw from the state, reinsure all or any part of its business, or increase capital, surplus, or any other account for the security of policyholders or creditors.

The notice shall be mailed to all commissioners within 30 days following the action taken or the date on which such action occurs.

(b) To report to the board of directors when the commissioner has taken any of the actions set forth in subparagraph (a) or has received a report from any other commissioner indicating that any such action has been taken in another state. The report to the board of directors shall contain all significant details of the action taken or the report received from another commissioner.

(c) To report to the board of directors when the commissioner has reasonable cause to believe from any examination, whether completed or in process, of any member company that the company may be an impaired or insolvent insurer.

(d) To furnish to the board of directors the NAIC Insurance Regulatory Information System (IRIS) ratios and listings of companies not included in the ratios developed by the National Association of Insurance Commissioners, and the board may use the information contained therein in carrying out its duties and responsibilities under this section. The report and the information contained therein shall be kept confidential by the board of directors until such time as made public by the commissioner or other lawful authority.

II. The commissioner may seek the advice and recommendations of the board of directors concerning any matter affecting the duties and responsibilities of the commissioner regarding the financial condition of member insurers and companies seeking admission to transact insurance business in this state.

III. The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation, or conservation of any member insurer or germane to the solvency of any company seeking to do insurance business in this state. Such reports and recommendations shall not be considered public documents.

IV. It shall be the duty of the board of directors, upon majority vote, to notify the commissioner of any information indicating any member insurer may be an impaired or insolvent insurer.

V. The board of directors may, upon majority vote, request that the commissioner order an examination of any member insurer which the board in good faith believes may be an impaired or insolvent insurer. Within 30 days of the receipt of such request, the commissioner shall begin an examination. The examination may be conducted as a National Association of Insurance Commissioners examination or may be conducted by such persons as the commissioner designates. The cost of the examination shall be paid by the association and the examination report shall be treated as are other examination reports. In no event shall the examination report be released to the board of directors prior to its release to the public, but this shall not preclude the commissioner from complying with paragraph I. The commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the commissioner, but it shall not be open to public inspection prior to the release of the examination report to the public.

VI. The board of directors may, upon majority vote, make recommendations to the commissioner for the detection and prevention of insurer insolvencies.

VII. The board of directors shall, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report to the commissioner containing such information as it may have in its possession bearing on the history and causes of the insolvency. The board shall cooperate with the boards of directors of guaranty associations in other states in preparing a report on the history and causes of insolvency of a particular insurer, and may adopt by reference any report prepared by such other associations.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:13 Credits for Assessments Paid. 

I. A member insurer may offset against its tax liability under RSA 400-A any assessment described in RSA 408-B:9, II(b) for the life insurance and annuity account, and for the health account for guaranteeing the performance of contractual obligations of an impaired or insolvent insurer in regard to disability income coverages only, to the extent of 20 percent of the amount of the assessment for each of the 5 calendar years following the year in which the assessment was paid. If a member insurer ceases doing business, all uncredited assessments described above may be credited against its tax liability under RSA 400-A for the year it ceases doing business.

II. Any sums acquired by refund from the association by member insurers, as stated in RSA 408-B:9, VI, and which were previously offset against taxes as described in paragraph I, shall be paid by these insurers to the state of New Hampshire in the manner required by the commissioner. The association shall notify the commissioner that refunds have been made.


Source. 1995, 305:1. 1996, 188:20, eff. Jan. 1, 1997.

    408-B:14 Miscellaneous Provisions. 

I. Nothing in this chapter shall be construed to reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment liability.

II. Records shall be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under RSA 408-B:8. Records of the negotiations or meetings shall be made public only upon the termination of a liquidation, rehabilitation, or conservation proceeding involving the impaired or insolvent insurer, upon the termination of the impairment or insolvency of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this paragraph shall limit the duty of the association or render a report of its activities under this section.

III. For the purpose of carrying out its obligations under this chapter, the association shall be deemed to be a creditor of the impaired or insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee pursuant to RSA 408-B:8, XIII. Assets of the impaired or insolvent insurer attributable to covered policies shall be used to continue all covered policies and pay all contractual obligations of the impaired or insolvent insurer as required by this chapter. Assets attributable to covered policies, as used in this subsection, are that proportion of the assets which the reserves that should have been established for such policies bear to the reserves that should have been established for all policies of insurance written by the impaired or insolvent insurer.

IV. (a) Prior to the termination of any liquidation, rehabilitation or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders, and policyowners of the insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of the insolvent insurer. In such a determination, consideration shall be given to the welfare of the policyholders of the continuing or successor insurer.

(b) No distribution to stockholders, if any, of an impaired or insolvent insurer shall be made until and unless the total amount of valid claims of the association with interest thereon for funds expended in carrying out its powers and duties under RSA 408-B:8 with respect to the insurer have been fully recovered by the association.

V. (a) If an order for liquidation or rehabilitation of an insurer domiciled in this state has been entered, the receiver appointed under the order shall have a right to recover on behalf of the insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation subject to the limitations of subparagraphs (b)-(d).

(b) No such distribution shall be recoverable if the insurer shows that when paid the distribution was lawful and reasonable, and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations.

(c) Any person who was an affiliate that controlled the insurer at the time the distributions were paid shall be liable up to the amount of distributions received. Any person who was an affiliate that controlled the insurer at the time the distributions were declared, shall be liable up to the amount of distributions which would have been received if they had been paid immediately. If 2 or more persons are liable with respect to the same distributions, they shall be jointly and severally liable.

(d) The maximum amount recoverable under this paragraph shall be the amount needed in excess of all other available assets of the insolvent insurer to pay the contractual obligations of the insolvent insurer.

(e) If any person liable under subparagraph (c) is insolvent, all its affiliates that controlled it at the time the distribution was paid, shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:15 Examination of the Association;  Annual Report. 

The association shall be subject to examination and regulation 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 the preceding fiscal year.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:16 Tax Exemptions. 

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. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:17 Immunity. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or the commissioner's representatives, for any action or omission by them in the performance of their powers and duties under this chapter. Such immunity shall extend to the participation in any organization of one or more other state associations of similar purposes and to any such organization and its agents or employees.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:18 Stay of Proceedings;  Reopening Default Judgments. 

All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed 60 days from the date an order of liquidation, rehabilitation or conservation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to judgment under any decision, order, verdict, or finding based on default, the association may apply to have such judgment set aside by the same court that made such judgment and shall be permitted to defend against such suit on the merits.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:19 Prohibited Advertisement of Insurance Guaranty Association Act in Insurance Sales;  Notice to Policyholders. 

I. No person, including an insurer, agent or affiliate of an insurer shall make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or television station, or in any other way, any advertisement, announcement or statement, written or oral, which uses the existence of the insurance guaranty association of this state for the purpose of sales, solicitation or inducement to purchase any form of insurance covered by the New Hampshire life and health insurance guaranty association act. Provided, however, that this paragraph shall not apply to the New Hampshire life and health insurance guaranty association or any other entity which does not sell or solicit insurance. The use of the protection afforded by this chapter, other than as provided by this paragraph, by any person in the sale, marketing, or advertising of insurance constitutes unfair competition and unfair practices under the New Hampshire unfair trade practices act, and is subject to sanctions imposed in that chapter.

II. Within 180 days after January 1, 1996, the association shall prepare a summary document describing the general purposes and current limitations of the chapter and complying with paragraph III. This document shall be submitted to the commissioner for approval. Unless paragraph IV applies, at the expiration of the 60th day after the date on which the commissioner approves the document, an insurer may not deliver a policy or contract covered by a guaranty fund to a policy or contract holder unless the summary document is delivered to the policy or contract holder prior to or at the time of delivery of the policy or contract. The document shall also be available upon request by a policyholder. The distribution, delivery or contents or interpretation of this document does not guarantee that either the policy or the contract or the holder of the policy or contract is covered in the event of the impairment or insolvency of a member insurer. The description document shall be revised by the association as amendments to the chapter may require. Failure to receive this document does not give the policyholder, contract holder, certificate holder, or insured any greater rights than those stated in this chapter.

III. The document prepared under paragraph II shall contain a clear and conspicuous disclaimer on its face. The commissioner shall approve the disclaimer. The disclaimer shall:

(a) State the name, address and telephone number of the life and health insurance guaranty association and insurance department.

(b) Prominently warn the policy or contract holder that the life and health insurance guaranty association may not cover the policy or, if coverage is available, it will be subject to substantial limitations and exclusions and conditioned on continued residence in the state.

(c) State the types of policies for which guaranty funds will provide coverage.

(d) State that the insurer and its agents are prohibited by law from using the existence of the life and health insurance guaranty association for the purpose of sales, solicitation, or inducement to purchase any form of insurance.

(e) State that the policy or contract holder should not rely on coverage under the life and health insurance guaranty association when selecting an insurer.

(f) Explain rights available and procedures for filing a complaint to allege a violation of any provisions of this chapter.

(g) Provide other information as directed by the commissioner, including but not limited to, sources for information about the financial condition of insurers provided that the information is not proprietary and is subject to disclosure under that state's public records law.

IV. No insurer or agent may deliver a policy or contract not covered by the association unless the insurer or agent, prior to or at the time of delivery, gives the policy or contract holder a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the life and health insurance guaranty association. The commissioner shall approve the notice.


Source. 1995, 305:1. 1997, 167:4, 5, eff. Aug. 8, 1997.

    408-B:2 Purpose. 

I. The purpose of this chapter is to protect, subject to certain limitations, the persons specified in RSA 408-B:5, I against failure in the performance of contractual obligations, under life and health insurance policies and annuity contracts specified in RSA 408-B:5, II, because of the impairment or insolvency of the member insurer that issued the policies or contracts.

II. To provide this protection, an association of insurers is created to pay benefits and to continue coverages as limited herein, and members of the association are subject to assessment to provide funds to carry out the purpose of this chapter.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:20 Prospective Application. 

This chapter shall not apply to any insurer which is insolvent or unable to fulfill its contractual obligations on January 1, 1996.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:3 Construction. 

This chapter shall be liberally construed to effect the purpose under RSA 408-B:2 which shall constitute an aid and guide to interpretation.


Source. 1995, 305:1, eff. Jan. 1, 1996.

    408-B:4 Definitions. 

In this chapter:

I. "Account" means either of the 2 accounts created under RSA 408-B:6.

II. "Association" means the New Hampshire life and health insurance guaranty association created under RSA 408-B:6.

III. "Commissioner" means the commissioner of insurance.

IV. "Contractual obligation" means any obligation under a policy or contract or certificate under a group policy or contract, or portion thereof for which coverage is provided under RSA 408-B:5.

V. "Covered policy" means any policy or contract within the scope of this chapter under RSA 408-B:5.

VI. "Impaired insurer" means a member insurer which, on or after January 1, 1996, is not an insolvent insurer, and:

(a) Is deemed by the commissioner to be potentially unable to fulfill its contractual obligations, or

(b) Is placed under an order of rehabilitation or conservation by a court of competent jurisdiction.

VII. "Insolvent insurer" means a member insurer which on or after January 1, 1996, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency.

VIII. "Member insurer" means any insurer licensed or which holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided under RSA 408-B:5, and includes any insurer whose license or certificate of authority in this state may have been suspended, revoked, not renewed or voluntarily withdrawn, but does not include:

(a) A nonprofit hospital or medical service organization.

(b) A health maintenance organization.

(c) A fraternal benefit society.

(d) A mandatory state pooling plan.

(e) A mutual assessment company or any entity that operates on an assessment basis.

(f) An insurance exchange.

(g) Any entity similar to any of the above.

IX. "Moody's Corporate Bond Yield Average" means the Monthly Average Corporates as published by Moody's Investors Service, Inc., or any successor thereto.

X. "Person" means any individual, corporation, partnership, association, or voluntary organization.

XI. "
Premiums
" means amounts received on covered policies or contracts less premiums, considerations, and deposits returned on such policies or contracts and less dividends and experience credits on such policies or contracts. "Premiums" does not include any amounts received for any policies or contracts or for the portions of any policies or contracts for which coverage is not provided under RSA 408-B:5, II, except that assessable premium shall not be reduced on account of RSA 408-B:5, II(b)(3) relating to interest limitations and RSA 408-B:5, III(b) relating to limitations with respect to any one individual, any one participant and any one contract holder; provided that "premiums" shall not include:

(a) Any premiums in excess of $5,000,000 on any unallocated annuity contract not issued under a governmental retirement plan established under Section 401, 403(b) or 457 of the United States Internal Revenue Code; or

(b) With respect to multiple non-group policies of life insurance owned by one owner, whether the policy owner is an individual, firm, corporation, or other person, and whether the persons insured are officers, managers, employees or other persons, premiums in excess of $5,000,000 with respect to these policies or contracts, regardless of the number of policies or contracts held by the owner.

XII. "
Resident
" means a person to whom a contractual obligation is owed and who resides in this state at the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer, whichever occurs first. A person may be a resident of only one state, which in the case of a person other than a natural person shall be its principal place of business. Citizens of the United States that are either: (a) residents of foreign countries or (b) residents of United States possessions, territories or protectorates that do not have an association similar to the association created by this chapter, shall be deemed residents of the state of domicile of the insurer that issued the policies or contracts.

XIII. "
Structured settlement annuity
" means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant.

XIV. "
Supplemental contract
" means any agreement entered into for the distribution of policy or contract proceeds.

XV. "
Unallocated annuity contract
" means any annuity contract or group annuity certificate which is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate.


Source. 1995, 305:1. 2015, 205:1, 2, eff. Sept. 4, 2015.

    408-B:5 Coverage and Limitations. 

I. This chapter shall provide coverage for the policies and contracts specified in paragraph II:

(a) To persons who, regardless of where they reside (except for nonresident certificate holders under group policies or contracts), are the beneficiaries, assignees, or payees of the persons covered under subparagraph (b); and

(b) To persons who are owners of or certificate holders under the policies or contracts, (other than unallocated annuity contracts and structured settlement annuities) and in each case who:

(1) Are residents; or

(2) Are not residents, but only under all of the following conditions:

(A) The insurers that issued the policies or contracts are domiciled in this state;

(B) The states in which the persons reside have associations similar to the association created by this chapter; and

(C) The persons are not eligible for coverage by an association in any other state because the insurer was not licensed in the state at the time specified in the state's guaranty association law.

(c) For unallocated annuity contracts specified in paragraph II, subparagraphs (a) and (b) shall not apply, and this chapter shall, except as provided in subparagraphs (e) and (f), provide coverage to:

(1) Persons who are the owners of the unallocated annuity contracts if the contracts are issued to or in connection with a specified benefit plan whose plan sponsor has its principal place of business in this state; and

(2) Persons who are owners of unallocated annuity contracts issued to or in connection with government lotteries if the owners are residents.

(d) For structured settlement annuities specified in paragraph II; subparagraphs (a) and (b) shall not apply, and this chapter shall, except as provided in subparagraphs (e) and (f), provide coverage to a person who is a payee under a structured settlement annuity, or beneficiary of a payee if the payee is deceased, if the payee:

(1) Is a resident, regardless of where the contract owner resides; or

(2) Is not a resident, but only under both of the following conditions:

(A)(i) The contract owner of the structured settlement annuity is a resident; or

(ii) The contract owner of the structured settlement annuity is not a resident, but the insurer that issued the structured settlement annuity is domiciled in this state, and the state in which the contract owner resides has an association similar to the association created by this chapter; and

(B) Neither the payee or beneficiary nor the contract owner is eligible for coverage by the association of the state in which the payee or contract owner resides.

(e) This chapter shall not provide coverage to:

(1) A person who is a payee or beneficiary of a contract owner resident of this state, if the payee or beneficiary is afforded any coverage by the association of another state; or

(2) A person covered under subparagraph (c), if any coverage is provided by the association of another state to the person.

(f) This chapter is intended to provide coverage to a person who is a resident of this state and, in special circumstances, to a nonresident. In order to avoid duplicate coverage, if a person who would otherwise receive coverage under this chapter is provided coverage under the laws of any other state, the person shall not be provided coverage under this chapter. In determining the application of the provisions of this paragraph in situations where a person could be covered by the association of more than one state, whether as an owner, payee, beneficiary, or assignee, this chapter shall be construed in conjunction with other state laws to result in coverage by only one association.

II. (a) This chapter shall provide coverage to the persons specified in paragraph I for direct, non-group life, health or annuity policies or contracts, and for certificates under direct group policies and contracts, and for supplemental contracts to any of these, and for unallocated annuity contracts issued by member insurers, except as limited by this chapter. Annuity contracts and certificates under group annuity contracts include, but are not limited to, guaranteed investment contracts, deposit administration contracts, unallocated funding agreements, allocated funding agreements, structured settlement annuities, annuities issued to or in connection with government lotteries and any immediate or deferred annuity contracts.

(b) This chapter shall not provide coverage for:

(1) A portion of a policy or contract not guaranteed by the insurer, or under which the risk is borne by the policy or contract owner;

(2) Any policy or contract of reinsurance, unless assumption certificates have been issued;

(3) A portion of a policy or contract to the extent that the rate of interest on which it is based, or the interest rate, crediting rate, or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or change in value:

(A) Averaged over the period of 4 years prior to the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds a rate of interest determined by subtracting 2 percentage points from Moody's Corporate Bond Yield Average averaged for that same 4-year period or for such lesser period if the policy or contract was issued less than 4 years before the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier; and

(B) On and after the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds the rate of interest determined by subtracting 3 percentage points from Moody's Corporate Bond Yield Average as most recently available;

(4) Any plan or program of an employer, association, or similar entity to provide life, health, or annuity benefits to its employees or members to the extent that the plan or program is self-funded or uninsured, including, but not limited to, benefits payable by an employer, association, or similar entity under:

(A) A multiple-employer welfare arrangement as defined in 29 U.S.C. section 1002(40);

(B) A minimum premium group insurance plan;

(C) A stop-loss group insurance plan; or

(D) An administrative services only contract;

(5) Any portion of a policy or contract to the extent that it provides dividends or experience rating credits, or provides that any fees or allowances be paid to any person, including the policy or contract holder, in connection with the service to or administration of the policy or contract;

(6) Any policy or contract issued in this state by a member insurer at a time when it was not licensed or did not have a certificate of authority to issue the policy or contract in this state;

(7) Any unallocated annuity contract issued to an employee benefit plan protected under the federal Pension Benefit Guaranty Corporation;

(8) Any portion of any unallocated annuity contract which is not issued to or in connection with a specific employee, union, or association of natural persons benefit plan or a government lottery;

(9) Any portion of a policy or contract to the extent that the assessments required by RSA 408-B:9 with respect to the policy or contract are preempted by federal or state law;

(10) A portion of a policy or contract to the extent it provides for interest or other changes in value to be determined by the use of an index or other external reference stated in the policy or contract, but which have not been credited to the policy or contract, or as to which the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier. If a policy's or contract's interest or changes in value are credited less frequently than annually, then for purposes of determining the values that have been credited and are not subject to forfeiture under this subparagraph, the interest or change in value determined by using the procedures defined in the policy or contract shall be credited as if the contractual date of the crediting interest or changing values was the date of impairment or insolvency, whichever is earlier, and shall not be subject to forfeiture; and

(11) A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to Part C or Part D of subchapter XVIII, chapter 7 of Title 42 of the United States Code, commonly known as Medicare Part C and D, or any regulations issued pursuant thereto.

III. The benefits for which the association may become liable shall in no event exceed the lesser of:

(a) The contractual obligations for which the insurer is liable or would have been liable if it were not an impaired or insolvent insurer; or

(b)(1) With respect to any one life, regardless of the number of policies or contracts:

(A) $300,000 in life insurance death benefits, but not more than $100,000 in net cash surrender and net cash withdrawal values for life insurance;

(B) In health insurance benefits:

(i) $100,000 for coverages not defined as disability insurance or basic hospital, medical and surgical insurance or long-term care insurance, as defined in RSA 415-D, including any net cash surrender and net cash withdrawal values;

(ii) $300,000 for disability insurance, and $300,000 for long-term care insurance, as defined in RSA 415-D;

(iii) $500,000 for basic hospital medical and surgical insurance or major medical insurance;

(C) $250,000 in the present value of annuity benefits, including net cash surrender and net cash withdrawal values; or

(2) With respect to each individual participating in a governmental retirement plan established under Section 401, 403(b) or 457 of the United States Internal Revenue Code covered by an unallocated annuity contract or the beneficiaries of each such individual if deceased, in the aggregate, $250,000 in present value annuity benefits, including net cash surrender and net cash withdrawal values; or

(3) With respect to each payee of a structured settlement annuity or beneficiary or beneficiaries of the payee if deceased, $250,000 in present value annuity benefits, in the aggregate, including net cash surrender and net cash withdrawal value, if any.

(4) However, in no event shall the association be obligated to cover more than:

(A) An aggregate of $300,000 in benefits with respect to any one life under subparagraphs (b)(1), (2) and (3) except with respect to benefits for basic hospital, medical and surgical insurance and major medical insurance under subparagraph (b)(1)(B)(iii), in which case the aggregate liability of the association shall not exceed $500,000 with respect to any one individual; or

(B) With respect to one owner of multiple, non-group policies of life insurance, whether the policy owner is an individual, firm, corporation or other person, and whether the persons insured are officers, managers, employees, or other persons, more than $5,000,000 in benefits, regardless of the number of policies and contracts held by the owner.

(5) With respect to either one contract owner provided coverage under subparagraph I(c)(2); or one plan sponsor whose plans own directly or in trust one or more unallocated annuity contracts not included in subparagraph (b)(2) of this paragraph, $5,000,000 in benefits, irrespective of the number of contracts with respect to the contract owner or plan sponsor. However, in the case where one or more unallocated annuity contracts are covered contracts under this chapter and are owned by a trust or other entity for the benefit of 2 or more plan sponsors, coverage shall be afforded by the association if the largest interest in the trust or entity owning the contract or contracts is held by a plan sponsor whose principal place of business is in this state and in no event shall the association be obligated to cover more than $5,000,000 in benefits with respect to all these unallocated contracts.

(6) The limitations set forth in this paragraph are limitations on the benefits for which the association is obligated before taking into account either its subrogation and assignments rights or the extent to which those benefits could be provided out of the assets of the impaired or insolvent insurer attributable to covered policies. The costs of the association's obligations under this chapter may be met by the use of assets attributable to covered policies or reimbursed to the association pursuant to its subrogation and assignment rights.

(7) In performing its obligations to provide coverage under RSA 408-B:8, the association shall not be required to guarantee, assume, reinsure, or perform, or cause to be guaranteed, assumed, reinsured, or performed, the contractual obligations of the insolvent or impaired insurer under a covered policy or contract that do not materially affect the economic values or economic benefits of the covered policy or contract.


Source. 1995, 305:1. 2010, 54:1. 2015, 205:3, eff. Sept. 4, 2015.

    408-B:6 Creation of the Association. 

I. There is created a nonprofit legal entity to be known as the New Hampshire life and health insurance guaranty association, which shall be the same association created under RSA 404-D:6. All member insurers shall be and remain members of the association as a condition of their authority to transact insurance in this state. The association shall perform its functions under the plan of operation established and approved under RSA 408-B:10 and shall exercise its powers through a board of directors established under RSA 408-B:7. For purposes of administration and assessment, the association shall maintain 2 accounts:

(a) The life insurance and annuity account which includes the following subaccounts:

(1) Life insurance account;

(2) Annuity account, which shall include annuity contracts owned by a governmental retirement plan (or its trustee) established under Section 401, 403(b) or 457 of the United States Internal Revenue Code, but shall otherwise excluded unallocated annuities; and

(3) Unallocated annuity account which shall exclude contracts owned by a governmental retirement benefit plan, or its trustee established under Section 401, 403(b), or 457 of the United States Internal Revenue Code.

(b) The health insurance account.

II. The association shall come under the immediate supervision of the commissioner and shall be subject to the applicable provisions of the insurance laws of this state. Meetings or records of the association may be opened to the public upon majority vote of the board of directors of the association.


Source. 1995, 305:1. 1997, 167:1. 2015, 205:4, eff. Sept. 4, 2015.

    408-B:7 Board of Directors. 

I. The board of directors of the association shall consist of not less than 5 nor more than 9 member insurers serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term by a majority vote of the remaining board members, subject to the approval of the commissioner.

II. In approving selections or in appointing members to the board, the commissioner shall consider, among other things, whether all member insurers are fairly represented.

III. Members of the board may be reimbursed from the assets of the association for expense incurred by them as members of the board of directors but members of the board shall not otherwise be compensated by the association for their services.


Source. 1995, 305:1. 1997, 167:2, eff. Aug. 8, 1997.

    408-B:8 Powers and Duties of the Association. 

I. If a member insurer is an impaired domestic insurer, the association may, in its discretion, and subject to any conditions imposed by the association that do not impair the contractual obligations of the impaired insurer, that are approved by the commissioner, and that are, except in cases of court-ordered conservation or rehabilitation, also approved by the impaired insurer:

(a) Guarantee, assume or reinsure, or cause to be guaranteed, assumed, or reinsured, any or all of the policies or contracts of the impaired insurer;

(b) Provide such moneys, pledges, notes, guarantees, or other means as are proper to effectuate subparagraph (a) and assure payment of the contractual obligations of the impaired insurer pending action under subparagraph (a); or

(c) Loan money to the impaired insurer.

II. (a) If a member insurer is an impaired insurer, whether domestic, foreign or alien, and the insurer is not paying claims timely, then subject to the preconditions specified in subparagraph (b), the association shall, in its discretion, either:

(1) Take any of the actions specified in paragraph I, subject to the conditions in such paragraph; or

(2) Provide substitute benefits in lieu of the contractual obligations of the impaired insurer solely for health claims, periodic annuity benefit payments, death benefits, supplemental benefits, and cash withdrawals for policy or contract owners who petition therefor under claims of emergency or hardship in accordance with standards proposed by the association and approved by the commissioner.

(b) The association shall be subject to the requirements of subparagraph (a) only if:

(1) The laws of its state of domicile provide that until all payments of or on account of the impaired insurer's contractual obligations by all guaranty associations, along with all expenses thereof and interest on all such payments and expenses, shall have been repaid to the guaranty associations or a plan of repayment by the impaired insurer shall have been approved by the guaranty associations:

(A) The delinquency proceeding shall not be dismissed;

(B) Neither the impaired insurer nor its assets shall be returned to the control of its shareholders or private management;

(C) It shall not be permitted to solicit or accept new business or have any suspended or revoked license restored; and

(2)(A) The impaired insurer is a domestic insurer, and it has been placed under an order of rehabilitation by a court of competent jurisdiction in this state; or

(B) The impaired insurer is a foreign or alien insurer, and

(i) It has been prohibited from soliciting or accepting new business in this state;

(ii) Its certificate of authority has been suspended or revoked in this state; and

(iii) A petition for rehabilitation or liquidation has been filed in a court of competent jurisdiction in its state of domicile by the commissioner of the state.

III. If a member insurer is an insolvent insurer, the association shall, in its discretion, either:

(a)(1) Guaranty, assume or reinsure, or cause to be guaranteed, assumed or reinsured, the policies or contracts of the insolvent insurer; or

(2) Assure payment of the contractual obligations of the insolvent insurer; and

(3) Provide such monies, pledges, guarantees, or other means as are reasonably necessary to discharge such duties; or

(b) With respect only to life and health insurance policies, provide benefits and coverages in accordance with paragraph IV.

IV. When proceeding under paragraph II(a)(2) or III(b), the association shall, with respect to only life and health insurance policies:

(a) Assure payment of benefits for premiums identical to the premiums and benefits (except for terms of conversion and renewability) that would have been payable under the policies of the insolvent insurer, for claims incurred:

(1) With respect to group policies, not later than the earlier of the next renewal date under such policies or contracts or 45 days, but in no event less than 30 days, after the date on which the association becomes obligated with respect to the policies.

(2) With respect to individual policies, not later than the earlier of the next renewal date (if any) under the policies or one year, but in no event less than 30 days, from the date on which the association becomes obligated with respect to the policies.

(b) Make diligent efforts to provide all known insureds or group policyholders with respect to group policies 30 days notice of the termination of the benefits provided.

(c) With respect to individual policies, make available to each known insured, or owner if other than the insured, and with respect to an individual formerly insured under a group policy who is not eligible for replacement group coverage, make available substitute coverage on an individual basis in accordance with the provisions of subparagraph (d), if the insureds had a right under law or the terminated policy to convert coverage to individual coverage or to continue an individual policy in force until a specified age or for a specified time, during which the insurer had no right unilaterally to make changes in any provision of the policy or had a right only to make changes in premium by class.

(d)(1) In providing the substitute coverage required under subparagraph (c), the association may offer either to reissue the terminated coverage or to issue an alternative policy.

(2) Alternative or reissued policies shall be offered without requiring evidence of insurability, and shall not provide for any waiting period or exclusion that would not have applied under the terminated policy.

(3) The association may reinsure any alternative or reissued policy.

(e)(1) Alternative policies adopted by the association shall be subject to the approval of the commissioner. The association may adopt alternative policies of various types for future issuance without regard to any particular impairment or insolvency.

(2) Alternative policies shall contain at least the minimum statutory provisions required in this state and provide benefits that shall not be unreasonable in relation to the premium charged. The association shall set the premium in accordance with a table of rates which it shall adopt. The premium shall reflect the amount of insurance to be provided and the age and class of risk of each insured, but shall not reflect any changes in the health of the insured after the original policy was last underwritten.

(3) Any alternative policy issued by the association shall provide coverage of a type similar to that of the policy issued by the impaired or insolvent insurer, as determined by the association.

(f) If the association elects to reissue terminated coverage at a premium rate different from that charged under the terminated policy, the premium shall be set by the association in accordance with the amount of insurance provided and the age and class of risk, subject to approval of the commissioner or by a court of competent jurisdiction.

(g) The association's obligations with respect to coverage under any policy of the impaired or insolvent insurer or under any reissued or alternative policy shall cease on the date such coverage or policy is replaced by another similar policy by the policyholder, the insured, or the association.

V. When proceeding under paragraphs II(a)(2) or III with respect to any policy or contract carrying guaranteed minimum interest rates, the association shall assure the payment or crediting of a rate of interest consistent with RSA 408-B:5, II(b)(3).

VI. Nonpayment of premiums within 31 days after the date required under the terms of any guaranteed, assumed, alternative or reissued policy or contract or substitute coverage shall terminate the association's obligations under the policy or coverage under this chapter with respect to the policy or coverage, except with respect to any claims incurred or any net cash surrender value which may be due in accordance with the provisions of this chapter.

VII. Premiums due for coverage after entry of an order of liquidation of an insolvent insurer shall belong to and be payable at the direction of the association, and the association shall be liable for unearned premiums due to policy or contract owners arising after the entry of the order.

VIII. The protection provided by this chapter shall not apply where any guaranty protection is provided to residents of this state by the laws of the domiciliary state or jurisdiction of the impaired or insolvent insurer other than this state.

IX. In carrying out its duties under paragraphs II and III, the association may, subject to approval by the court:

(a) Impose permanent policy or contract liens in connection with any guarantee, assumption, or reinsurance agreement, if the association finds that the amounts which can be assessed under this chapter are less than the amounts needed to assure full and prompt performance of the association's duties under this chapter, or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of such permanent policy or contract liens, to be in the public interest.

(b) Impose temporary moratoriums or liens on payments of cash values and policy loans, or any other right to withdraw funds held in conjunction with policies or contracts, in addition to any contractual provisions for deferral of cash or policy loan value.

X. If the association fails to act within a reasonable period of time as provided in paragraphs II(a)(2), III, and IV, the commissioner shall have the powers and duties of the association under this chapter with respect to impaired or insolvent insurers.

XI. The association may render assistance and advice to the commissioner, upon the commissioner's request, concerning rehabilitation, payment of claims, continuance of coverage, or the performance of other contractual obligations of any impaired or insolvent insurer.

XII. The association shall have standing to appear before any court in this state with jurisdiction over an impaired or insolvent insurer concerning which the association is or may become obligated under this chapter. Such standing shall extend to all matters germane to the powers and duties of the association, including, but not limited to, proposals for reinsuring, modifying, or guaranteeing the policies or contracts of the impaired or insolvent insurer and the determination of the policies or contracts and contractual obligations. The association shall also have the right to appear or intervene before a court in another state with jurisdiction over an impaired or insolvent insurer for which the association is or may become obligated or with jurisdiction over a third party against whom the association may have rights through subrogation of the insurer's policyholders.

XIII. (a) Any person receiving benefits under this chapter shall be deemed to have assigned the rights under, and any causes of action relating to, the covered policy or contract to the association to the extent of the benefits received because of this chapter, whether the benefits are payments of or on account of contractual obligations, continuation of coverage, or provision of substitute or alternative coverages. The association may require an assignment to it of such rights and cause of action by any payee, policy or contract owner, beneficiary, insured or annuitant, as a condition precedent to the receipt of any right or benefits conferred by this chapter upon such person.

(b) The subrogation rights of the association under this paragraph shall have the same priority against the assets of the impaired or insolvent insurer as that possessed by the person entitled to receive benefits under this chapter.

(c) In addition to subparagraphs (a) and (b), the association shall have all common law rights of subrogation and any other equitable or legal remedy which would have been available to the impaired or insolvent insurer or holder of a policy or contract with respect to such policy or contracts.

XIV. The association may:

(a) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter.

(b) Sue or be sued, including taking any legal actions necessary or proper to recover any unpaid assessments under RSA 408-B:9 and to settle claims or potential claims against it.

(c) Borrow money to effect the purposes of this chapter; any notes or other evidence of indebtedness of the association not in default shall be legal investments for domestic insurers and may be carried as admitted assets.

(d) Employ or retain such persons as are necessary to handle the financial transactions of the association, and to perform such other functions as become necessary or proper under this chapter.

(e) Take such legal action as may be necessary to avoid payment of improper claims.

(f) Exercise, for the purposes of this chapter and to the extent approved by the commissioner, the powers of a domestic life or health insurer, but in no case may the association issue insurance policies or annuity contracts other than those issued to perform its obligations under this chapter.

XV. The association may join an organization of one or more other state associations of similar purposes, to further the purposes and administer the powers and duties of the association.

XVI. In carrying out its duties in connection with guaranteeing, assuming, or reinsuring policies or contracts under paragraph I or II, the association may, subject to approval of the receivership court, issue substitute coverage for a policy or contract that provides an interest rate, crediting rate, or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value by issuing an alternative policy or contract in accordance with the following provisions:

(a) In lieu of the index or other external reference provided for in the original policy or contract, the alternative policy or contracts provides for:

(1) A fixed interest rate; or

(2) Payment of dividends with minimum guarantees; or

(3) A different method for calculating interest or changes in value;

(b) There is no requirement for evidence of insurability, waiting period or other exclusion that would not have applied under the replaced policy or contract, and;

(c) The alternative policy or contract is substantially similar to the replaced policy or contract in all other material terms.


Source. 1995, 305:1. 2015, 205:5, eff. Sept. 4, 2015.

    408-B:9 Assessments. 

I. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers, separately for each account, at such time and for such amounts as the board finds necessary. Assessments shall be due not less than 30 days after prior written notice to the member insurers.

II. There shall be 2 assessments, as follows:

(a) Class A assessments shall be made for the purpose of meeting administrative and legal costs and other expenses and examinations conducted under the authority of RSA 408-B:12, V. Class A assessments may be made whether or not related to a particular impaired or insolvent insurer.

(b) Class B assessments shall be made to the extent necessary to carry out the powers and duties of the association under RSA 408-B:8 with regard to an impaired or an insolvent insurer.

III. (a) The amount of any Class A assessment shall be determined by the board and may be made on a pro rata or non-pro rata basis. If pro rata, the board may provide that it be credited against future Class B assessments. A non-pro rata assessment shall not exceed $150 per member insurer in any one calendar year. The amount of any Class B assessment shall be allocated for assessment purposes among the accounts pursuant to an allocation formula which may be based on the premiums or reserves of the impaired or insolvent insurer or any other standard deemed by the board in its sole discretion as being fair and reasonable under the circumstances.

(b) Class B assessments against member insurers for each account and subaccount shall be in the proportion that the premiums received on business in this state by each assessed member insurer or policies or contracts covered by each account for the 3 most recent calendar years for which information is available preceding the year in which the insurer became impaired or insolvent, as the case may be, bears to such premiums received on business in this state for such calendar years by all assessed member insurers.

(c) Assessments for funds to meet the requirements of the association with respect to an impaired or insolvent insurer shall not be made until necessary to implement the purposes of this chapter. Classification of assessments under paragraph II and computation of assessments under this paragraph shall be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible.

IV. The association may abate or defer, in whole or in part, the assessment of a member insurer if, in the opinion of the board, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. In the event an assessment against a member insurer is abated, or deferred in whole or in part, the amount by which the assessment is abated or deferred may be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this section.

V. (a) Subject to the provisions of subparagraph (b), the total of all assessments authorized by the association with respect to a member insurer for each subaccount of the life insurance and annuity account and for the health account shall not in any one calendar year exceed 2 percent of that member insurer's average annual premiums received in this state on the policies and contracts covered by the subaccount or account during the 3 calendar years preceding the year in which the insurer became an impaired or insolvent insurer. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in either account an amount sufficient to carry out the responsibilities of the association, the necessary additional funds shall be assessed as soon thereafter as permitted by this chapter.

(b) The board may provide in the plan of operation a method of allocating funds among claims, whether relating to one or more impaired or insolvent insurers, when the maximum assessment will be insufficient to cover anticipated claims.

(c) If a one percent assessment for any subaccount of the life and annuity account in any one year does not provide an amount sufficient to carry out the responsibilities of the association, then pursuant to subparagraph III(b), the board shall access all subaccounts of the life and annuity account for the necessary additional amount, subject to the maximum stated in subparagraph V(a).

VI. The board may, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each insurer to that account, the amount by which the assets of the account exceed the amount the board finds is necessary to carry out during the coming year the obligations of the association with regard to that account, including assets accruing from assignment, subrogation, net realized gains, and income from investments. A reasonable amount may be retained in any account to provide funds for the continuing expenses of the association and for future losses.

VII. It shall be proper for any member insurer, in determining its premium rates and policyowner dividends as to any kind of insurance within the scope of this chapter, to consider the amount reasonably necessary to meet its assessment obligations under this chapter.

VIII. The association shall issue to each insurer paying an assessment under this chapter, other than Class A assessment, a certificate of contribution, in a form prescribed by the commissioner, for the amount of the assessment so paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. A certificate of contribution may be shown by the insurer in its financial statement as an asset in such form and for such amount, if any, and period of time as the commissioner may approve.


Source. 1995, 305:1. 1997, 167:3. 2015, 205:6, eff. Sept. 4, 2015.

    408-C:1 Purposes. 

The purposes of this compact are, through means of joint and cooperative action among the compacting states:

I. To promote and protect the interest of consumers of individual and group annuity, life insurance, disability income and long-term care insurance products.

II. To develop uniform standards for insurance products covered under the compact.

III. To establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one or more compacting states.

IV. To give appropriate regulatory approval to those product filings and advertisements satisfying the applicable uniform standard.

V. To improve coordination of regulatory resources and expertise between state insurance departments regarding the setting of uniform standards and review of insurance products covered under the compact.

VI. To create the Interstate Insurance Product Regulation Commission.

VII. To perform these and such other related functions as may be consistent with the state regulation of the business of insurance.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:10 Product Filing and Approval. 

I. Insurers and third-party filers seeking to have a product approved by the commission shall file the product with, and pay applicable filing fees to, the commission. Nothing in this chapter shall be construed to restrict or otherwise prevent an insurer from filing its product with the insurance department in any state wherein the insurer is licensed to conduct the business of insurance, and such filing shall be subject to the laws of the states where filed.

II. The commission shall establish appropriate filing and review processes and procedures pursuant to commission rules and operating procedures. Notwithstanding any provision herein to the contrary, the commission shall promulgate rules to establish conditions and procedures under which the commission will provide public access to product filing information. In establishing such rules, the commission shall consider the interests of the public in having access to such information, as well as protection of personal medical and financial information and trade secrets, that may be contained in a product filing or supporting information.

III. Any product approved by the commission may be sold or otherwise issued in those compacting states for which the insurer is legally authorized to do business.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:11 Review of Commission Decisions Regarding Filings. 

I. Not later than 30 days after the commission has given notice of a disapproved product or advertisement filed with the commission, the insurer or third party filer whose filing was disapproved may appeal the determination to a review panel appointed by the commission. The commission shall promulgate rules to establish procedures for appointing such review panels and provide for notice and hearing. An allegation that the commission, in disapproving a product or advertisement filed with the commission, acted arbitrarily, capriciously, or in a manner that is an abuse of discretion or otherwise not in accordance with the law, is subject to judicial review in accordance with RSA 408-C:3, IV.

II. The commission shall have authority to monitor, review and reconsider products and advertisement subsequent to their filing or approval upon a finding that the product does not meet the relevant uniform standard. Where appropriate, the commission may withdraw or modify its approval after proper notice and hearing, subject to the appeal process in paragraph I.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:12 Finance. 

I. The commission shall pay or provide for the payment of the reasonable expenses of its establishment and organization. To fund the cost of its initial operation, the commission may accept contributions and other forms of funding from the National Association of Insurance Commissioners, compacting states and other sources. Contributions and other forms of funding from other sources shall be of such a nature that the independence of the commission concerning the performance of its duties shall not be compromised.

II. The commission shall collect a filing fee from each insurer and third party filer filing a product with the commission to cover the cost of the operations and activities of the commission and its staff in a total amount sufficient to cover the commission's annual budget.

III. The commission's budget for a fiscal year shall not be approved until it has been subject to notice and comment as set forth in RSA 408-C:7.

IV. The commission shall be exempt from all taxation in and by the compacting states.

V. The commission shall not pledge the credit of any compacting state, except by and with the appropriate legal authority of that compacting state.

VI. The commission shall keep complete and accurate accounts of all its internal receipts, including grants and donations, and disbursements of all funds under its control. The internal financial accounts of the commission shall be subject to the accounting procedures established under its bylaws. The financial accounts and reporting including the system of internal controls and procedures of the commission shall be audited annually by an independent certified public accountant. Upon the determination of the commission, but no less frequently than every 3 years, the review of the independent auditor shall include a management and performance audit of the commission. The commission shall make an annual report to the governor and legislature of the compacting states, which shall include a report of the independent audit. The commission's internal accounts shall not be confidential and such materials may be shared with the commissioner of any compacting state upon request provided, however, that any work papers related to any internal or independent audit and any information regarding the privacy of individuals and insurers' proprietary information, including trade secrets, shall remain confidential.

VII. No compacting state shall have any claim to or ownership of any property held by or vested in the commission or to any commission funds held pursuant to the provisions of this compact.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:13 Compacting States, Effective Date, and Amendment. 

I. Any state is eligible to become a compacting state.

II. The compact shall become effective and binding upon legislative enactment of the compact into law by 2 compacting states; provided, the commission shall become effective for purposes of adopting uniform standards for, reviewing, and giving approval or disapproval of, products filed with the commission that satisfy applicable uniform standards only after 26 states are compacting states or, alternatively, by states representing greater than 40 percent of the premium volume for life insurance, annuity, disability income and long-term care insurance products, based on records of the NAIC for the prior year. Thereafter, it shall become effective and binding as to any other compacting state upon enactment of the compact into law by that state.

III. Amendments to the compact may be proposed by the commission for enactment by the compacting states. No amendment shall become effective and binding upon the commission and the compacting states unless and until all compacting states enact the amendment into law.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:14 Withdrawal, Default, and Termination. 

I. (a) Once effective, the compact shall continue in force and remain binding upon each and every compacting state; provided, that a compacting state may withdraw from the compact ("
withdrawing state
") by enacting a statute specifically repealing the statute which enacted the compact into law.

(b) The effective date of withdrawal is the effective date of the repealing statute. However, the withdrawal shall not apply to any product filings approved or self-certified, or any advertisement of such products, on the date the repealing statute becomes effective, except by mutual agreement of the commission and the withdrawing state unless the approval is rescinded by the withdrawing state as provided in subparagraph (e).

(c) The commissioner of the withdrawing state shall immediately notify the management committee in writing upon the introduction of legislation repealing this compact in the withdrawing state.

(d) The commission shall notify the other compacting states of the introduction of such legislation with 10 days after its receipt of notice thereof.

(e) The withdrawing state is responsible for all obligations, duties and liabilities incurred through the effective date of withdrawal, including any obligations, the performance of which extend beyond the effective date of withdrawal, except to the extent those obligations may have been released or relinquished by mutual agreement of the commission and the withdrawing state. The commission's approval of products and advertisement prior to the effective date of withdrawal shall continue to be effective and be given full force and effect in the withdrawing state, unless formally rescinded by the withdrawing state in the same manner as provided by the laws of the withdrawing state for the prospective disapproval of products or advertisement previously approved under state law.

(f) Reinstatement following withdrawal of any compacting state shall occur upon the effective date of the withdrawing state reenacting the compact.

II. (a) If the commission determines that any compacting state has at any time defaulted ("
defaulting state
") in the performance of any of its obligations or responsibilities under this compact, the bylaws or duly promulgated rules or operating procedures, then, after notice and hearing as set forth in the bylaws, all rights, privileges and benefits conferred by this compact on the defaulting state shall be suspended from the effective date of default as fixed by the commission. The grounds for default include, but are not limited to, failure of a compacting state to perform its obligations or responsibilities, and any other grounds designated in commission rules. The commission shall immediately notify the defaulting state in writing of the defaulting state's suspension pending a cure of the default. The commission shall stipulate the conditions and the time period within which the defaulting state must cure its default. If the defaulting state fails to cure the default within the time period specified by the commission, the defaulting state shall be terminated from the compact and all rights, privileges and benefits conferred by this compact shall be terminated from the effective date of termination.

(b) Product approvals by the commission or product self-certifications, or any advertisement in connection with such product, that are in force on the effective date of termination shall remain in force in the defaulting state in the same manner as if the defaulting state had withdrawn voluntarily pursuant to RSA 408-C:14, I.

(c) Reinstatement following termination of any compacting state requires a reenactment of the compact.

III. (a) The compact dissolves effective upon the date of the withdrawal or default of the compacting state which reduces membership in the compact to one compact state.

(b) Upon the dissolution of this compact, the compact becomes null and void and shall be of no further force or effect, and the business and affairs of the commission shall be wound up and any surplus funds shall be distributed in accordance with the bylaws.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:15 Severability and Construction. 

The provisions of this compact shall be severable; and if any phrase, clause, sentence or provision of this compact is declared to be unconstitutional or the applicability thereof, to any state, agency, person, or circumstances held invalid, the constitutionality of the remainder of this compact and the applicability thereof, to any other state, agency, person or circumstance shall not be affected thereby. It is the legislative intent that the provisions of this compact be reasonably and liberally construed to effectuate its purpose.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:16 Binding Effect of Compact and Other Laws. 

I. (a) Nothing in this chapter shall prevent the enforcement of any other law of a compacting state, except as provided in subparagraph (b).

(b) For any product approved or certified to the commission, the rules, uniform standards and any other requirements of the commission shall constitute the exclusive provisions applicable to the content, approval and certification of such products. For advertisement that is subject to the commission's authority, any rule, uniform standard or other requirement of the commission which governs the content of the advertisement shall constitute the exclusive provision that a commissioner may apply to the content of the advertisement. Notwithstanding the foregoing, no action taken by the commission shall abrogate or restrict:

(1) The access of any person to state courts;

(2) Remedies available under state law related to breach of contract, tort, or other laws not specifically directed to the content of the product;

(3) State law relating to the construction of insurance contracts; or

(4) The authority of the attorney general of the state, including but not limited to maintaining any actions or proceedings, as authorized by law.

(c) All insurance products filed with individual states shall be subject to the laws of those states.

II. (a) All lawful actions of the commission, including all rules and operating procedures promulgated by the commission, are binding upon the compacting states.

(b) All agreements between the commission and the compacting states are binding in accordance with their terms.

(c) Upon the request of a party to a conflict over the meaning or interpretation of commission actions, and upon a majority vote of the compacting states, the commission may issue advisory opinions regarding the meaning or interpretation in dispute.

(d) In the event any provision of this compact exceeds the constitutional limits imposed on the legislature of any compacting state, the obligations, duties, powers or jurisdiction sought to be conferred by that provision upon the commission shall be ineffective as to that compacting state, and those obligations, duties, powers or jurisdiction shall remain in the compacting state and shall be exercised by the agency thereof to which those obligations, duties, powers or jurisdiction are delegated by law in effect at the time this compact becomes effective.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:2 Definitions. 

For purposes of this compact:

I. "
Advertisement
" means any material designed to create public interest in a product, or induce the public to purchase, increase, modify, reinstate, borrow on, surrender, replace or retain a policy, as more specifically defined in the rules and operating procedures of the commission.

II. "
Bylaws
" means those bylaws established by the commission for its governance, or for directing or controlling the commission' s actions or conduct.

III. "
Compacting state
" means any state which has enacted this compact legislation and which has not withdrawn pursuant to RSA 408-C:14, I, or been terminated pursuant to RSA 408-C:14, II.

IV. "
Commission
" means the "
Interstate Insurance Product Regulation Commission
" established by this compact.

V. "
Commissioner
" means the chief insurance regulatory official of a state including, but not limited to commissioner, superintendent, director, or administrator.

VI. "
Domiciliary state'
' means the state in which an insurer is incorporated or organized; or, in the case of an alien insurer, its state of entry.

VII. "
Insurer
" means any entity licensed by a state to issue contracts of insurance for any of the lines of insurance covered by this chapter.

VIII. "
Member
" means the person chosen by a compacting state as its representative to the commission, or designee.

IX. "
Non-compacting state
" means any state that is not at the time a compacting state.

X. "
Operating procedures
" means procedures promulgated by the commission implementing a rule, uniform standard or a provision of this compact.

XI. "
Product
" means the form of a policy or contract, including any application, endorsement, or related form that is attached to and made a part of the policy or contract, and any evidence of coverage or certificate, for an individual or group annuity, life insurance, disability income or long-term care insurance product that an insurer is authorized to issue.

XII. "
Rule
" means a statement of general or particular applicability and future effect promulgated by the commission, including a uniform standard developed pursuant to RSA 408-C:7, designed to implement, interpret, or prescribe law or policy or describing the organization, procedure, or practice requirements of the commission, that shall have the force and effect of law in the compacting states.

XIII. "
State
" means any state, district or territory of the United States of America.

XIV. "
Third-party filer
" means an entity that submits a product filing to the commission on behalf of an insurer.

XV. "
Uniform standard
"means a standard adopted by the commission for a product line, pursuant to RSA 408-C:7, and shall include all of the product requirements in aggregate; provided, that each uniform standard shall be construed, whether express or implied, to prohibit the use of any inconsistent, misleading or ambiguous provisions in a product and the form of the product made available to the public shall not be unfair, inequitable or against public policy as determined by the commission.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:3 Commission Established and Venue. 

I. The compacting states hereby create and establish a joint public agency known as the "
Interstate Insurance Product Regulation Commission.
" Pursuant to RSA 408-C:4, the commission shall have the power to develop uniform standards for product lines, receive and provide prompt review of products filed therewith, and give approval to those product filings satisfying applicable uniform standards; provided, it is not intended for the commission to be the exclusive entity for receipt and review of insurance product filings. Nothing in this chapter shall prohibit any insurer from filing its product in any state wherein the insurer is licensed to conduct the business of insurance; and any such filing shall be subject to the laws of the state where filed.

II. The commission is a body corporate and politic, and an instrumentality of the compacting states.

III. The commission is solely responsible for its liabilities except as otherwise specifically provided in this compact.

IV. Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:4 Powers of the Commission. 

The commission shall have the following powers:

I. To promulgate rules, pursuant to RSA 408-C:7, which shall have the force and effect of law and shall be binding in the compacting states to the extent and in the manner provided in this compact.

II. To exercise its rulemaking authority and establish reasonable uniform standards for products covered under the compact, and advertisement related thereto, which shall have the force and effect of law and shall be binding in the compacting states, but only for those products filed with the commission, provided, that a compacting state shall have the right to opt out of such uniform standard pursuant to RSA 408-C:7, to the extent and in the manner provided in this compact, and, provided further, that any uniform standard established by the commission for long-term care insurance products may provide the same or greater protections for consumers as, but shall not provide less than, those protections set forth in the National Association of Insurance Commissioner's (NAIC) Long-Term Care Insurance Model Act, and Long-Term Care Insurance Model Regulation, respectively, adopted as of 2001. The commission shall consider whether any subsequent amendments to the NAIC Long-Term Care Insurance Model Act or Long-Term Care Insurance Model Regulation adopted by the NAIC require amending of the uniform standards established by the commission for long-term care insurance products.

III. To receive and review in an expeditious manner products filed with the commission, and rate filings for disability income and long-term care insurance products, and give approval of those products and rate filings that satisfy the application uniform standard, which such approval shall have the force and effect of law and be binding on the compacting states to the extent and in the manner provided in this compact.

IV. To receive and review in an expeditious manner advertisement relating to long-term care insurance products for which uniform standards have been adopted by the commission, and give approval to all advertisement that satisfies the applicable uniform standard. For any product covered under this compact, other than long-term care insurance products, the commission shall have the authority to require an insurer to submit all or any part of its advertisement with respect to that product for review or approval prior to use, if the commission determines that the nature of the product is such that an advertisement of the product could have the capacity or tendency to mislead the public. The actions of the commission as provided in this section shall have the force and effect of law and shall be binding in the compacting states to the extent and in the manner provided in the compact.

V. To exercise its rulemaking authority and designate products and advertisement that may be subject to a self-certification process without the need for prior approval by the commission.

VI. To promulgate operating procedures, pursuant to RSA 408-C:7, that shall be binding in the compacting states to the extent and in the manner provided in this compact.

VII. To bring and prosecute legal proceedings or actions in its name as the commission; provided, that the standing of any state insurance department to sue or be sued under applicable law shall not be affected.

VIII. To issue subpoenas requiring the attendance and testimony of witnesses and the production of evidence.

IX. To establish and maintain offices.

X. To purchase and maintain insurance and bonds.

XI. To borrow, accept or contract for services of personnel, including, but not limited to, employees of a compacting state.

XII. To hire employees, professionals or specialists, and elect or appoint officers, and to fix their compensation, define their duties and give them appropriate authority to carry out the purposes of the compact, and determine their qualifications; and to establish the commission's personnel policies and programs relating to, among other things, conflicts of interest, rates of compensation and qualifications of personnel.

XIII. To accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and to receive, utilize and dispose of the same; provided, that at all times the commission shall strive to avoid any appearance of impropriety.

XIV. To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, real, personal or mixed, provided that at all times the commission shall strive to avoid any appearance of impropriety.

XV. To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, real, personal or mixed.

XVI. To remit filing fees to compacting states as may be set forth in the bylaws, rules, or operating procedures.

XVII. To enforce compliance by compacting states with rules, uniform standards, operating procedures and bylaws.

XVIII. To provide for dispute resolution among compacting states.

XIX. To advise compacting states on issues relating to insurers domiciled or doing business in non-compacting jurisdictions, consistent with the purposes of this compact.

XX. To provide advice and training to those personnel in state insurance departments responsible for product review, and to be a resource for state insurance departments.

XXI. To establish a budget and make expenditures.

XXII. To borrow money.

XXIII. To appoint committees, including advisory committees comprising members, state insurance regulators, state legislators or their representatives, insurance industry and consumer representatives, and such other interested persons as may be designated in the bylaws.

XXIV. To provide and receive information from, and to cooperate with law enforcement agencies.

XXV. To adopt and use a corporate seal.

XXVI. To perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of the business of insurance.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:5 Organization of the Commission. 

I. Membership, voting and bylaws:

(a) Each compacting state shall have and be limited to one member. Each member shall be qualified to serve in that capacity pursuant to applicable law of the compacting state. Any member may be removed or suspended from office as provided by the law of the state from which he or she shall be appointed. Any vacancy occurring in the commission shall be filled in accordance with the laws of the compacting state wherein the vacancy exists. Nothing in this chapter shall be construed to affect the manner in which a compacting state determines the election or appointment and qualification of its own commissioner.

(b) Each member shall be entitled to one vote and shall have an opportunity to participate in the governance of the commission in accordance with the bylaws. Notwithstanding any provision of this chapter to the contrary, no action of the commission with respect to the promulgation of a uniform standard shall be effective unless 
2/3 of the members vote in favor thereof.

(c) The commission shall, by a majority of the members, prescribe bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes, and exercise the powers, of the compact, including, but not limited to:

(1) Establishing the fiscal year of the commission;

(2) Providing reasonable procedures for appointing and electing members, as well as holding meetings, of the management committee;

(3) Providing reasonable standards and procedures:

(A) For the establishment and meetings of other committees, and

(B) Governing any general or specific delegation of any authority or function of the commission;

(4) Providing reasonable procedures for calling and conducting meetings of the commission that consist of a majority of commission members, ensuring reasonable advance notice of each such meeting and providing for the right of citizens to attend each such meeting with enumerated exceptions designed to protect the public's interest, the privacy of individuals, and insurers' proprietary information, including trade secrets. The commission may meet in camera only after a majority of the entire membership votes to close a meeting 
en toto or in part. As soon as practicable, the commission shall make public:

(A) A copy of the vote to close the meeting revealing the vote of each member with no proxy votes allowed, and

(B) Votes taken during such meeting;

(5) Establishing the titles, duties and authority and reasonable procedures for the election of the officers of the commission;

(6) Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the commission. Notwithstanding any civil service or other similar laws of any compacting state, the bylaws shall exclusively govern the personnel policies and programs of the commission;

(7) Promulgating a code of ethics to address permissible and prohibited activities of commission members and employees; and

(8) Providing a mechanism for winding up the operations of the commission and the equitable disposition of any surplus funds that may exist after the termination of the compact after the payment and/or reserving of all of its debts and obligations.

(d) The commission shall publish its bylaws in a convenient form and file a copy thereof and a copy of any amendments thereto, with the appropriate agency or officer in each of the compacting states.

II. Management committee, officers and personnel:

(a) A management committee comprising no more than 14 members shall be established as follows:

(1) One member from each of the 6 compacting states with the largest premium volume for individual and group annuities, life, disability income and long-term care insurance products, determined from the records of the NAIC for the prior year;

(2) Four members from those compacting states with at least 2 percent of the market based on the premium volume described above, other than the 6 compacting states with the largest premium volume, selected on a rotating basis as provided in the bylaws; and

(3) Four members from those compacting states with less than 2 percent of the market, based on the premium volume described above, with one selected from each of the 4 zone regions of the NAIC as provided in the bylaws.

(b) The management committee shall have such authority and duties as may be set forth in the bylaws, including but not limited to:

(1) Managing the affairs of the commission in a manner consistent with the bylaws and purposes of the commission;

(2) Establishing and overseeing an organizational structure within, and appropriate procedures for, the commission to provide for the creation of uniform standards and other rules, receipt and review of product filings, administrative and technical support functions, and the review of decisions regarding the disapproval of a product filing, and the review of elections made by a compacting state to opt out of a uniform standard; provided, that a uniform standard shall not be submitted to the compacting states for adoption unless approved by 
2/3 of the members of the management committee;

(3) Overseeing the offices of the commission; and

(4) Planning, implementing, and coordinating communications and activities with other state, federal and local government organizations in order to advance the goals of the commission.

(c) The commission shall elect annually officers from the management committee, with each having such authority and duties, as may be specified in the bylaws.

(d) The management committee may, subject to the approval of the commission, appoint or retain an executive director for such period, upon such terms and conditions and for such compensation as the commission may deem appropriate. The executive director shall serve as secretary to the commission, but shall not be a member of the commission. The executive director shall hire and supervise such other staff as may be authorized by the commission.

III. Legislative and Advisory Committees:

(a) A legislative committee comprised of state legislators or their designees shall be established to monitor the operations of, and make recommendations to, the commission, including the management committee; provided that the manner of selection and term of any legislative committee member shall be as set forth in the bylaws. Prior to the adoption by the commission of any uniform standard, revision to the bylaws, annual budget or other significant matter as may be provided in the bylaws, the management committee shall consult with and report to the legislative committee.

(b) The commission shall establish 2 advisory committees, one of which shall be comprised of consumer representatives independent of the insurance industry, and the other comprised of insurance industry representatives.

(c) The commission may establish additional advisory committees as its bylaws may provide for the carrying out of its functions.

IV. Corporate records of the commission: The commission shall maintain its corporate books and records in accordance with the bylaws.

V. Qualified immunity, defense and indemnification:

(a) The members, officers, executive director, employees and representatives of the commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities; provided, that nothing in this paragraph shall be construed to protect any such person from suit and/or liability of any damage, loss, injury or liability caused by the intentional or willful and wanton misconduct of that person.

(b) The commission shall defend any member, officer, executive director, employee, or representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities; provided, that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further, that the actual or alleged act, error or omission did not result from that person's intentional or willful and wanton misconduct.

(c) The commission shall indemnify and hold harmless any member, officer, executive director, employee or representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties or responsibilities, provided, that the actual or alleged act, error or omission did not result from the intentional or willful and wanton misconduct of that person.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:6 Meetings and Acts of the Commission. 

I. The commission shall meet and take such actions as are consistent with the provisions of this compact and the bylaws.

II. Each member of the commission shall have the right and power to cast a vote to which that compacting state is entitled and to participate in the business and affairs of the commission. A member shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for members' participation in meetings by telephone or other means of communication.

III. The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:7 Rules and Operating Procedures;  Rulemaking Functions of the Commission and Opting Out of Uniform Standards. 

I. The commission shall promulgate reasonable rules, including uniform standards, and operating procedures in order to effectively and efficiently achieve the purposes of this compact. Notwithstanding the foregoing, in the event the commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of this chapter, or the powers granted hereunder, then such an action by the commission shall be invalid and have no force and effect.

II. Rules and operating procedures shall be made pursuant to a rulemaking process that conforms to the Model State Administrative Procedure Act of 1981 as amended, as may be appropriate to the operations of the commission. Before the commission adopts a uniform standard, the commission shall give written notice to the relevant state legislative committee or committees in each compacting state responsible for insurance issues of its intention to adopt the uniform standard. The commission in adopting a uniform standard shall consider fully all submitted materials and issue a concise explanation of its decision.

III. A uniform standard shall become effective 90 days after its promulgation by the commission or such later date as the commission may determine; provided, however, that a compacting state may opt out of a uniform standard as provided in this chapter. "Opt out" shall be defined as any action by a compacting state to decline to adopt or participate in a promulgated uniform standard. All other rules and operating procedures, and amendments thereto, shall become effective as of the date specified in each rule, operating procedure or amendment.

IV. A compacting state may opt out of a uniform standard, either by legislation or rule duly promulgated by the insurance department under the compacting state's administrative procedure act.

(a) If a compacting state elects to opt out of a uniform standard by rule, it shall:

(1) Give written notice to the commission no later than 10 business days after the uniform standard is promulgated, or at the time the state becomes a compacting state; and

(2) Find that the uniform standard does not provide reasonable protections to the citizens of the state, given the conditions in the state.

(b) The commissioner shall make specific findings of fact and conclusions of law, based on a preponderance of the evidence, detailing the conditions in the state which warrant a departure from the uniform standard and determining that the uniform standard would not reasonably protect the citizens of the state. The commissioner shall consider and balance the following factors and find that the conditions in the state and needs of the citizens of the state outweigh:

(1) The intent of the legislature to participate in, and the benefits of, an interstate agreement to establish national uniform consumer protections for the products subject to this chapter; and

(2) The presumption that a uniform standard adopted by the commission provides reasonable protections to consumers of the relevant product.

(c) Notwithstanding the foregoing, a compacting state may, at the time of its enactment of this compact, prospectively opt out of all uniform standards involving long-term care insurance products by expressly providing for such opt out in the enacted compact and such an opt out shall not be treated as a material variance in the offer or acceptance of any state to participate in this compact. Such an opt out shall be effective at the time of enactment of this compact by the compacting state and shall apply to all existing uniform standards involving long-term care insurance products and those subsequently promulgated.

V. (a) If a compacting state elects to opt out of a uniform standard, the uniform standard shall remain applicable in the compacting state electing to opt out until such time the opt out legislation is enacted into law or the rule opting out becomes effective.

(b) Once the opt out of a uniform standard by a compacting state becomes effective as provided under the laws of that state, the uniform standard shall have no further force and effect in that state unless and until the legislation or rule implementing the opt out is repealed or otherwise becomes ineffective under the laws of the state. If a compacting state opts out of a uniform standard after the uniform standard has been made effective in that state, the opt out shall have the same prospective effect as provided under RSA 408-C:14 for withdrawals.

VI. If a compacting state has formally initiated the process of opting out of a uniform standard by rule, and while the regulatory opt out is pending, the compacting state may petition the commission, at least 15 days before the effective date of the uniform standard, to stay the effectiveness of the uniform standard in that state. The commission may grant a stay if it determines the regulatory opt out is being pursued in a reasonable manner and there is a likelihood of success. If a stay is granted or extended by the commission, the stay or extension thereof may postpone the effective date by up to 90 days, unless affirmatively extended by the commission; provided, a stay may not be permitted to remain in effect for more than one year unless the compacting state can show extraordinary circumstances which warrant a continuance of the stay, including, but not limited to, the existence of a legal challenge that prevents the compacting state from opting out. A stay may be terminated by the commission upon notice that the rulemaking process has been terminated.

VII. Not later than 30 days after a rule or operating procedure is promulgated, any person may file a petition for judicial review of the rule or operating procedure; provided, that the filing of such a petition shall not stay or otherwise prevent the rule or operating procedure from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the commission consistent with applicable law and shall not find the rule or operating procedure to be unlawful if the rule or operating procedure represents a reasonable exercise of the commission's authority.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:8 Commission Records and Enforcement. 

I. The commission shall promulgate rules establishing conditions and procedures for public inspection and copying of its information and official records, except such information and records involving the privacy of individuals and insurers' trade secrets. The commission may promulgate additional rules under which it may make available to federal and state agencies, including law enforcement agencies, records and information otherwise exempt from disclosure, and may enter into agreements with such agencies to receive or exchange information or records subject to nondisclosure and confidentiality provisions.

II. Except as to privileged records, data and information, the laws of any compacting state pertaining to confidentiality or nondisclosure shall not relieve any compacting state commissioner of the duty to disclose any relevant records, data or information to the commission; provided, that disclosure to the commission shall not be deemed to waive or otherwise affect any confidentiality requirement; and further provided, that, except as otherwise expressly provided in this chapter, the commission shall not be subject to the compacting state's laws pertaining to confidentiality and nondisclosure with respect to records, data and information in its possession. Confidential information of the commission shall remain confidential after such information is provided to any commissioner.

III. The commission shall monitor compacting states for compliance with duly adopted bylaws, rules, including uniform standards, and operating procedures. The commission shall notify any non-complying compacting state in writing of its noncompliance with commission bylaws, rules or operating procedures. If a non-complying compacting state fails to remedy its noncompliance within the time specified in the notice of noncompliance, the compacting state shall be deemed to be in default as set forth in RSA 408-C:14.

IV. The commissioner of any state in which an insurer is authorized to do business, or is conducting the business of insurance, shall continue to exercise his or her authority to oversee the market regulation of the activities of the insurer in accordance with the provisions of the state's laws. The commissioner's enforcement of compliance with the compact is governed by the following provisions:

(a) With respect to the commissioner's market regulation of a product or advertisement that is approved or certified to the commission, the content of the product or advertisement shall not constitute a violation of the provisions, standards or requirements of the compact except upon a final order of the commission, issued at the request of a commissioner after prior notice to the insurer and an opportunity for hearing before the commission.

(b) Before a commissioner may bring an action for violation of any provision, standard or requirement of the compact relating to the content of an advertisement not approved or certified to the commission, the commission, or an authorized commission officer or employee, must authorize the action. However, authorization pursuant to this paragraph shall not require notice to the insurer, opportunity for hearing or disclosure of requests for authorization or records of the commission's action on such requests.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-C:9 Dispute Resolution. 

The commission shall attempt, upon the request of a member, to resolve any dispute or other issues that are subject to this compact and which may arise between 2 or more compacting states, or between compacting states and non-compacting states, and the commission shall promulgate an operating procedure providing for resolution of such disputes.


Source. 2004, 196:2, eff. Aug. 6, 2004.

    408-D:1 Short Title. 

This chapter may be cited as the life settlements act.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:10 Life Settlement Provider and Life Settlement Producer Disclosure to Insurer. 

Prior to the initiation of a plan, transaction, or series of transactions, a life settlement producer or life settlement provider shall fully disclose to an insurer a plan, transaction, or series of transactions, to which the life settlement producer or life settlement provider is a party, to originate, renew, continue or finance a life insurance policy with the insurer for the purpose of engaging in the business of life settlements at anytime prior to, or during the first 5 years after, issuance of the policy.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:11 General Rules. 

I. (a) A life settlement provider entering into a life settlement contract shall first obtain:

(1) If the viator is the insured, a written statement from a licensed attending physician that the viator is of sound mind and under no constraint or undue influence to enter into a life settlement contract; and

(2) A document in which the insured consents to the release of his or her medical records to a licensed life settlement provider, life settlement producer, and the insurance company that issued the life insurance policy covering the life of the insured.

(b) Within 20 days after a viator executes documents necessary to transfer any rights under an insurance policy or within 20 days of entering any agreement, option, promise, or any other form of understanding, expressed or implied, to viaticate the policy, the life settlement provider shall give written notice to the insurer that issued that insurance policy that the policy has or will become a viaticated policy. The notice shall be accompanied by the documents required by subparagraph (c).

(c) The life settlement provider shall deliver a copy of the medical release required under subparagraph (a)(2), a copy of the viator's application for the life settlement contract, the notice required under subparagraph (b) and a request for verification of coverage to the insurer that issued the life policy that is the subject of the life transaction. The NAIC's form for verification of coverage shall be used unless another form is developed and approved by the commissioner.

II. The insurer shall respond to a request for verification of coverage submitted on an approved form by a life settlement provider or life settlement producer or life insurance producer within 30 calendar days of the date the request is received and shall indicate whether, based on the medical evidence and documents provided, the insurer intends to pursue an investigation at this time regarding the validity of the insurance contract or possible fraud. The insurer shall accept a request for verification of coverage made on an NAIC form or any other form approved by the commissioner. The insurer shall accept an original or facsimile or electronic copy of such request and any accompanying authorization signed by the viator. Failure by the insurer to meet its obligations under this paragraph shall be a violation of RSA 408-D:12 and RSA 408-D:16.

III. Prior to or at the time of execution of the life settlement contract, the life settlement provider shall obtain a witnessed document in which the viator consents to the life settlement contract, represents that the viator has a full and complete understanding of the life settlement contract, that he or she has a full and complete understanding of the benefits of the life insurance policy, acknowledges that he or she is entering into the life settlement contract freely and voluntarily and, for persons with a terminal or chronic illness or condition, acknowledges that the insured has a terminal or chronic illness and that the terminal or chronic illness or condition was diagnosed after the life insurance policy was issued.

IV. A life settlement producer may perform any of the requirements of this section on behalf of the life settlement provider.

V. All medical information solicited or obtained by any licensee shall be subject to the applicable provisions of state law relating to confidentiality of medical information.

VI. All life settlement contracts entered into in this state shall provide the viator with an absolute right to rescind the life settlement contract before the earlier of 30 calendar days after the date upon which the life settlement contract is executed by all parties or 15 calendar days after the life settlement proceeds have been sent to the viator as provided in RSA 408-D:9, I(f). Rescission by the viator may be conditioned upon the viator both giving notice and repaying to the life settlement provider within the rescission period all proceeds of the settlement and any premiums, loans, and loan interest paid by or on behalf of the life settlement provider in connection with or as a consequence of the life settlement contract. If the insured dies during the rescission period, the life settlement contract shall be deemed to have been rescinded, subject to repayment to the life settlement provider or life settlement purchaser of all life settlement proceeds, and any premiums, loans, and loan interest that have been paid by the life settlement provider or life settlement purchaser, which shall be paid within 60 calendar days of the death of the insured. In the event of any rescission, if the life settlement provider has paid commissions or other compensation to a life settlement producer in connection with the rescinded transaction, the life settlement producer shall refund all such commissions and compensation to the life settlement provider within 5 business days following receipt of written demand from the life settlement provider, which demand shall be accompanied by either the viator's notice of rescission if rescinded at the election of the viator, or notice of the death of the insured if rescinded by reason of the death of the insured within the applicable rescission period.

VII. The life settlement provider shall instruct the viator to send the executed documents required to effect the change in ownership, assignment, or change in beneficiary directly to the independent escrow agent.

VIII. Within 3 business days after the date the escrow agent receives the document, (or from the date the life settlement provider receives the documents), if the viator erroneously provides the documents directly to the life settlement provider, the life settlement provider shall pay or transfer the proceeds of the life settlement into an escrow or trust account maintained in a state or federally-chartered financial institution whose deposits are insured by the Federal Deposit Insurance Corporation (FDIC). Upon payment of the settlement proceeds into the escrow account, the escrow agent shall deliver the original change in ownership, assignment, or change in beneficiary forms to the life settlement provider or related provider trust or other designated representative of the life settlement provider. Upon the escrow agent's receipt of the acknowledgment of the properly completed transfer of ownership, assignment or designation of beneficiary from the insurance company, the escrow agent shall pay the settlement proceeds to the viator.

IX. Failure to tender consideration to the viator for the life settlement contract within the time set forth in the disclosure pursuant to RSA 408-D:9, I(f) renders the life settlement contact voidable by the viator for lack of consideration until the time consideration is tendered to and accepted by the viator. Funds shall be deemed sent by a life settlement provider to a viator as of the date that the escrow agent either releases funds for wire transfer to the viator or places a check for delivery to the viator via United States Postal Service or other nationally recognized delivery service.

X. Contacts with the insured for the purpose of determining the health status of the insured by the life settlement provider or life settlement producer after the life settlement has occurred shall only be made by the life settlement provider or life settlement producer licensed in this state or its authorized representatives and shall be limited to once every 3 months for insureds with a life expectancy of more than one year, and to no more than once a month for insureds with a life expectancy of one year or less. The life settlement provider or life settlement producer shall explain the procedure for these contacts at the time the life settlement contract is entered into. The limitations set forth in this subsection shall not apply to any contacts with an insured for reasons other than determining the insured's health status. Life settlement providers and life settlement producers shall be responsible for the actions of their authorized representatives.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:12 Prohibited Practices. 

I. It is a violation of this chapter for any person to solicit or promote STOLI or to knowingly participate in any transaction, practice, or course of business involving the sale or settlement of STOLI.

II. It is a violation of this chapter for any person to enter into a life settlement contract at any time prior to the application or issuance of a policy which is the subject of a life settlement contract or within a 5 year period commencing with the date of issuance of the insurance policy or certificate unless the viator certifies to the life settlement provider that one or more of the following conditions have been met within the 5 year period:

(a) The policy was issued upon the viator's exercise of conversion rights arising out of a group or individual policy, provided the total of the time covered under the conversion policy plus the time covered under the prior policy is at least 60 months. The time covered under a group policy shall be calculated without regard to any change in insurance carriers, provided the coverage has been continuous and under the same group sponsorship;

(b) The viator submits independent evidence to the life settlement provider that one or more of the following conditions have been met within the 5 year period:

(1) The viator or insured is terminally or chronically ill;

(2) The viator's spouse dies;

(3) The viator divorces his or her spouse;

(4) The viator retires from full-time employment;

(5) The viator becomes physically or mentally disabled and a physician determines that the disability prevents the viator from maintaining full-time employment; or

(6) A final order, judgment or decree is entered by a court of competent jurisdiction, on the application of a creditor of the viator, adjudicating the viator bankrupt or insolvent, or approving a petition seeking reorganization of the viator or appointing a receiver, trustee, or liquidator to all or a substantial part of the viator assets; or

(c) The viator enters into a life settlement contract more than 2 years after the date of issuance of a policy and, with respect to the policy, at all times prior to the date that is 2 years after policy issuance, the following conditions are met:

(1) Policy premiums have been funded exclusively with unencumbered assets, including an interest in the life insurance policy being financed only to the extent of its net cash surrender value, provided by, or fully recourse liability incurred by, the insured or a person described in RSA 408-D:2, IX(c)(5); and

(2) There is no agreement or understanding with any other person to guarantee any such liability or to purchase, or stand ready to purchase, the policy, including through an assumption or forgiveness of the loan.

III. Copies of the independent evidence described in subparagraph I(b) and document required by RSA 408-D:11, I shall be submitted to the insurer when the life settlement provider or other party entering into a life settlement contact with a viator submits a request to the insurer for verification of coverage. The copies shall be accompanied by a letter of attestation from the life settlement provider that the copies are true and correct copies of the documents received by the life settlement provider.

IV. If the life settlement provider submits to the insurer a copy of the owner or insured's certification described in and the independent evidence required by subparagraph I(c) when the life settlement provider submits a requests to the insurer to effect the transfer of the policy or certificate to the life settlement provider, the copy shall be deemed to conclusively establish that the life settlement contract satisfies the requirements of this section and the insurer shall timely respond to the request.

V. No insurer may, as a condition of responding to a request for verification of coverage or effecting the transfer of a policy pursuant to a life settlement contract, require that the viator, insured, life settlement provider or life settlement producer sign any forms, disclosures, consent, or waiver form that has not been expressly approved by the commissioner for use in connection with life settlement contracts in this state.

VI. Upon receipt of a properly completed request for change of ownership or beneficiary of a policy, the insurer shall respond in writing within 30 calendar days with written acknowledgement confirming that the change has been effected or specifying the reasons why the requested change cannot be processed. The insurer shall not unreasonably delay effecting change of ownership or beneficiary and shall not otherwise seek to interfere with any life settlement contract lawfully entered into in this state.

VII. With respect to any life settlement contract or insurance policy, no life settlement producer knowingly shall solicit an offer from, effectuate a life settlement with or make a sale to any life settlement provider, life settlement purchaser, financing entity or related provider trust that is controlling, controlled by, or under common control with such life settlement producer.

VIII. With respect to any life settlement contract or insurance policy, no life settlement producer knowingly may enter into a life settlement contract with a viator, if, in connection with such life settlement contract, anything of value will be paid to a life settlement producer that is controlling, controlled by, or under common control with such life settlement provider or the life settlement purchaser, financing entity, or related provider trust that is involved in such life settlement contract.

IX. A violation of paragraph I or II shall be deemed a fraudulent life settlement act.

X. No life settlement provider shall enter into a life settlement contract unless the life settlement promotional, advertising, and marketing materials, as may be prescribed by rule, have been filed with the commissioner. In no event shall any marketing materials expressly reference that the insurance is "free" for any period of time. The inclusion of any reference in the marketing materials that would cause a viator to reasonably believe that the insurance is free for any period of time shall be considered a violation of this chapter.

XI. No life insurance producer, insurance company, life settlement producer, or life settlement provider shall make any statement or representation to the applicant or policyholder in connection with the sale or financing of a life insurance policy to the effect that the insurance is free or without cost to the policyholder for any period of time unless provided in the policy.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:13 Advertising for Life Settlements. 

The purpose of this section is to provide prospective viators with clear and unambiguous statements in the advertisement of life settlements and to assure the clear, truthful, and adequate disclosure of the benefits, risks, limitations, and exclusions of any life settlement contract. This purpose is intended to be accomplished by the establishment of guidelines and standards of permissible and impermissible conduct in the advertising of life settlements to assure that product descriptions are presented in a manner that prevents unfair, deceptive, or misleading advertising and is conducive to accurate presentation and description of life settlements through the advertising media and material used by life settlement licensees.

I. This section shall apply to any advertising of life settlement contracts, or related products or services intended for dissemination in this state, including Internet advertising viewed by persons located in this state. Where disclosure requirements are established pursuant to federal regulation, this section shall be interpreted so as to minimize or eliminate conflict with federal regulation wherever possible.

II. Every life settlement licensee shall establish and at all times maintain a system of control over the content, form, and method of dissemination of all advertisements of its contracts, products and services. All advertisements, regardless of by whom written, created, designed, or presented, shall be the responsibility of the life settlement licensees, as well as the individual who created or presented the advertisement. A system of control shall include regular routine notification, at least once a year, to agents and others authorized by the life settlement licensee who disseminate advertisements of the requirements and procedures for approval prior to the use of any advertisements not furnished by the life settlement licensee.

III. Advertisements shall be truthful and not misleading in fact or by implication. The form and content of an advertisement of a life settlement contract shall be sufficiently complete and clear so as to avoid deception. It shall not have the capacity or tendency to mislead or deceive. Whether an advertisement has the capacity or tendency to mislead or deceive shall be determined by the commissioner from the overall impression that the advertisement may be reasonably expected to create upon a person of average education or intelligence within the segment of the public to which it is directed.

IV. The information required to be disclosed under this section shall not be minimized, rendered obscure, or presented in an ambiguous fashion or intermingled with the text of the advertisement so as to be confusing or misleading.

(a) An advertisement shall not omit material information or use words, phrases, statements, references, or illustrations if the omission or use has the capacity, tendency, or effect of misleading or deceiving viators as to the nature or extent of any benefit, loss covered, premium payable, or state or federal tax consequence. The fact that the life settlement contract offered is made available for inspection prior to consummation of the sale, or an offer is made to refund the payment if the viator is not satisfied, or that the life settlement contract includes a "free look" period that satisfies or exceeds legal requirements, does not remedy misleading statements.

(b) An advertisement shall not use the name or title of a life insurance company or a life insurance policy unless the advertisement has been approved by the insurer.

(c) An advertisement shall not state or imply that interest charged on an accelerated death benefit or a policy loan is unfair, inequitable, or in any manner an incorrect or improper practice.

(d) The words "free," "no cost," "without cost," "no additional cost," "at no cost," or words of similar import shall not be used with respect to any benefit or service unless true. An advertisement may specify the charge for a benefit or service or may state that a charge is included in the payment or use other appropriate language.

(e) Testimonials, appraisals, or analysis used in advertisements must be genuine; represent the current opinion of the author; be applicable to the life settlement contract, if any; and be accurately reproduced with sufficient completeness to avoid misleading or deceiving prospective viators as to the nature or scope of the testimonials, appraisal, analysis, or endorsement. In using testimonials, appraisals, or analysis, a licensee under this chapter makes as its own all the statements contained therein, and the statements are subject to all the provisions of this section.

(1) If the individual making a testimonial, appraisal, analysis, or an endorsement has a financial interest in the party making use of the testimonial, appraisal, analysis, or endorsement, either directly or through a related entity as a stockholder, director, officer, employee, or otherwise, or receives any benefit directly or indirectly other than required union scale wages, that fact shall be prominently disclosed in the advertisement.

(2) An advertisement shall not state or imply that a life settlement contract benefit or service has been approved or endorsed by a group of individuals, society, association or other organization unless that is the fact and unless any relationship between an organization and the life settlement licensee is disclosed. If the entity making the endorsement or testimonial is owned, controlled or managed by the life settlement licensee, or receives any payment or other consideration from the life settlement licensee for making an endorsement or testimonial, that fact shall be disclosed in the advertisement.

(3) When an endorsement refers to benefits received under a life settlement contract all pertinent information shall be retained for a period of 5 years after its use.

V. An advertisement shall not contain statistical information unless it accurately reflects recent and relevant facts. The source of all statistics used in an advertisement shall be identified.

VI. An advertisement shall not disparage insurers, life settlement providers, life settlement producers, life settlement investment agents, insurance producers, policies, services or methods of marketing.

VII. The name of the life settlement licensee shall be clearly identified in all advertisements about the licensee or its life settlement contract, products, or services, and if any specific life settlement contract is advertised, the life settlement contract shall be identified either by form number or some other appropriate description. If an application is part of the advertisement, the name of the life settlement provider shall be shown on the application.

VIII. An advertisement shall not use a trade name, group designation, name of the parent company of a life settlement licensee, name of a particular division of the life settlement licensee, service mark, slogan, symbol, or other device or reference without disclosing the name of the life settlement licensee, if the advertisement would have the capacity or tendency to mislead or deceive as to the true identify of the life settlement licensee, or to create the impression that a company other than the life settlement licensee would have any responsibility for the financial obligation under a life settlement contract.

IX. An advertisement shall not use any combination of words, symbols, or physical materials that by their content, phraseology, shape, color, or other characteristics are so similar to a combination of words, symbols, or physical materials used by a government program or agency or otherwise appear to be of such a nature that they tend to mislead prospective viators into believing that the solicitation is in some manner connected with a government program or agency.

X. An advertisement may state that a life settlement licensee is licensed in the state where the advertisement appears, provided it does not exaggerate that fact or suggest or imply that competing life settlement licensee may not be so licensed. The advertisement may ask the audience to consult the licensee's web site or contact the insurance department to find out if the state requires licensing and, if so, whether the life settlement provider or life settlement producer is licensed.

XI. An advertisement shall not create the impression that the life settlement provider, its financial condition or status, the payment of its claims or the merits, desirability, or advisability of its life settlement contracts are recommended or endorsed by any government entity.

XII. The name of the actual licensee shall be stated in all of its advertisements. An advertisement shall not use a trade name, any group designation, name of any affiliate or controlling entity of the licensee, service mark, slogan, symbol, or other device in a manner that would have the capacity or tendency to mislead or deceive as to the true identity of the actual licensee or create the false impression that an affiliate or controlling entity would have any responsibility for the financial obligation of the licensee.

XIII. An advertisement shall not directly or indirectly create the impression that any division or agency of the state or of the U.S. government endorses, approves, or favors:

(a) Any life settlement licensee or its business practices or methods of operation;

(b) The merits, desirability or advisability, of any life settlement contract;

(c) Any life settlement contract; or

(d) Any life insurance policy or life insurance company.

XIV. If the advertiser emphasizes the speed with which the viatication will occur, the advertising must disclose the average time frame from completed application to the date of offer and from acceptance of the offer to receipt of the funds by the viator.

XV. If the advertising emphasizes the dollar amounts available to viators, the advertising shall disclose the average purchase price as a percent of face value obtained by viators contracting with the licensee during the past 6 months.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:14 Fraud Prevention and Control. 

I. Fraudulent life settlement acts, interference, and participation of convicted felons prohibited.

(a) A person shall not commit a fraudulent life settlement act.

(b) A person shall not knowingly or intentionally interfere with the enforcement of the provisions of this chapter or investigations of suspected or actual violations of this chapter.

(c) A person in the business of life settlements shall not knowingly or intentionally permit any person convicted of a felony involving dishonesty or breach of trust to participate in the business of life settlements.

II. Fraud warning required.

(a) Life settlement contracts and applications for life settlements, regardless of the form of transmission, shall contain the following statement or a substantially similar statement: "Any person who knowingly presents false information in an application for insurance or life settlement contract is guilty of a crime and may be subject to fines and confinement in prison."

(b) The lack of a statement as required in subparagraph (a) does not constitute a defense in any prosecution for a fraudulent life settlement act.

III. Mandatory reporting of fraudulent life settlement acts.

(a) Any person engaged in the business of life settlements having knowledge or a reasonable suspicion that a fraudulent life settlement act is being, will be or has been committed shall provide to the commissioner the information as required by, and in a manner prescribed by, the commissioner.

(b) Any other person having knowledge or a reasonable belief that a fraudulent life settlement act is being, will be, or has been committed may provide to the commissioner the information required by, and in a manner prescribed by, the commissioner.

IV. Immunity from liability.

(a) No civil liability shall be imposed on and no cause of action shall arise from a person's furnishing information concerning suspected, anticipated, or completed fraudulent life settlement acts or suspected or completed fraudulent insurance acts, if the information is provided to or received from:

(1) The commissioner or the commissioner's employees, agents, or representatives;

(2) Federal, state, or local law enforcement or regulatory officials or their employees, agents, or representatives;

(3) A person involved in the prevention and detection of fraudulent life settlement acts or that person's agents, employees, or representatives;

(4) The National Association of Insurance Commissioners (NAIC), National Association of Securities Dealers (NASD), the North American Securities Administration Association (NASAA), or their employees, agents, or representatives, or other regulatory body overseeing life insurance, life settlements, securities, or investment fraud; or

(5) The life insurer that issued the life insurance policy covering the life of the insured; or

(b) Subparagraph (a) shall not apply to statements made with actual malice. In an action brought against a person for filing a report or furnishing other information concerning a fraudulent life settlement act, the party bringing the action shall plead specifically any allegation that subparagraph (a) does not apply because the person filing the report or furnishing the information did so with actual malice.

(c) A person furnishing information as identified in subparagraph (a) shall be entitled to an award of attorney's fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander or any other relevant tort arising out of activities in carrying out the provisions of this chapter and the party bringing the action was not substantially justified in doing so. For purposes of this section a proceeding is "substantially justified" if it had a reasonable basis in law or fact at the time that it was initiated. However, such an award does not apply to any person furnishing information concerning his or her own fraudulent life settlement acts.

(d) This section does not abrogate or modify common law or statutory privileges or immunities enjoyed by a person described in subparagraph (a).

V. Confidentiality.

(a) The documents and evidence provided pursuant to paragraph IV or obtained by the commissioner in an investigation of suspected or actual fraudulent life settlement acts shall be privileged and confidential and shall not be a public record under RSA 91-A and shall not be subject to discovery or subpoena in a civil or criminal action.

(b) Subparagraph (a) shall not prohibit release by the commissioner of documents and evidence obtained in an investigation of suspected or actual fraudulent life settlement acts:

(1) In administrative or judicial proceedings to enforce laws administered by the commissioner; or

(2) To federal, state, or local law enforcement or regulatory agencies, to an organization established for the purpose of detecting and preventing fraudulent life settlement acts or to the NAIC.

(c) Release of documents and evidence under subparagraph (b) shall not abrogate or modify the privilege granted in subparagraph (a).

VI. Other law enforcement or regulatory authority. This act shall not:

(a) Preempt the authority or relieve the duty of other law enforcement or regulatory agencies to investigate, examine and prosecute suspected violations of law;

(b) Prevent or prohibit a person from disclosing voluntarily information concerning life settlement fraud to a law enforcement or regulatory agency other than the insurance department; or

(c) Limit the powers granted elsewhere by the laws of this state to the commissioner or an insurance fraud unit to investigate and examine possible violations of law and to take appropriate action against wrongdoers.

VII. Life settlement antifraud initiatives.

(a) Life settlement providers and life settlement producers shall have in place antifraud initiatives reasonably calculated to detect, prosecute, and prevent fraudulent life settlement acts. At the discretion of the commissioner, the commissioner may order, or a licensee may request and the commissioner may grant, such modifications of the following required initiatives as necessary to ensure an effective antifraud program. The modifications may be more or less restrictive than the required initiatives so long as the modifications may reasonably be expected to accomplish the purpose of this section. Antifraud initiatives shall include:

(1) Fraud investigators, who may be life settlement provider or life settlement producer employees or independent contractors; and

(2) An antifraud plan, which shall be submitted to the commissioner. The antifraud plan shall include, but not be limited to:

(A) A description of the procedures for detecting and investigating possible fraudulent life settlement acts and procedures for resolving material inconsistencies between medical records and insurance applications;

(B) A description of the procedures for reporting possible fraudulent life settlement acts to the commissioner;

(C) A description of the plan for antifraud education and training of underwriters and other personnel; and

(D) A description or chart outlining the organizational arrangement of the antifraud personnel who are responsible for the investigation and reporting of possible fraudulent life settlement acts and investigating unresolved material inconsistencies between medical records and insurance applications.

(b) Antifraud plans submitted to the commissioner shall be privileged and confidential and shall not be a public record under RSA 91-A and shall not be subject to discovery or subpoena in a civil or criminal action.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:15 Injunctions;  Civil Remedies;  Cease and Desist. 

I. In addition to the penalties and other enforcement provisions of this chapter, if any person violates this chapter or any rule implementing this chapter, the commissioner may seek an injunction in a court of competent jurisdiction and may apply for temporary and permanent orders that the commissioner determines are necessary to restrain the person from committing the violation.

II. Any person damaged by the acts of a person found in violation of this chapter by the commissioner may bring a civil action against the person committing the violation in a court of competent jurisdiction.

III. The commissioner may issue, in accordance with RSA 541-A, a cease and desist order upon a person that violates any provision of this chapter, any rule or order adopted by the commissioner, or any written agreement entered into with the commissioner.

IV. When the commissioner finds that an activity in violation of this chapter presents an immediate danger to the public that requires an immediate final order, the commissioner may issue an emergency cease and desist order reciting with particularity the facts underlying the findings. The emergency cease and desist order is effective immediately upon service of a copy of the order on the respondent and remains effective for 90 days. If the commissioner begins non-emergency cease and desist proceedings, the emergency cease and desist order remains effective, absent an order by a court of competent jurisdiction pursuant to RSA 541:18.

V. In addition the penalties and other enforcement provisions of this chapter, any person who violates this chapter is subject to civil penalties of up to $2,500 per violation. Imposition of civil penalties shall be pursuant to an order of the commissioner issued under RSA 400-A:23. The commissioner's order may require a person found to be in violation of this chapter to make restitution to persons aggrieved by violations of this chapter.

VI. A person convicted of a violation of this chapter shall be ordered to pay restitution to persons aggrieved by the violation of this chapter. Restitution shall be ordered in addition to a fine or imprisonment, but not in lieu of a fine or imprisonment. The commissioner may order a life settlement provider to pay restitution to persons aggrieved by the violations of this chapter committed by its appointed life settlement producers.

VII. Except for a fraudulent life settlement act committed by a viator, the enforcement provisions and penalties of this section shall not apply to a viator.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:16 Unfair Trade Practices. 

A violation of this chapter, including the commission of a fraudulent life settlement act, shall be considered an unfair trade practice under RSA 417.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:17 Rulemaking. 

The commissioner shall have the authority to:

I. Adopt rules pursuant to RSA 541-A, implementing this chapter;

II. Establish standards for evaluating reasonableness of payments under life settlement contracts for persons who are terminally or chronically ill. This authority includes, but is not limited to, regulation of discount rates used to determine the amount paid in exchange for assignment, transfer, sale, devise, or bequest of a benefit under a life insurance policy insuring the life of a person that is chronically or terminally ill;

III. Establish appropriate licensing requirements, fees, and standards for continued licensure for life settlement providers and life settlement producers;

IV. Require a bond or other mechanism for financial accountability for life settlement providers and life settlement producers; and

V. Adopt rules governing the relationship and responsibilities of both insurers and life settlement providers and life settlement producers during the viatication of a life insurance policy or certificate.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:18 Severability. 

If any provision of this act or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of the act which can be given effect without the invalid provision or application, and to this end the provisions of this act are declared to be severable.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:19 Applicability. 

A life settlement provider or life settlement producer transacting business in this state may continue to do so pending approval or disapproval of the life settlement provider, or life settlement producer application for licensure if the application is filed with the commissioner within one month of the effective date of this chapter.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:2 Definitions. 

In this chapter:

I. "
Advertising
" means any written, electronic, or printed communication or any communication by means of recorded telephone messages or transmitted on radio, television, the Internet, or similar communications media, including film strips, motion pictures, and videos, published, disseminated, circulated, or placed before the public, directly or indirectly, in this state, for the purpose of creating an interest in or inducing a person to purchase or sell, assign, devise, bequest, or transfer the death benefit or ownership of a life insurance policy to a life settlement contact.

II. "
Business of life settlements
" means an activity involved in, but not limited to, the offering, soliciting, negotiating, procuring, effectuating, monitoring, tracking, underwriting, selling, transferring, assigning, pledging, hypothecating or in any other manner, acquiring an interest in a life insurance policy by means of a life settlement contract.

III. "
Chronically ill
" means:

(a) Being unable to perform at least 2 activities of daily living, including eating, toileting, transferring, bathing, dressing, or continence;

(b) Requiring substantial supervision to protect the individual from threats to health and safety due to severe cognitive impairment; or

(c) Having a level of disability similar to that described in subparagraph (a) as determined by the department of health and human services.

IV. "
Commissioner
" means the insurance commissioner.

V. (a) "
Financing entity
" means an underwriter, placement agent, lender, purchaser of securities, purchaser of a policy or certificate from a life settlement provider, credit enhancer, or any entity that has a direct ownership in a policy or certificate that is the subject of a life settlement contract, but:

(1) Whose principal activity related to the transaction is providing funds to effect the life settlement contract or purchase of one or more viaticated policies; and

(2) Who has an agreement in writing with one or more licensed life settlement providers to finance the acquisition of life settlement contracts.

(b) "Financing entity" does not include a non-accredited investor or a life settlement purchaser.

VI. "Fraudulent life settlement act" includes:

(a) Acts or omissions committed by any person who, knowingly or with intent to defraud, for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to engage in acts including, but not limited to:

(1) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by a life settlement provider, life settlement premium finance lender, life settlement producer, life settlement purchaser, financing entity insurer, insurance producer, or any other person, false material information, or concealing material information, as part of, in support of, or concerning a fact material to one or more of the following:

(A) An application for the issuance of a life settlement contract or insurance policy;

(B) The underwriting of a life settlement contract or insurance policy;

(C) A claim for payment or benefit pursuant to a life settlement contract or insurance policy;

(D) Premiums paid on an insurance policy;

(E) Payments and changes in ownership or beneficiary made in accordance with the terms of a life settlement contract or insurance policy;

(F) The reinstatement or conversion of an insurance policy;

(G) The solicitation, offer, effectuation, or sale of a life settlement contract or insurance policy;

(H) The issuance of written evidence of life settlement contracts or insurance;

(I) A financing transaction; or

(J) A plan which involves "stranger-originated life insurance" (STOLI) as defined in paragraph XVI.

(2) Employing any plan, financial structure, device, scheme, or artifice to defraud related to viaticated policies.

(b) In the furtherance of a fraud or to prevent the detection of a fraud any person commits or permits its employees or its agents to:

(1) Remove, conceal, alter, destroy, or sequester from the commissioner the assets or records of a licensee or other person engaged in the business of life settlements;

(2) Misrepresent or conceal the financial condition of a licensee, financing entity, insurer, or other person;

(3) Transact the business of life settlements in violation of laws requiring a license, certificate of authority or other legal authority for the transaction of the business of life settlements; or

(4) File with the commissioner or the equivalent chief insurance regulatory official of another jurisdiction a document containing false information or otherwise concealing information about a material fact from the commissioner.

(c) Embezzlement, theft, misappropriation or conversion of moneys, funds, premiums, credits, or other property of a life settlement provider, insurer, insured, viator, insurance policy owner, or any other person engaged in the business of life settlements or insurance.

(d) Recklessly entering into, negotiating, brokering, otherwise dealing in a life settlement contract, the subject of which is a life insurance policy that was obtained by presenting false information concerning any fact material to the policy or by concealing, for the purpose of misleading another, information concerning any fact material to the policy, where the person or the persons intended to defraud the policy's issuer, the life settlement provider, or the viator. "
Recklessly
" means engaging in the conduct in conscious and clearly unjustifiable disregard of a substantial likelihood of the existence of the relevant facts or risks, such disregard involving a gross deviation from acceptable standards of conduct.

(e) Facilitating the change of state of ownership of a policy or certificate or the state of residency of a viator to a state or jurisdiction that does not have a law similar to this chapter for the express purposes of evading or avoiding the provisions of this chapter.

(f) Attempting to commit, assisting, aiding or abetting the commission of, or conspiracy to commit the acts or omissions specified in this paragraph.

VII. "
Life insurance producer
" means any person licensed in this state as a resident or nonresident insurance producer who has received qualification or authority for life insurance coverage or a life line of coverage pursuant to RSA 402-J:7, I(a).

VIII. "
Life settlement producer
" means a person as provided for in RSA 408-D:3, who working for a fee, commission, or other valuable consideration, offers or attempts to solicit or negotiate life settlement contracts between a viator and one or more life settlement providers or one or more life settlement producers. The term does not include an attorney, certified public accountant or a financial planner accredited by a nationally recognized accreditation agency, who is retained to represent the viator and whose compensation is not paid directly or indirectly by the life settlement provider or life settlement purchaser.

IX. "
Life settlement contract
" means the transfer for compensation or value of ownership or beneficial interest in a trust or other entity that owns such policy if the trust or other entity was formed or availed of for the principal purpose of acquiring one or more life insurance contacts, which life insurance contract insures the life of a person residing in this state.

(a) "Life settlement contract" includes a written agreement between a viator and a life settlement provider or any affiliate of the life settlement provider establishing the terms under which compensation or anything of value is or will be paid, which compensation or value is less than the expected death benefits of the policy, in return for the viator's present or future assignment, transfer, sale, devise, or bequest of the death benefit or ownership of any portion of the insurance policy or certificate of insurance.

(b) "Life settlement contract" includes a premium finance loan made for a life insurance policy by a lender to viator on, before or after the date of issuance of the policy where:

(1) The viator or the insured receives on the date of the premium finance loan a guarantee of a future life settlement value of the policy; or

(2) The viator or the insured agrees on the date of the premium finance loan to sell the policy or any portion of its death benefit on any date following the issuance of the policy.

(c) "Life settlement contract" does not include:

(1) A policy loan or accelerated death benefit made by the insurer pursuant to the policy's terms;

(2) Loan proceeds that are used solely to pay:

(A) Premiums for the policy;

(B) The costs of the loan, including, without limitation, interest, arrangement fees, utilization fees and similar fees, closing costs, legal fees and expenses, trustee fees and expenses, and third party collateral provider fees and expenses, including fees payable to letter of credit issuers;

(3) A loan made by a bank or other licensed financial institution in which the lender takes an interest in a life insurance policy solely to secure repayment of a loan or, if there is a default on the loan and the policy is transferred, the transfer of such a policy by the lender, provided that the default itself is not pursuant to an agreement or understanding with any other person for the purpose of evading regulation under this chapter;

(4) A loan made by a lender that does not violate RSA 415-B, provided that the premium finance loan is not described in subparagraph (b);

(5) An agreement where all the parties are closely related to the insured by blood or law, or have a lawful substantial economic interested in the continued life, health and bodily safety of the person insured, or are trusts established primarily for the benefit of such parties;

(6) Any designation, consent, or agreement by an insured who is an employee of an employer in connection with the purchase by the employer, or trust established by the employer, of life insurance on the life of the employee;

(7) A bona fide business succession planning arrangement:

(A) Between one or more shareholders in a corporation or between a corporation and one or more of its shareholders or one or more trusts established by its shareholders;

(B) Between one or more partners in a partnership or between a partnership and one or more of its partners or one or more trusts established by its partners; or

(C) Between one or more members in a limited liability company or between a limited liability company and one or more of its members or one or more trusts established by its members;

(8) An agreement entered into by a service recipient, or a trust established by the service recipient, and a service provider, or a trust established by the service provider, who performs significant services for the service recipient's trade or business; or

(9) Any other contract, transaction, or arrangement exempted from the definition of life settlement contract by the commissioner based on a determination that the contract, transaction, or arrangement is not of the type to be regulated by this chapter.

X. (a) "
Life settlement provider
" means a person, other than a viator, that enters into or effectuates a life settlement contract with a viator resident in this state.

(b) "Life settlement provider" does not include:

(1) A bank, savings bank, savings and loan association, credit union or other licensed lending institution that takes an assignment of a life insurance policy solely as collateral for a loan;

(2) A premium finance company making premium finance loans and exempted by the commissioner from the licensing requirement under the premium finance laws that takes an assignment of a life insurance policy solely as collateral for a loan;

(3) The issuer of the life insurance policy;

(4) An authorized or eligible insurer that provides stop loss coverage or financial guaranty insurance to a life settlement provider, life settlement purchaser, financing entity, special purpose entity or related provider trust;

(5) A natural person who enters into or effectuates no more than one agreement in a calendar year for the transfer of life insurance policies for any value less than the expected death benefit;

(6) A financing entity;

(7) A special purpose entity;

(8) A related provider trust;

(9) A life settlement purchaser; or

(10) Any other person that the commissioner determines is not the type of person intended to be covered by the definition of life settlement provider.

XI. (a) "
Life settlement purchaser
" means a person who provides a sum of money as consideration for the life insurance policy or an interest in the death benefits of a life insurance policy, or a person who owns or acquires or is entitled to a beneficial interest in a trust that owns a life settlement contract or is the beneficiary of a life insurance policy that has been or will be the subject of a life settlement contract, for the purpose of deriving an economic benefit.

(b) "Life settlement purchaser" does not include:

(1) A licensee under this chapter;

(2) An accredited investor or qualified institutional buyer as defined, respectively, in Rule 501(a) or Rule 144A promulgated under the Federal Securities Act of 1933, as amended;

(3) A financing entity;

(4) A special purpose entity; or

(5) A related provider trust.

XII. "
Person
" means a natural person or a legal entity, including, but not limited to, an individual, a partnership, limited liability company, association, trust, or corporation.

XIII. "
Policy
" means an individual or group policy, group certificate, contract, or arrangement of life insurance owned by a resident of this state, regardless of whether delivered or issued for delivery in this state.

XIV. "
Related provider trust
" means a titling trust or other trust established by a licensed life settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. In order to qualify as a related provider trust, the trust must have a written agreement with the licensed life settlement provider under which the licensed life settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to life settlement transactions available to the commissioner as if those records and files were maintained directly by the licensed life settlement provider.

XV. "
Special purpose entity
" means a corporation, partnership, trust, limited liability company, or other similar entity formed solely to provide either directly or indirectly access to institutional capital markets:

(a) For a financing entity or licensed life settlement provider;

(b) In connection with a transaction in which the securities in the special purposes entity are acquired by the viator or by "qualified institutional buyers" as defined in Rule 144 promulgated under the Securities Act of 1933, as amended; or

(c) The securities pay a fixed rate of return commensurate with established asset-backed institutional capital markets.

XVI. "
Stranger-originated life insurance
" or "
STOLI
" means a practice or plan to initiate a life insurance policy for the benefit of a third party investor who, at the time of policy origination, has no insurable interest in the insured. STOLI practices include but are not limited to cases in which life insurance is purchased with resources or guarantees from or through a person, or entity who, at the time of policy inception, could not lawfully initiate the policy himself, herself, or itself, and where, at the time of inception, there is an arrangement or agreement, whether verbal or written, to directly or indirectly transfer the ownership of the policy and/or the policy benefits to a third party. Trusts that are created to give the appearance of insurable interest and are used to initiate policies for investors violate insurable interest laws and the prohibition against wagering on life. STOLI arrangements do not include those practices set forth in RSA 408-D:2, XI(b)(2).

XVII. "
Terminally ill
" means having an illness or sickness that can reasonably be expected to result in death in 24 months or less.

XVIII. "
Viaticated policy
" means a life insurance policy or certificate that has been acquired by a life settlement provider pursuant to a life settlement contract.

XIX. (a) "
Viator
" means the owner of a life insurance policy or a certificate holder under a group policy who resides in this state and enters or seeks to enter into a life settlement contract. For the purposes of this chapter, a viator shall not be limited to an owner of a life insurance policy or a certificate holder under a group policy insuring the life of an individual with a terminal or chronic illness or condition except where specifically addressed. If there is more than one viator on a single policy and the viators are residents of different states, the transaction shall be governed by the law of the state in which the viator having the largest percentage ownership resides or, if the viators hold equal ownership, the state of residence of one viator agreed upon in writing by all the viators.

(b) "Viator" does not include:

(1) A licensee under this chapter, including a life insurance producer acting as a life settlement producer pursuant to this chapter;

(2) Qualified institutional buyer as defined, respectively, in Rule 144A promulgated under the Federal Securities Act of 1933, as amended;

(3) A financing entity;

(4) A special purpose entity; or

(5) A related provider trust.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:3 License and Appointment Requirements. 

I. (a) A person shall not operate as a life settlement provider or life settlement producer without first obtaining a license from the commissioner of the state of residence of the viator. If there is no license requirement in the state of residence of the viator, then a license must be obtained in New Hampshire.

(b)(1) A resident or nonresident life insurance producer who has been duly licensed with a life line of authority in this state or his or her home state for at least one year shall be deemed to meet the licensing requirements of subparagraph VI(b)(1) and (2) of this section and shall be permitted to operate as a life settlement producer upon demonstration of evidence of financial responsibility as required in subparagraph VI(b)(3).

(2) Not later than 30 days from the first day of operating as a life settlement producer, the life insurance producer shall notify the commissioner that he or she is acting as a life settlement producer on a form prescribed by the commissioner, and shall pay any applicable fee to be determined by the commissioner. Notification shall include an acknowledgement by the life insurance producer that he or she will operate as a life settlement producer in accordance with this chapter.

(3) The insurer that issued the policy being viaticated shall not be responsible for any act or omission of a life settlement producer or life settlement provider arising out of or in connection with the life settlement transaction, unless the insurer receives compensation for the placement of a life settlement contract from the life settlement provider or life settlement producer in connection with the life settlement contract.

(4) While such life settlement producer's appointment remains in force, the life settlement provider shall be bound by the acts of the person named therein within his or her apparent authority as its acknowledged producer.

(c) A person licensed as an attorney, certified public accountant or financial planner accredited by a nationally recognized accreditation agency, who is retained to represent the viator, whose compensation is not paid directly or indirectly by the life settlement provider, may negotiate life settlement contracts on behalf of the viator without having to obtain a license as a life settlement producer.

II. Application for a life settlement provider or a life settlement producer license shall be made to the commissioner by the applicant on a form prescribed by the commissioner, and these applications shall be accompanied by the producer fees specified in RSA 400-A:29.

III. Licenses may be renewed from year to year on the anniversary date upon payment of the annual renewal fees specified in RSA 400-A:29. Failure to pay the fees by the renewal date results in expiration of the license.

IV. The applicant shall provide information on forms required by the commissioner. The commissioner shall have authority, at any time, to require the applicant to fully disclose the identity of all stockholders, partners, officers, members, and employees, and the commissioner may, in the exercise of the commissioner's discretion, refuse to issue a license in the name of any person if not satisfied that any officer, employee, stockholder, partner, or member thereof who may materially influence the applicant's conduct meets the standards of this chapter.

V. (a) A life settlement producer that solicits or negotiates a life settlement contract between a viator and a life settlement provider shall be appointed by the life settlement provider.

(b) To appoint a life settlement producer, the life settlement provider shall file a notice of appointment in a format approved by the commissioner within 15 days from the date the contract between the life settlement provider and the life settlement producer is executed or the life settlement contract is signed and executed.

(c) The life settlement provider shall pay a producer appointment fee as set forth in RSA 400-A:29 for each life settlement producer appointed by the life settlement provider.

(d) The life settlement provider shall notify the commissioner within 15 days of any termination of an appointment of a life settlement producer using a format approved by the commissioner.

VI. Upon the filing of an application and the payment of the license fee, the commissioner shall make an investigation of each applicant and issue a license if the commissioner finds that the applicant:

(a) If the life settlement provider:

(1) Has provided a detailed plan of operation;

(2) Is competent and trustworthy and intends to act in good faith;

(3) Has a good business reputation and has had experience, training, or education so as to be qualified in the business for which the license is applied; and

(4) Has demonstrated evidence of financial responsibility in a format prescribed by the commissioner through either a surety bond executed and issued by an insurer authorized to issue surety bonds in this state or a deposit of cash, certificates of deposit or securities or any combination thereof in the amount of $250,000.

(b) If a life settlement producer:

(1) Is competent and trustworthy and intends to act in good faith;

(2) Has a good business reputation and has had 15 hours of training or education related to life settlements and life settlement transactions so as to be qualified in the business for which the license is applied;

(3) The commissioner may ask for evidence of financial responsibility at any time the commissioner deems necessary;

(4) Any surety bond issued pursuant to subparagraph (a)(4) shall be in the favor of this state and shall specifically authorize recovery by the commissioner on behalf of any person in this state who sustained damages as the result of erroneous acts, failure to act, conviction of fraud, or conviction of unfair practices by the life settlement provider or life settlement producer; and

(5) Notwithstanding any provision of this paragraph to the contrary, the commissioner shall accept, as evidence of financial responsibility, proof that financial instruments in accordance with the requirements in this paragraph have been filed with one state where the applicant is licensed as a life settlement provider or life settlement producer.

VII. The commissioner shall not issue a license to a nonresident applicant, unless a written designation of an agent for service of process is filed and maintained with the commissioner or the applicant has filed with the commissioner, the applicant's written irrevocable consent that any action against the applicant may be commenced against the applicant by service of process on the commissioner.

VIII. A life settlement provider or life settlement producer shall provide to the commissioner new or revised information about officers, 10 percent or more stockholders, partners, directors, members of designated employees within 30 days of the change.

IX. An individual licensed as a life settlement producer shall complete on an annual basis 15 hours of training related to life settlements and life settlement transactions, as required by the commissioner. Any person failing to meet the requirements of this paragraph shall be subject to the penalties imposed by the commissioner.


Source. 2010, 132:1, eff. June 14, 2010. 2021, 56:6, eff. July 24, 2021.

    408-D:4 License Revocation and Denial. 

I. The commissioner may refuse to issue, suspend, revoke, or refuse to renew the license of a life settlement provider, or a life settlement producer, or a life insurance producer operating as a life settlement producer if the commissioner finds that:

(a) There was any material misrepresentation in the application for the license;

(b) The licensee or any officer, partner, member, or key management personnel has been convicted of fraudulent or dishonest practices, is subject to final administrative action, or is otherwise shown to be untrustworthy or incompetent;

(c) The life settlement provider demonstrates a pattern of unreasonable payments to viators;

(d) The licensee or any officer, partner, member, or key management personnel has been found guilty of, or has pleaded guilty or nolo contendere to any felony, or to a misdemeanor involving fraud or moral turpitude, regardless of whether a judgment of conviction has been entered by the court;

(e) The life settlement provider has entered into any life settlement contract using a form that has not been approved pursuant to this chapter;

(f) The life settlement provider has failed to honor contractual obligations set out in a life settlement contract;

(g) The licensee no longer meets the requirements for initial licensure;

(h) The life settlement provider has assigned, transferred, or pledged a settled policy to a person other than a life settlement provider licensed in this state, life settlement purchaser, an accredited investor or qualified institutional buyer as defined respectively in Rule 501(a) or Rule 144A promulgated under the Federal Securities Act of 1933, as amended, financing entity, special purpose entity, or related provider trust; or

(i) The licensee or any officer, partner, member, or key management personnel has violated any provision of this chapter.

II. If the commissioner denies a license application or suspends, revokes, or refuses to renew the license of a life settlement provider or life settlement producer, or suspends, revokes, or refuses to renew a license of a life insurance producer operating as a life settlement producer pursuant to this chapter the commissioner shall conduct a hearing in accordance with RSA 541-A.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:5 Approval of Life Settlement Contracts and Life Settlement Provider Disclosure Statements. 

I. A person shall not use a life settlement contract form or provide to a viator a disclosure statement form in this state unless first filed with and approved by the commissioner.

II. The commissioner shall disapprove a life settlement contract form or disclosure statement form if, in the commissioner's opinion, the life settlement contract or provisions contained therein fail to meet the requirements of RSA 408-D:9, RSA 408-D:11, RSA 408-D:14 and RSA 408-D:15, II, or are unreasonable, contrary to the interests of the public, or otherwise misleading or unfair to the viator. At the commissioner's discretion, the commissioner may require the submission of advertising material.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:6 Reporting Requirements and Privacy. 

I. Each life settlement provider shall file with the commissioner on or before March 1 of each year an annual statement containing such information as the commissioner may prescribe by rule. Individual transaction data regarding the business of life settlements or data that could compromise the privacy of personal, financial, and health information of the viator or insured shall be filed with the commissioner on a confidential basis.

II. Except as otherwise allowed or required by law, a life settlement provider, life settlement producer, insurance company, insurance producer, information bureau, rating agency or company, or any other person with actual knowledge of an insured's identity, shall not disclose that identity as an insured, or the insured's financial or medical information to any other person unless the disclosure:

(a) Is necessary to effect a life settlement between the viator and a life settlement provider and the viator and insured have provided prior written consent to the disclosure;

(b) Is necessary to effect a life settlement purchase agreement between the life settlement purchaser and a life settlement provider and the viator and insured have provided prior written consent to the disclosure;

(c) Is provided in response to an investigation or examination by the commissioner or any other governmental officer or agency or pursuant to the requirements of RSA 408-D:15, III;

(d) Is a term of or condition to the transfer of a policy by one life settlement provider to another life settlement provider;

(e) Is necessary to permit a financing entity, related provider trust, or special purpose entity to finance the purchase of policies by a life settlement provider, and the viator and insured have provided prior written consent to the disclosure;

(f) Is necessary to allow the life settlement provider or life settlement producer or their authorized representatives to make contacts for the purpose of determining health status; or

(g) Is required to purchase stop loss coverage or financial guaranty insurance.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:7 Examination or Investigations. 

I. Authority, scope, and scheduling of examinations.

(a)(1) The commissioner may conduct an examination under this chapter of a licensee as often as the commissioner in his or her discretion deems appropriate.

(2) In scheduling and determining the nature, scope, and frequency of the examinations, the commissioner may consider such matters as consumer complaints, results of financial statement analyses and ratios, changes in management or ownership, actuarial opinions, report of independent certified public accountants, and other relevant criteria as determined by the commissioner.

(b) For purposes of completing an examination of a licensee under this chapter, the commissioner may examine or investigate any person, or the business of any person, in so far as the examination or investigation is, in the sole discretion of the commissioner, necessary or material to the examination of the licensee.

(c) In lieu of an examination under this chapter of any foreign or alien licensee licensed in this state, the commissioner may, at the commissioner's discretion, accept an examination report on the licensee as prepared by the commissioner for the licensee's state of domicile or port-of-entry state.

(d) As far as practical, the examination of a foreign or alien licensee shall be made in cooperation with the insurance supervisory officials of other states in which the licensee transacts business.

II. Record retention requirements.

(a) A person required to be licensed by this chapter shall for 5 years retain copies of all:

(1) Proposed, offered, or executed contracts, purchase agreements, underwriting documents, policy forms, and applications from the date of the proposal, offer, or execution of the contract or purchase agreement, whichever is later;

(2) All checks, drafts, or other evidence and documentation related to the payment, transfer, deposit or release of funds from the date of the transaction; and

(3) All other records and documents related to the requirements of this chapter.

(b) This paragraph shall not relieve a person of the obligation to produce these documents to the commissioner after the retention period has expired if the person has retained the documents.

(c) Records required to be retained by this section shall be legible and complete and may be retained in paper, photograph, microprocess, magnetic, mechanical, or electronic media, or by any process that accurately reproduces or forms a durable medium for the reproduction of a record.

III. Conduct of examinations.

(a) Upon determining that an examination should be conducted, the commissioner shall issue an examination warrant appointing one or more examiners to perform the examination and instructing them as to the scope of the examination. In conducting the examination, the examiner shall observe those guidelines and procedures set forth in the Examiners Handbook adopted by the National Association of Insurance Commissioners (NAIC). The commissioner may also employ such other guidelines or procedures as the commissioner may deem appropriate.

(b) Every licensee or person from whom information is sought, its officers, directors, and agents shall provide to the examiners timely, convenient, and free access at all reasonable hours at its offices to all books, records, accounts, papers, documents, assets, and computer or other recordings relating to the property, assets, business, and affairs of the licensee being examined. The officers, directors, employees, and agents of the licensee or person shall facilitate the examination and aid in the examination so far as it is in their power to do so. The refusal of a licensee, by its officers, directors, employees, or agents, to submit to examination or to comply with any reasonable written request of the commissioner shall be grounds for suspension or refusal of, or nonrenewal of, any license or authority held by the licensee to engage in the life settlement business or other business subject to the commissioner's jurisdiction. Any proceedings for suspension, revocation, or refusal of any license or authority shall be conducted pursuant to Title XXXVII.

(c) The commissioner may issue subpoenas, administer oaths, and examine under oath any person as to any matter pertinent to the examination. Upon the failure or refusal of a person to obey a subpoena, the commissioner may petition a court of competent jurisdiction, and upon proper showing, the court may enter an order compelling the witness to appear and testify or produce documentary evidence.

(d) When making an examination under this chapter, the commissioner may retain attorneys, appraisers, independent actuaries, independent certified public accountants, or other professionals and specialists as examiners, the reasonable cost of which shall be borne by the licensee that is the subject of the examination.

(e) Nothing contained in this chapter shall be construed to limit the commissioner's authority to terminate or suspend an examination in order to pursue other legal or regulatory action pursuant to the insurance laws of this state. Findings of fact and conclusions made pursuant to any examination shall be prima facie evidence in any legal or regulatory action.

(f) Nothing contained in this chapter shall be construed to limit the commissioner's authority to use and, if appropriate, to make public any final or preliminary examination report, any examiner or licensee workpapers or other documents, or any other information discovered or developed during the course of any examination in the furtherance of any legal or regulatory action which the commissioner may, in his or her sole discretion, deem appropriate.

IV. Examination reports.

(a) Examination reports shall be comprised of only facts appearing upon the books, records, or other documents of the licensee, its agents, or other persons examined, or as ascertained from the testimony of its officers or agents or other persons examined concerning its affairs, and such conclusions and recommendations as the examiners find reasonably warranted from the facts.

(b) No later than 60 days following completion of the examination, the examiner in charge shall file with the commissioner a verified written report of examination under oath. Upon receipt of the verified report, the commissioner shall transmit the report to the licensee examined, together with a notice that shall afford the licensee examined a reasonable opportunity of not more than 30 days to make a written submission or rebuttal with respect to any matters contained in the examination report.

(c) In the event the commissioner determines that regulatory action is appropriate as a result of an examination, the commissioner may initiate any proceedings or actions provided by law.

V. Confidentiality of examination information.

(a) Names and individual identification data for all viators, owners, purchasers, and insureds shall be considered private and confidential information and shall not be disclosed by the commissioner, unless the disclosure is to another regulator or is required by law.

(b) Except as otherwise provided in this chapter, all examination reports, working papers, recorded information, documents, and copies thereof produced by, obtained by, or disclosed to the commissioner or any other person in the course of an examination made under this chapter, or in the course of analysis or investigation by the commissioner of the financial condition or market conduct of a licensee shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. The commissioner is authorized to use the documents, materials, or other information in the furtherance of any regulatory or legal action brought as part of the commissioner's official duties.

(c) Documents, materials, or other information, including, but not limited to, all working papers, and copies thereof, in the possession or control of the NAIC and its affiliates and subsidiaries shall be confidential by law and privileged, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action if they are:

(1) Created, produced, or obtained by or disclosed to the NAIC and its affiliates and subsidiaries in the course of assisting an examination made under this chapter, or assisting a commissioner in the analysis or investigation of the financial condition or market conduct of a licensee; or

(2) Disclosed to the NAIC and its affiliates and subsidiaries under subparagraph V(e) by a commissioner.

(d) Neither the commissioner nor any person that received the documents, material or other information while acting under the authority of the commissioner, including the NAIC and its affiliates and subsidiaries, shall be permitted to testify in any private civil action concerning any confidential documents, materials or information subject to this paragraph.

(e) In order to assist in the performance of the commissioner's duties, the commissioner:

(1) May share documents, materials or other information, including the confidential and privileged documents, materials or information subject to this paragraph, with other state, federal, and international regulatory agencies, with the NAIC and its affiliates and subsidiaries, and with state, federal and international law enforcement authorities, provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material, communication, or other information;

(2) May receive documents, materials, communications, or information, including otherwise confidential and privileged documents, materials, or information, from the NAIC and its affiliates and subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice or the understanding that it is confidential or privileged under the jurisdiction that is the source of the document, material, or information; and

(3) May enter into agreements governing sharing and use of information consistent with this paragraph.

(f) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subparagraph V(e).

(g) A privilege established under the law of any state or jurisdiction that is substantially similar to the privilege established under this paragraph shall be available and enforced in any proceeding in, and in any court of, this state.

(h) Nothing contained in this chapter shall prevent or be construed as prohibiting the commissioner from disclosing the content of an examination report, preliminary examination report or results, or any matter relating thereto, to the commissioner of any other state or country, or to law enforcement officials of this or any other state or agency of the federal government at any time or to the NAIC, so long as such agency or office receiving the report or matters relating thereto agrees in writing to hold it confidential and in a manner consistent with this chapter.

VI. Conflict of interest.

(a) An examiner may not be appointed by the commissioner if the examiner, either directly or indirectly, has a conflict of interest, or is affiliated with the management of, or owns a pecuniary interest in, any person subject to examination under this chapter. This section shall not be construed to automatically preclude an examiner from being:

(1) A viator;

(2) An insured in a viaticated insurance policy; or

(3) A beneficiary in an insurance policy that is proposed to be viaticated.

(b) Notwithstanding the requirements of this paragraph, the commissioner may retain from time to time, on an individual basis, qualified actuaries, certified public accountants, or other similar individuals who are independently practicing their professions, even though these persons may from time to time be similarly employed or retained by persons subject to examination under this chapter.

VII. Cost of examinations. The cost of examinations shall be borne by the licensee examined, and shall be pursuant to RSA 400-A:37, III(d), VII, and VIII.

VIII. Immunity from liability.

(a) No cause of action shall arise nor shall any liability be imposed against the commissioner, the commissioner's authorized representatives, or any examiner appointed by the commissioner for any statements made or conduct performed in good faith while carrying out the provisions of this chapter.

(b) No cause of action shall arise, nor shall any liability be imposed against any person for the act of communicating or delivering information or data to the commissioner or the commissioner's authorized representative or examiner pursuant to an examination made under this chapter, if the act of communication or delivery was performed in good faith and without fraudulent intent or the intent to deceive. This paragraph does not abrogate or modify in any way any common law or statutory privilege or immunity heretofore enjoyed by any person identified in subparagraph (a).

(c) A person identified in subparagraph (a) or (b) shall be entitled to an award of attorney's fees and costs if he or she is the prevailing party in a civil cause of action for libel, slander, or any other relevant tort arising out of activities in carrying out the provisions of this chapter, and the party bringing the action was not substantially justified in doing so. For purposes of this paragraph, a proceeding is "substantially justified" if it had a reasonable basis in law or fact at the time that it was initiated.

IX. Investigative authority of the commissioner. The commissioner may investigate suspected fraudulent life settlement acts and persons engaged in the business of life settlements. The confidentiality protections set forth in paragraph V shall apply to any investigation conducted by the commissioner.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:8 Life Insurer Disclosure to Viator. 

I. Life insurers shall provide individual life insurance policyholders with a written notice that any of the acts described in paragraph III can have significant future financial, tax, or other implications and the consumer should consult with a licensed financial advisor, attorney, or other professional who can explain to the consumer all available options and consequences before acting.

II. The timing of the issuance of the notice, and the form of the notice shall be as set forth in rules adopted by the commissioner.

III. Actions that may have a significant future financial, tax, or other implication to the consumer are:

(a) Sale of the policy.

(b) Surrender of the policy.

(c) Lapse of the policy.

(d) Assignment of the policy or any right under the policy.

(e) Failure to pay premium.

(f) Application of the equity of the policy toward payment of premium.

(g) Application of accumulated dividends toward payment of premium.

(h) Financing of premium payments.

IV. Life insurers shall comply with regulations that require annual reporting to the consumer of policy information including annual reporting of the cash value of the policy.


Source. 2010, 132:1, eff. June 14, 2010.

    408-D:9 Life Settlement Provider Disclosure to Viator and Insured;  Life Settlement Producer Disclosure to Viator. 

I. With each application for a life settlement, a life settlement provider or a life settlement producer on behalf of the life settlement provider shall provide the viator with at least the following disclosures no later than the time the application for the life settlement contract is signed by all parties. The disclosure shall be provided in a separate document that is signed by the viator and the life settlement provider or life settlement producer, and shall provide the following information:

(a) There are possible alternatives to life settlement contracts including, but not limited to, any accelerated death benefits or policy loans offered under the viator's life insurance policy, and the viator should consider all options carefully and seek advice from a licensed financial advisor, attorney, or other professional who can explain all available options and consequences.

(b) Some or all of the proceeds of the life settlement may be taxable under federal income tax and state franchise and income taxes, and assistance should be sought from a professional tax advisor.

(c) Proceeds of the life settlement could be subject to the claims of creditors.

(d) Receipt of the proceeds of a life settlement may adversely affect the viator's eligibility for Medicaid or other government benefits or entitlements, and advice should be obtained from the appropriate government agencies.

(e) The viator has the right to rescind a life settlement contract before the earlier of 30 calendar days after the date upon which the life settlement contract is executed by all parties or 15 calendar days after the life settlement proceeds have been paid to the viators, as provided in RSA 408-D:11, VI. Rescission, if exercised by the viator, is effective only if both notice of the rescission is given, and the viator repays all proceeds and any premiums, loans, and loan interest paid on account of the life settlement provider within the rescission period. If the insured dies during the rescission period, the life settlement contract shall be deemed to have been rescinded, subject to repayment by the viator or the viator's estate of all life settlement proceeds and any premiums, loans, and loan interest the life settlement within 60 days of the insured's death.

(f) Funds will be sent to the viator within 3 business days after the life settlement provider has received the insurer or group administrator's written acknowledgment that ownership of the policy or interest in the certificate has been transferred and the beneficiary has been designated.

(g) Entering into a life settlement contract may cause other rights or benefits, including conversion rights and waiver of premium benefits that may exist under the policy or certificate, to be forfeited by the viator. Assistance should be sought from a financial adviser.

(h) Disclosure to a viator shall include distribution of a brochure describing the process of life settlements. The NAIC's form for the brochure shall be used unless another form is developed or approved by the commissioner.

(i) The amount and method of calculating the compensation paid or to be paid to the life settlement producer, or any other person acting for the owner in connection with the transaction, wherein the term compensation includes anything of value paid or given.

(j) The disclosure document shall contain the following language: "All medical, financial, or personal information solicited or obtained by a life settlement provider or life settlement producer about an insured, including the insured's identity or the identity of family members, a spouse, or a significant other, may be disclosed as necessary to effect the life settlement contract between the viator and the life settlement provider. If you are asked to provide this information, you will be asked to consent to the disclosure. The information may be provided to someone who buys the policy or provides funds for the purchase. You may be asked to renew your permission to share information every 2 years."

(k) Following execution of a life settlement contract, the insured may be contacted for the purpose of determining the insured's health status and to confirm the insured's residential or business street address and telephone number, or as otherwise provided in this chapter. This contact shall be limited to once every 3 months if the insured has a life expectancy of more than one year, and no more than once per month if the insured has a life expectancy of one year or less. All such contacts shall be made only by a life settlement provider licensed in this state in which the viator resided at the time of the life settlement, or by the authorized representative of a duly licensed life settlement provider.

(l) The affiliation, if any, between the life settlement provider and the issuer of the insurance policy to be viaticated;

(m) The disclosure document shall include the name, address, and telephone number of the life settlement provider;

(n) Any affiliations or contractual arrangements between the life settlement provider and the life settlement purchaser;

(o) If an insurance policy to be viaticated has been issued as a joint policy or involves family riders or any coverage of a life other than the insured under the policy to be viaticated, the viator shall be informed of the possible loss of coverage on the other lives under the policy and shall be advised to consult with his or her insurance producer or the insurer issuing the policy for advice on the proposed life settlement;

(p) State the dollar amount of the current death benefit payable to the life settlement provider under the policy or certificate. If known, the life settlement provider shall also disclose the availability of any additional guaranteed insurance benefits, the dollar amount of any accidental death and dismemberment benefits under the policy or certificate, and the extent to which the viator's interest in those benefits will be transferred as a result of the life settlement contract;

(q) State whether the funds will be escrowed with an independent third party during the transfer process, and if so, provide the name, business address, and telephone number of the independent third party escrow agent, and the fact that the viator or owner may inspect or receive copies of the relevant escrow or trust agreements or documents.

II. A life settlement producer shall provide the viator with at least the following written disclosures no later than the date the life settlement contract is signed by all parties. The written disclosures shall be conspicuously displayed in the life settlement contract or in a separate document signed by the viator and provide the following information:

(a) The name, business address, and telephone number of the life settlement producer.

(b) A full, complete, and accurate description of all offers, counter-offers, acceptances, and rejections relating to the proposed life settlement contract.

(c) A written disclosure of any affiliations or contractual arrangements between the life settlement producer and any person making an offer in connection with the proposed life settlement contracts.

(d) The amount and method of calculating the life settlement producer's compensation, which term "compensation" includes anything of value paid or given to a life settlement producer for the placement of a policy.

(e) Where any portion of the life settlement producer's compensation, as defined in subparagraph (d), is taken from a proposed life settlement offer, the life settlement producer shall disclose the total amount of the life settlement offer and the percentage of the life settlement offer comprised by the life settlement producer's compensation.

III. If the life settlement provider transfers ownership or changes the beneficiary of the insurance policy, the life settlement provider shall communicate in writing the change in ownership or beneficiary to the insured within 20 days after the change.


Source. 2010, 132:1, eff. June 14, 2010.

    408-E:1 Purpose and Scope. 

This chapter specifically permits life insurance companies to issue funding agreements as a type of insurance business permitted under authority of RSA 401:1, III and establishes standards for the regulation of funding agreements.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:2 Definitions. 

In this chapter:

I. "
Funding agreement
" means an agreement issued by a life insurance company, not based on mortality or morbidity, providing for the accumulation of funds by the insurer for the purpose of making one or more payments to the holder, where the initial premium paid is $1,000,000 or more. Except as provided in this chapter, a "funding agreement" does not constitute life insurance or an annuity and does not constitute a security as defined in RSA 421-B:1-102(53).

II. "
Holder
" means a person described in RSA 408-E:4 to whom the life insurance company may issue a funding agreement.

III. "
Life insurance company
" means a life insurance company authorized to do business pursuant to RSA 401:1, III.

IV. "
Optional modes of settlement
" means the manner in which the funding agreement is structured to make payments to the holder.


Source. 2013, 108:1. 2015, 273:18, eff. Jan. 1, 2016.

    408-E:3 Authorization and Regulation of Funding Agreements. 

I. Any licensed life insurance company may deliver or issue for delivery one or more funding agreements.

II. For the purposes of RSA 402-C:44, funding agreements shall be treated as insurance contracts, and holders of funding agreements shall be entitled to the same priority of distribution as policyholders.

III. Except as provided in this chapter, funding agreements shall not be subject to consumer protections that apply to annuity contracts including free-look requirements that permit consumers to void an issued contract and receive a return of premium by returning the contract within a specified time frame.

IV. Funding agreements shall be filed for approval by the commissioner consistent with this chapter.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:4 Permissible Holders of Funding Agreements. 

Funding agreements may be issued to:

I. Persons authorized by a state or foreign country to engage in an insurance business or to subsidiaries of such persons.

II. Entities other than persons authorized to engage in an insurance business and to individuals for the purpose of funding:

(a) Benefits under any employee benefit plan as defined in the federal Employee Retirement Income Security Act of 1974, 29 U.S.C. section 1001 et seq., maintained in the United States or in a foreign country;

(b) Activities of any organization exempt from taxation under section 501(c) of the Internal Revenue Code or of any similar organization in any foreign country;

(c) Any program of the government of the United States, the government of any state, foreign country or political subdivision thereof, or any agency or instrumentality thereof;

(d) Any agreement providing for one or more payments in satisfaction of a claim;

(e) Any program of an institution which has assets in excess of $25,000,000; or

(f) Any program of an institution for the purposes of providing collateral security for securities registered with the federal Securities and Exchange Commission.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:5 Amounts Guaranteed or Credited Under Funding Agreements. 

An amount shall not be guaranteed or credited under a funding agreement except upon:

I. Reasonable assumptions as to investment income and expenses; and

II. A basis equitable to all holders of funding agreements of a given class.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:6 Allocation to Separate Accounts. 

Amounts paid to the insurer, and proceeds applied under optional modes of settlement under the funding agreement may be allocated by the insurer to one or more separate accounts pursuant to the provisions in RSA 408 addressing separate accounts.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:7 Reserve Requirements. 

In establishing minimum reserve requirements for funding agreements the commissioner may use any relevant actuarial guidelines, regulations, interpretations, or papers as well as standards set forth in the Valuation Manual of the National Association of Insurance Commissioners for deposit-type contracts.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-E:8 Rules. 

The commissioner may adopt rules, pursuant to RSA 541-A, relative to:

I. The standards to be followed in the approval of forms of funding agreements;

II. The reserves to be maintained by insurers issuing funding agreements;

III. The accounting and reporting of funds credited under funding agreements; and

IV. The disclosure of information to be given to holders or third parties that purchase funding agreements.


Source. 2013, 108:1, eff. Aug. 23, 2013.

    408-F:1 Title. 

This chapter shall be known and may be cited as the New Hampshire Life and Health Insurance Guaranty Association Act of 2019.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:10 Plan of Operation. 

I. (a) The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon the commissioner's written approval or unless the commissioner has not disapproved it within 30 days.

(b) If the association fails to submit a suitable plan of operation within 120 days after January 1, 2020, or if at any time thereafter the association fails to submit suitable amendments to the plan, the commissioner shall, after notice and hearing, adopt such reasonable rules under RSA 541-A as are necessary or advisable to effectuate the provisions of this chapter. The rules shall continue in force until modified by the commissioner or superseded by a plan submitted by the association and approved by the commissioner.

II. All member insurers shall comply with the plan of operation.

III. The plan of operation shall, in addition to requirements enumerated elsewhere in this chapter:

(a) Establish procedures for handling the assets of the association.

(b) Establish the amount and method of reimbursing members of the board of directors under RSA 408-F:7.

(c) Establish regular places and times for meetings including telephone conference calls of the board of directors.

(d) Establish procedures for records to be kept of all financial transactions of the association, its agents, and the board of directors.

(e) Establish the procedures whereby selections for the board of directors will be made and submitted to the commissioner.

(f) Establish any additional procedure for assessments under RSA 408-F:9.

(g) Contain additional provisions necessary or proper for the execution of the powers and duties of the association.

IV. The plan of operation may provide that any or all powers and duties of the association, except those under RSA 408-F:8, XIII(c) and RSA 408-F:9, are delegated to a corporation, association or other organization which performs or will perform functions similar to those of this association, or its equivalent, in 2 or more states. Such a corporation, association, or organization shall be reimbursed for any payments made on behalf of the association and shall be paid for its performance of any function of the association. A delegation under this paragraph shall take effect only with the approval of both the board of directors and the commissioner, and may be made only to a corporation, association, or organization which extends protection not substantially less favorable and effective than that provided by this chapter.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:11 Duties and Powers of the Commissioner. 

In addition to the duties and powers enumerated elsewhere in this chapter:

I. The commissioner shall:

(a) Upon request of the board of directors, provide the association with a statement of the premiums in this and any other appropriate states for each member insurer.

(b) When an impairment is declared and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time; notice to the impaired insurer shall constitute notice to its shareholders, if any; the failure of the impaired insurer to promptly comply with such demand shall not excuse the association from the performance of its powers and duties under this chapter.

(c) In any liquidation or rehabilitation proceeding involving a domestic insurer, be appointed as the liquidator or rehabilitator.

II. The commissioner may suspend or revoke, after notice and hearing, the certificate of authority to transact business in this state of any member insurer which fails to pay an assessment when due or fails to comply with the plan of operation. As an alternative, the commissioner may levy a forfeiture on any member insurer which fails to pay an assessment when due. Such forfeiture shall not exceed 5 percent of the unpaid assessment per month, but no forfeiture shall be less than $100 per month.

III. Any action of the board of directors or the association may be appealed to the commissioner by any member insurer if the appeal is taken within 60 days of the final action being appealed. If a member company is appealing an assessment, the amount assessed shall be paid to the association and available to meet association obligations during the pendency of an appeal. If the appeal on the assessment is upheld, the amount paid in error or excess shall be returned to the member company. Any final action or order of the commissioner shall be subject to judicial review in a court of competent jurisdiction.

IV. The liquidator, rehabilitator, or conservator of any impaired insurer may notify all interested persons of the effect of this chapter.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:12 Prevention of Insolvencies. 

To aid in the detection and prevention of member insurer insolvencies or impairments:

I. It shall be the duty of the commissioner:

(a) To notify the commissioners of all the other states, territories of the United States, and the District of Columbia when the commissioner takes any of the following actions against a member insurer:

(1) Revocation of license;

(2) Suspension of license; or

(3) Makes any formal order that such member insurer restrict its premium writing, obtain additional contributions to surplus, withdraw from the state, reinsure all or any part of its business, or increase capital, surplus, or any other account for the security of policy owners, contract owners, certificate holders, or creditors. The notice shall be mailed to all commissioners within 30 days following the action taken or the date on which such action occurs.

(b) To report to the board of directors when the commissioner has taken any of the actions set forth in subparagraph (a) or has received a report from any other commissioner indicating that any such action has been taken in another state. The report to the board of directors shall contain all significant details of the action taken or the report received from another commissioner.

(c) To report to the board of directors when the commissioner has reasonable cause to believe from any examination, whether completed or in process, of any member company that the company may be an impaired or insolvent insurer.

(d) To furnish to the board of directors the NAIC Insurance Regulatory Information System (IRIS) ratios and listings of companies not included in the ratios developed by the National Association of Insurance Commissioners, and the board may use the information contained therein in carrying out its duties and responsibilities under this section. The report and the information contained therein shall be kept confidential by the board of directors until such time as made public by the commissioner or other lawful authority.

II. The commissioner may seek the advice and recommendations of the board of directors concerning any matter affecting the duties and responsibilities of the commissioner regarding the financial condition of member insurers and insurers and health maintenance organizations seeking admission to transact business in this state.

III. The board of directors may, upon majority vote, make reports and recommendations to the commissioner upon any matter germane to the solvency, liquidation, rehabilitation, or conservation of any member insurer or germane to the solvency of any insurer or health maintenance organization seeking to do business in this state. Such reports and recommendations shall not be considered public documents.

IV. It shall be the duty of the board of directors, upon majority vote, to notify the commissioner of any information indicating any member insurer may be an impaired or insolvent insurer.

V. The board of directors may, upon majority vote, request that the commissioner order an examination of any member insurer which the board in good faith believes may be an impaired or insolvent insurer. Within 30 days of the receipt of such request, the commissioner shall begin an examination. The examination may be conducted as a National Association of Insurance Commissioners examination or may be conducted by such persons as the commissioner designates. The cost of the examination shall be paid by the association and the examination report shall be treated as are other examination reports. In no event shall the examination report be released to the board of directors prior to its release to the public, but this shall not preclude the commissioner from complying with paragraph I. The commissioner shall notify the board of directors when the examination is completed. The request for an examination shall be kept on file by the commissioner, but it shall not be open to public inspection prior to the release of the examination report to the public.

VI. The board of directors may, upon majority vote, make recommendations to the commissioner for the detection and prevention of member insurer insolvencies.

VII. The board of directors shall, at the conclusion of any insurer insolvency in which the association was obligated to pay covered claims, prepare a report to the commissioner containing such information as it may have in its possession bearing on the history and causes of the insolvency. The board shall cooperate with the boards of directors of guaranty associations in other states in preparing a report on the history and causes of insolvency of a particular insurer, and may adopt by reference any report prepared by such other associations.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:13 Credits for Assessments Paid. 

I. A member insurer may offset against its tax liability under RSA 400-A any assessment described in RSA 408-F:9, II(b) for the life insurance and annuity account, and for the health account for guaranteeing the performance of contractual obligations of an impaired or insolvent insurer in regard to disability income coverages only, to the extent of 20 percent of the amount of the assessment for each of the 5 calendar years following the year in which the assessment was paid. If a member insurer ceases doing business, all uncredited assessments described above may be credited against its tax liability under RSA 400-A for the year it ceases doing business.

II. Any sums acquired by refund from the association by member insurers, as stated in RSA 408-F:9, VI, and which were previously offset against taxes as described in paragraph I, shall be paid by these member insurers to the state of New Hampshire in the manner required by the commissioner. The association shall notify the commissioner that refunds have been made.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:14 Miscellaneous Provisions. 

I. Nothing in this chapter shall be construed to reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment liability.

II. Records shall be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under RSA 408-F:8. Records of the negotiations or meetings shall be made public only upon the termination of a liquidation, rehabilitation, or conservation proceeding involving the impaired or insolvent insurer, upon the termination of the impairment or insolvency of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this paragraph shall limit the duty of the association or render a report of its activities under this section.

III. For the purpose of carrying out its obligations under this chapter, the association shall be deemed to be a creditor of the impaired or insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee, pursuant to RSA 408-F:8, XIII. Assets of the impaired or insolvent insurer attributable to covered policies shall be used to continue all covered policies and pay all contractual obligations of the impaired or insolvent insurer as required by this chapter. Assets attributable to covered policies or contracts, as used in this subsection, are that proportion of the assets which the reserves that should have been established for such policies or contracts bear to the reserves that should have been established for all policies of insurance or health benefit plans written by the impaired or insolvent insurer.

IV. (a) Prior to the termination of any liquidation, rehabilitation or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders, contract owners, certificate holders, enrollees and policy owners of the insolvent insurer, and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of the insolvent insurer. In such a determination, consideration shall be given to the welfare of the policy owners, contract owners, certificate holders, and enrollees of the continuing or successor member insurer.

(b) No distribution to stockholders, if any, of an impaired or insolvent insurer shall be made until and unless the total amount of valid claims of the association with interest thereon for funds expended in carrying out its powers and duties under RSA 408-F:8 with respect to the member insurer have been fully recovered by the association.

V. (a) If an order for liquidation or rehabilitation of a member insurer domiciled in this state has been entered, the receiver appointed under the order shall have a right to recover on behalf of the member insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the member insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation subject to the limitations of subparagraphs (b)-(d).

(b) No such distribution shall be recoverable if the member insurer shows that when paid the distribution was lawful and reasonable, and that the member insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the member insurer to fulfill its contractual obligations.

(c) Any person who was an affiliate that controlled the member insurer at the time the distributions were paid shall be liable up to the amount of distributions received. Any person who was an affiliate that controlled the member insurer at the time the distributions were declared, shall be liable up to the amount of distributions which would have been received if they had been paid immediately. If 2 or more persons are liable with respect to the same distributions, they shall be jointly and severally liable.

(d) The maximum amount recoverable under this paragraph shall be the amount needed in excess of all other available assets of the insolvent insurer to pay the contractual obligations of the insolvent insurer.

(e) If any person liable under subparagraph (c) is insolvent, all its affiliates that controlled it at the time the distribution was paid, shall be jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:15 Examination of the Association;  Annual Report. 

The association shall be subject to examination and regulation 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 the preceding fiscal year.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:16 Tax Exemptions. 

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. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:17 Immunity. 

There shall be no liability on the part of and no cause of action of any nature shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the commissioner or the commissioner's representatives, for any action or omission by them in the performance of their powers and duties under this chapter. Such immunity shall extend to the participation in any organization of one or more other state associations of similar purposes and to any such organization and its agents or employees.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:18 Stay of Proceedings;  Reopening Default Judgments. 

All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed 60 days from the date an order of liquidation, rehabilitation or conservation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to judgment under any decision, order, verdict, or finding based on default, the association may apply to have such judgment set aside by the same court that made such judgment and shall be permitted to defend against such suit on the merits.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:19 Prohibited Advertisement of Insurance Guaranty Association Act in Insurance Sales;  Notice to Policyholders. 

I. No person, including a member insurer, agent or affiliate of a member insurer shall make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in any newspaper, magazine or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio station or television station, or in any other way, any advertisement, announcement or statement, written or oral, which uses the existence of the insurance guaranty association of this state for the purpose of sales, solicitation or inducement to purchase any form of insurance, or other coverage covered by the New Hampshire life and health insurance guaranty association act. Provided, however, that this paragraph shall not apply to the New Hampshire life and health insurance guaranty association or any other entity which does not sell or solicit insurance or coverage by a health maintenance organization. The use of the protection afforded by this chapter, other than as provided by this paragraph, by any person in the sale, marketing, or advertising of insurance constitutes unfair competition and unfair practices under the New Hampshire unfair trade practices act, and is subject to sanctions imposed in that chapter.

II. Within 180 days after January 1, 2020, the association shall prepare a summary document describing the general purposes and current limitations of the chapter and complying with paragraph III. This document shall be submitted to the commissioner for approval. Unless paragraph IV applies, at the expiration of the 60th day after the date on which the commissioner approves the document, a member insurer may not deliver a policy or contract covered by a guaranty fund to a policy owner, contract owner, certificate holder, or enrollee unless the summary document is delivered to the policy owner, contract owner, certificate holder, or enrollee prior to or at the time of delivery of the policy or contract. The document shall also be available upon request by a policy owner, contract owner, certificate holder, or enrollee. The distribution, delivery or contents or interpretation of this document does not guarantee that either the policy or the contract or the policy owner, contract owner, certificate holder, or enrollee is covered in the event of the impairment or insolvency of a member insurer. The description document shall be revised by the association as amendments to the chapter may require. Failure to receive this document does not give the policy owner, contract owner, certificate holder, enrollee, or insured any greater rights than those stated in this chapter.

III. The document prepared under paragraph II shall contain a clear and conspicuous disclaimer on its face. The commissioner shall approve the disclaimer. The disclaimer shall:

(a) State the name, address, and telephone number of the life and health insurance guaranty association and insurance department.

(b) Prominently warn the policy owner, contract owner, certificate holder, or enrollee that the life and health insurance guaranty association may not cover the policy or contract or, if coverage is available, it will be subject to substantial limitations and exclusions and conditioned on continued residence in the state.

(c) State the types of policies or contracts for which guaranty funds will provide coverage.

(d) State that the member insurer and its agents are prohibited by law from using the existence of the life and health insurance guaranty association for the purpose of sales, solicitation, or inducement to purchase any form of insurance or health maintenance organization coverage.

(e) State that the policy owner, contract owner, certificate holder, or enrollee should not rely on coverage under the life and health insurance guaranty association when selecting an insurer or health maintenance organization.

(f) Explain rights available and procedures for filing a complaint to allege a violation of any provisions of this chapter.

(g) Provide other information as directed by the commissioner, including but not limited to, sources for information about the financial condition of insurers provided that the information is not proprietary and is subject to disclosure under that state's public records law.

IV. No insurer or agent may deliver a policy or contract not covered by the association unless the insurer or agent, prior to or at the time of delivery, gives the policy owner, contract owner, certificate holder, or enrollee a separate written notice which clearly and conspicuously discloses that the policy or contract is not covered by the life and health insurance guaranty association. The commissioner shall approve the notice.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:2 Purpose. 

I. The purpose of this chapter is to protect, subject to certain limitations, the persons specified in RSA 408-F:5, I against failure in the performance of contractual obligations, under life, health and annuity policies, plans, or contracts specified in RSA 408-F:5, II, because of the impairment or insolvency of the member insurer that issued the policies, plans, or contracts.

II. To provide this protection, an association of member insurers is created to pay benefits and to continue coverages as limited herein, and members of the association are subject to assessment to provide funds to carry out the purpose of this chapter.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:20 Prospective Application. 

This chapter shall not apply to any member insurer which is insolvent or unable to fulfill its contractual obligations on December 31, 2019.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:3 Construction. 

This chapter shall be liberally construed to effect the purpose under RSA 408-F:2 which shall constitute an aid and guide to interpretation.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:4 Definitions. 

In this chapter:

I. "
Account
" means either of the 2 accounts created under RSA 408-F:6.

II. "
Association
" means the New Hampshire life and health insurance guaranty association created under RSA 408-F:6.

III. "
Commissioner
" means the commissioner of insurance.

IV. "
Contractual obligation
" means any obligation under a policy or contract or certificate under a group policy or contract, or portion thereof for which coverage is provided under RSA 408-F:5.

V. "
Covered contract
" or "
covered policy
" means any policy or contract within the scope of this chapter under RSA 408-F:5.

VI. "
Health benefit plan
" means any hospital or medical expense policy or certificate, or health maintenance organization subscriber contract or any other similar health contract. "Health benefit plan" does not include:

(a) Accident only insurance.

(b) Credit insurance.

(c) Dental only insurance.

(d) Vision only insurance.

(e) Medicare supplement insurance.

(f) Benefits for long-term care, home health care, community-based care, or any combination thereof.

(g) Disability income insurance.

(h) Coverage for on-site medical clinics.

(i) Specified disease, hospital confinement indemnity, or limited benefit health insurance if the types of coverage do not provide coordination of benefits and are provided under separate policies or certificates.

VII. "
Impaired insurer
" means a member insurer which, on or after January 1, 2020, is not an insolvent insurer; and

(a) Is deemed by the commissioner to be potentially unable to fulfill its contractual obligations; or

(b) Is placed under an order of rehabilitation or conservation by a court of competent jurisdiction.

VIII. "
Insolvent insurer
" means a member insurer which on or after January 1, 2020, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency.

IX. "
Member insurer
" means any insurer or health maintenance organization licensed or which holds a certificate of authority to transact in this state any kind of insurance or health insurance organization business for which coverage is provided under RSA 408-F:5, and includes any insurer or health maintenance organization whose license or certificate of authority in this state may have been suspended, revoked, not renewed or voluntarily withdrawn, but does not include:

(a) A nonprofit hospital or medical service organization.

(b) A fraternal benefit society.

(c) A mandatory state pooling plan.

(d) A mutual assessment company or any entity that operates on an assessment basis.

(e) An insurance exchange.

(f) An organization that has a certificate or license limited to the issuance of charitable gift annuities under RSA 403-E.

(g) Any entity similar to any of the above.

X. "
Moody's Corporate Bond Yield Average
" means the Monthly Average Corporates as published by Moody's Investors Service, Inc., or any successor thereto.

XI. "
Person
" means any individual, corporation, partnership, association, or voluntary organization.

XII. "
Premiums
" means amounts received on covered policies or contracts less premiums, considerations, and deposits returned on such policies or contracts and less dividends and experience credits on such policies or contracts. "Premiums" does not include any amounts received for any policies or contracts or for the portions of any policies or contracts for which coverage is not provided under RSA 408-F:5, II, except that assessable premium shall not be reduced on account of RSA 408-F:5, II(b)(3) relating to interest limitations and RSA 408-F:5, III(b) relating to limitations with respect to any one individual, any one participant and any one policy or contract holder; provided that "premiums" shall not include:

(a) Any premiums in excess of $5,000,000 on any unallocated annuity contract not issued under a governmental retirement plan established under section 401, 403(b) or 457 of the United States Internal Revenue Code; or

(b) With respect to multiple non-group policies of life insurance owned by one owner, whether the policy or contract owner is an individual, firm, corporation, or other person, and whether the persons insured are officers, managers, employees or other persons, premiums in excess of $5,000,000 with respect to these policies or contracts, regardless of the number of policies or contracts held by the owner.

XIII. "
Resident
" means a person to whom a contractual obligation is owed and who resides in this state at the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer, whichever occurs first. A person may be a resident of only one state, which in the case of a person other than a natural person shall be its principal place of business. Citizens of the United States that are either: (a) residents of foreign countries or (b) residents of United States possessions, territories or protectorates that do not have an association similar to the association created by this chapter, shall be deemed residents of the state of domicile of the member insurer that issued the policies or contracts.

XIV. "
Structured settlement annuity
" means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant.

XV. "
Supplemental contract
" means any agreement entered into for the distribution of policy or contract proceeds.

XVI. "
Unallocated annuity contract
" means any annuity contract or group annuity certificate which is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:5 Coverage and Limitations. 

I. This chapter shall provide coverage for the policies and contracts specified in paragraph II:

(a) To persons who, regardless of where they reside (except for nonresident certificate holders under group policies or contracts), are the beneficiaries, assignees, or payees, including health care providers rendering services covered under health insurance policies or certificates of the persons covered under subparagraph (b); and

(b) To persons who are owners of or certificate holders or enrollees under the policies or contracts, (other than unallocated annuity contracts and structured settlement annuities) and in each case who:

(1) Are residents; or

(2) Are not residents, but only under all of the following conditions:

(A) The member insurers that issued the policies or contracts are domiciled in this state;

(B) The states in which the persons reside have associations similar to the association created by this chapter; and

(C) The persons are not eligible for coverage by an association in any other state because the insurer or health maintenance organization was not licensed in the state at the time specified in the state's guaranty association law.

(c) For unallocated annuity contracts specified in paragraph II, subparagraphs (a) and (b) shall not apply, and this chapter shall, except as provided in subparagraphs (e) and (f), provide coverage to:

(1) Persons who are the owners of the unallocated annuity contracts if the contracts are issued to or in connection with a specified benefit plan whose plan sponsor has its principal place of business in this state; and

(2) Persons who are owners of unallocated annuity contracts issued to or in connection with government lotteries if the owners are residents.

(d) For structured settlement annuities specified in paragraph II; subparagraphs (a) and (b) shall not apply, and this chapter shall, except as provided in subparagraphs (e) and (f), provide coverage to a person who is a payee under a structured settlement annuity, or beneficiary of a payee if the payee is deceased, if the payee:

(1) Is a resident, regardless of where the contract owner resides; or

(2) Is not a resident, but only under both of the following conditions:

(A)(i) The contract owner of the structured settlement annuity is a resident; or

(ii) The contract owner of the structured settlement annuity is not a resident, but the insurer that issued the structured settlement annuity is domiciled in this state, and the state in which the contract owner resides has an association similar to the association created by this chapter; and

(B) Neither the payee or beneficiary nor the contract owner is eligible for coverage by the association of the state in which the payee or contract owner resides.

(e) This chapter shall not provide coverage to:

(1) A person who is a payee or beneficiary of a contract owner resident of this state, if the payee or beneficiary is afforded any coverage by the association of another state;

(2) A person covered under subparagraph (c), if any coverage is provided by the association of another state to the person; or

(3) A person who acquires rights to receive payments through a structured settlement factoring transaction as defined in 26 U.S.C. section 5891(c)(3)(A), regardless of whether the transaction occurred before or after such section became effective.

(f) This chapter is intended to provide coverage to a person who is a resident of this state and, in special circumstances, to a nonresident. In order to avoid duplicate coverage, if a person who would otherwise receive coverage under this chapter is provided coverage under the laws of any other state, the person shall not be provided coverage under this chapter. In determining the application of the provisions of this paragraph in situations where a person could be covered by the association of more than one state, whether as an owner, payee, enrollee, beneficiary, or assignee, this chapter shall be construed in conjunction with other state laws to result in coverage by only one association.

II. (a) This chapter shall provide coverage to the persons specified in paragraph I for policies and contracts of direct, non-group life insurance, health insurance, including health maintenance organization subscriber contracts and certificates, or annuities, and supplemental contracts to any of these, for certificates under direct group policies and contracts, and for supplemental contracts to any of these, and for unallocated annuity contracts issued by member insurers, except as limited by this chapter. Annuity contracts and certificates under group annuity contracts include, but are not limited to, guaranteed investment contracts, deposit administration contracts, unallocated funding agreements, allocated funding agreements, structured settlement annuities, annuities issued to or in connection with government lotteries and any immediate or deferred annuity contracts.

(b) Except as otherwise provided in subparagraph (c), this chapter shall not provide coverage for:

(1) A portion of a policy or contract not guaranteed by the member insurer, or under which the risk is borne by the policy or contract owner;

(2) Any policy or contract of reinsurance, unless assumption certificates have been issued;

(3) A portion of a policy or contract to the extent that the rate of interest on which it is based, or the interest rate, crediting rate, or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or change in value:

(A) Averaged over the period of 4 years prior to the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds a rate of interest determined by subtracting 2 percentage points from Moody's Corporate Bond Yield Average averaged for that same 4-year period or for such lesser period if the policy or contract was issued less than 4 years before the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier; and

(B) On and after the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds the rate of interest determined by subtracting 3 percentage points from Moody's Corporate Bond Yield Average as most recently available;

(4) Any plan or program of an employer, association, or similar entity to provide life, health, or annuity benefits to its employees or members to the extent that the plan or program is self-funded or uninsured, including, but not limited to, benefits payable by an employer, association, or similar entity under:

(A) A multiple-employer welfare arrangement as defined in 29 U.S.C. section 1002(40);

(B) A minimum premium group insurance plan;

(C) A stop-loss group insurance plan; or

(D) An administrative services only contract;

(5) Any portion of a policy or contract to the extent that it provides dividends or experience rating credits, or provides that any fees or allowances be paid to any person, including the policy or contract holder, in connection with the service to or administration of the policy or contract;

(6) Any policy or contract issued in this state by a member insurer at a time when it was not licensed or did not have a certificate of authority to issue the policy or contract in this state;

(7) Any unallocated annuity contract issued to an employee benefit plan protected under the federal Pension Benefit Guaranty Corporation;

(8) Any portion of any unallocated annuity contract which is not issued to or in connection with a specific employee, union, or association of natural persons benefit plan or a government lottery;

(9) Any portion of a policy or contract to the extent that the assessments required by RSA 408-F:9 with respect to the policy or contract are preempted by federal or state law;

(10) A portion of a policy or contract to the extent it provides for interest or other changes in value to be determined by the use of an index or other external reference stated in the policy or contract, but which have not been credited to the policy or contract, or as to which the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier. If a policy's or contract's interest or changes in value are credited less frequently than annually, then for purposes of determining the values that have been credited and are not subject to forfeiture under this subparagraph, the interest or change in value determined by using the procedures defined in the policy or contract shall be credited as if the contractual date of the crediting interest or changing values was the date of impairment or insolvency, whichever is earlier, and shall not be subject to forfeiture;

(11) A policy or contract providing any hospital, medical, prescription drug or other health care benefits pursuant to Part C or Part D of subchapter XVIII, chapter 7 of Title 42 of the United States Code, commonly known as Medicare Part C and D, or subchapter XIX, chapter 7 of Title 42 of the United States Code (commonly known as Medicaid), or any regulations issued pursuant thereto; and

(12) Structured settlement annuity benefits to which a payee or beneficiary has transferred his or her rights in a structured settlement factoring transaction as defined in 26 U.S.C. section 5891(c)(3)(A), regardless of whether the transaction occurred before or after such section became effective.

(c) The exclusion from coverage referenced in subparagraph (b)(3) of this section shall not apply to any portion of a policy or contract, including a rider, that provides long-term care or any other health insurance benefits.

III. The benefits for which the association may become liable shall in no event exceed the lesser of:

(a) The contractual obligations for which the insurer is liable or would have been liable if it were not an impaired or insolvent insurer; or

(b)(1) With respect to any one life, regardless of the number of policies or contracts:

(A) $300,000 in life insurance death benefits, but not more than $100,000 in net cash surrender and net cash withdrawal values for life insurance;

(B) For health insurance benefits:

(i) $100,000 for coverages not defined as disability income insurance or health benefit plans or long-term care insurance, as defined in RSA 415-D, including any net cash surrender and net cash withdrawal values;

(ii) $300,000 for disability income insurance, and $300,000 for long-term care insurance, as defined in RSA 415-D; or

(iii) $500,000 for health benefit plans;

(C) $250,000 in the present value of annuity benefits, including net cash surrender and net cash withdrawal values; or

(2) With respect to each individual participating in a governmental retirement plan established under Section 401, 403(b) or 457 of the United States Internal Revenue Code covered by an unallocated annuity contract or the beneficiaries of each such individual if deceased, in the aggregate, $250,000 in present value annuity benefits, including net cash surrender and net cash withdrawal values; or

(3) With respect to each payee of a structured settlement annuity or beneficiary or beneficiaries of the payee if deceased, $250,000 in present value annuity benefits, in the aggregate, including net cash surrender and net cash withdrawal value, if any.

(4) However, in no event shall the association be obligated to cover more than:

(A) An aggregate of $300,000 in benefits with respect to any one life under subparagraphs (b)(1), (2) and (3) except with respect to benefits for health benefit plans under subparagraph (b)(1)(B)(iii), in which case the aggregate liability of the association shall not exceed $500,000 with respect to any one individual; or

(B) With respect to one owner of multiple, non-group policies of life insurance, whether the policy or contract owner is an individual, firm, corporation or other person, and whether the persons insured are officers, managers, employees, or other persons, more than $5,000,000 in benefits, regardless of the number of policies and contracts held by the owner.

(5) With respect to either one contract owner provided coverage under subparagraph I(c)(2); or one plan sponsor whose plans own directly or in trust one or more unallocated annuity contracts not included in subparagraph (b)(2) of this paragraph, $5,000,000 in benefits, irrespective of the number of contracts with respect to the contract owner or plan sponsor. However, in the case where one or more unallocated annuity contracts are covered contracts under this chapter and are owned by a trust or other entity for the benefit of 2 or more plan sponsors, coverage shall be afforded by the association if the largest interest in the trust or entity owning the contract or contracts is held by a plan sponsor whose principal place of business is in this state and in no event shall the association be obligated to cover more than $5,000,000 in benefits with respect to all these unallocated contracts.

(6) The limitations set forth in this paragraph are limitations on the benefits for which the association is obligated before taking into account either its subrogation and assignments rights or the extent to which those benefits could be provided out of the assets of the impaired or insolvent insurer attributable to covered policies. The costs of the association's obligations under this chapter may be met by the use of assets attributable to covered policies or reimbursed to the association pursuant to its subrogation and assignment rights.

(7) For purposes of this chapter, benefits provided by a long-term care rider to a life insurance policy or annuity contract shall be considered the same type of benefits as the base life insurance policy or annuity contract to which it relates.

(8) In performing its obligations to provide coverage under RSA 408-F:8, the association shall not be required to guarantee, assume, reinsure, reissue or perform, or cause to be guaranteed, assumed, reinsured, reissued or performed, the contractual obligations of the insolvent or impaired insurer under a covered policy or contract that do not materially affect the economic values or economic benefits of the covered policy or contract.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:6 Creation of the Association. 

I. There is created a nonprofit legal entity to be known as the New Hampshire life and health insurance guaranty association, which shall be the same association created under RSA 404-D:6. All member insurers shall be and remain members of the association as a condition of their authority to transact insurance or a health maintenance organization business in this state. The association shall perform its functions under the plan of operation established and approved under RSA 408-F:10 and shall exercise its powers through a board of directors established under RSA 408-F:7. For purposes of administration and assessment, the association shall maintain 2 accounts:

(a) The life insurance and annuity account which includes the following subaccounts:

(1) Life insurance account;

(2) Annuity account, which shall include annuity contracts owned by a governmental retirement plan (or its trustee) established under section 401, 403(b) or 457 of the United States Internal Revenue Code, but shall otherwise excluded unallocated annuities; and

(3) Unallocated annuity account which shall exclude contracts owned by a governmental retirement benefit plan, or its trustee established under section 401, 403(b), or 457 of the United States Internal Revenue Code.

(b) The health account.

II. The association shall come under the immediate supervision of the commissioner and shall be subject to the applicable provisions of the insurance laws of this state. Meetings or records of the association may be opened to the public upon majority vote of the board of directors of the association.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:7 Board of Directors. 

I. The board of directors of the association shall consist of not less than 7 nor more than 11 member insurers serving terms as established in the plan of operation. The members of the board shall be selected by member insurers subject to the approval of the commissioner. Vacancies on the board shall be filled for the remaining period of the term by a majority vote of the remaining board members, subject to the approval of the commissioner.

II. In approving selections or in appointing members to the board, the commissioner shall consider, among other things, whether all member insurers are fairly represented.

III. Members of the board may be reimbursed from the assets of the association for expense incurred by them as members of the board of directors but members of the board shall not otherwise be compensated by the association for their services.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:8 Powers and Duties of the Association. 

I. If a member insurer is an impaired domestic insurer, the association may, in its discretion, and subject to any conditions imposed by the association that do not impair the contractual obligations of the impaired insurer, that are approved by the commissioner, and that are, except in cases of court-ordered conservation or rehabilitation, also approved by the impaired insurer:

(a) Guarantee, assume, reissue or reinsure, or cause to be guaranteed, assumed, reissued, or reinsured, any or all of the policies or contracts of the impaired insurer;

(b) Provide such moneys, pledges, notes, guarantees, or other means as are proper to effectuate subparagraph (a) and assure payment of the contractual obligations of the impaired insurer pending action under subparagraph (a); and

(c) Loan money to the impaired insurer.

II. (a) If a member insurer is an impaired insurer and the insurer is not paying claims timely, then subject to the preconditions specified in subparagraph (b), the association shall, in its discretion, either:

(1) Take any of the actions specified in paragraph I, subject to the conditions in such paragraph; or

(2) Provide substitute benefits in lieu of the contractual obligations of the impaired insurer solely for health claims, periodic annuity benefit payments, death benefits, supplemental benefits, and cash withdrawals for policy or contract owners who petition therefor under claims of emergency or hardship in accordance with standards proposed by the association and approved by the commissioner.

(b) The association shall be subject to the requirements of subparagraph (a) only if:

(1) The laws of its state of domicile provide that until all payments of or on account of the impaired insurer's contractual obligations by all guaranty associations, along with all expenses thereof and interest on all such payments and expenses, shall have been repaid to the guaranty associations or a plan of repayment by the impaired insurer shall have been approved by the guaranty associations:

(A) The delinquency proceeding shall not be dismissed;

(B) Neither the impaired insurer nor its assets shall be returned to the control of its shareholders or private management;

(C) It shall not be permitted to solicit or accept new business or have any suspended or revoked license restored; and

(2)(A) The impaired insurer is a domestic insurer, and it has been placed under an order of rehabilitation by a court of competent jurisdiction in this state; or

(B) The impaired insurer is a foreign insurer; and

(i) It has been prohibited from soliciting or accepting new business in this state;

(ii) Its certificate of authority has been suspended or revoked in this state; and

(iii) A petition for rehabilitation or liquidation has been filed in a court of competent jurisdiction in its state of domicile by the commissioner of the state.

III. If a member insurer is an insolvent insurer, the association shall, in its discretion, either:

(a)(1) Guarantee, assume, reissue, or reinsure, or cause to be guaranteed, assumed, reissued, or reinsured, the policies or contracts of the insolvent insurer; or

(2) Assure payment of the contractual obligations of the insolvent insurer; and

(3) Provide such monies, pledges, guarantees, or other means as are reasonably necessary to discharge such duties; or

(b) With respect only to policies and contracts, provide benefits and coverages in accordance with paragraph IV.

IV. When proceeding under paragraph II(a)(2) or III(b), the association shall, with respect to policies and contracts:

(a) Assure payment of benefits that would have been payable under the policies or contracts of the insolvent insurer, for claims incurred:

(1) With respect to group policies and contracts, not later than the earlier of the next renewal date under such policies or contracts or 45 days, but in no event less than 30 days, after the date on which the association becomes obligated with respect to the policies and contracts.

(2) With respect to individual policies, contracts and annuities, not later than the earlier of the next renewal date (if any) under the policies or contracts or one year, but in no event less than 30 days, from the date on which the association becomes obligated with respect to the policies or contracts.

(b) Make diligent efforts to provide all known insureds, enrollees or annuitants or group policyholders or contract owners with respect to group policies and contracts 30 days notice of the termination of the benefits provided.

(c) With respect to individual policies and contracts covered by the association, make available to each known insured, enrollee, or annuitant or owner if other than the insured, and with respect to an individual formerly an insured, enrollee, or annuitant under a group policy or contract who is not eligible for replacement group coverage, make available substitute coverage on an individual basis in accordance with the provisions of subparagraph (d), if the insureds, enrollees, or annuitants had a right under law or the terminated policy, contract or annuity to convert coverage to individual coverage or to continue an individual policy, contract, or annuity in force until a specified age or for a specified time, during which the insurer or health maintenance organization had no right unilaterally to make changes in any provision of the policy, contract, or annuity or had a right only to make changes in premium by class.

(d)(1) In providing the substitute coverage required under subparagraph (c), the association may offer either to reissue the terminated coverage or to issue an alternative policy or contract at actuarially justified rates, subject to the approval of the commissioner.

(2) Alternative or reissued policies or contracts shall be offered without requiring evidence of insurability, and shall not provide for any waiting period or exclusion that would not have applied under the terminated policy or contract.

(3) The association may reinsure any alternative or reissued policy or contract.

(e)(1) Alternative policies or contracts adopted by the association shall be subject to the approval of the commissioner. The association may adopt alternative policies or contracts of various types for future issuance without regard to any particular impairment or insolvency.

(2) Alternative policies or contracts shall contain at least the minimum statutory provisions required in this state and provide benefits that shall not be unreasonable in relation to the premium charged. The association shall set the premium in accordance with a table of rates which it shall adopt. The premium shall reflect the amount of insurance to be provided and the age and class of risk of each insured, but shall not reflect any changes in the health of the insured after the original policy or contract was last underwritten.

(3) Any alternative policy or contract issued by the association shall provide coverage of a type similar to that of the policy or contract issued by the impaired or insolvent insurer, as determined by the association.

(f) If the association elects to reissue terminated coverage at a premium rate different from that charged under the terminated policy or contract, the premium shall be actuarially justified and set by the association in accordance with the amount of insurance or coverage provided and the age and class of risk, subject to prior approval of the commissioner.

(g) The association's obligations with respect to coverage under any policy or contract of the impaired or insolvent insurer or under any reissued or alternative policy or contract shall cease on the date such coverage or policy or contract is replaced by another similar policy or contract by the policy or contract owner, the insured, the enrollee, or the association.

V. When proceeding under paragraphs II(a)(2) or III with respect to any policy or contract carrying guaranteed minimum interest rates, the association shall assure the payment or crediting of a rate of interest consistent with RSA 408-F:5, II(b)(3).

VI. Nonpayment of premiums within 31 days after the date required under the terms of any guaranteed, assumed, alternative or reissued policy or contract or substitute coverage shall terminate the association's obligations under the policy or contract, or coverage under this chapter with respect to the policy, contract, or coverage, except with respect to any claims incurred or any net cash surrender value which may be due in accordance with the provisions of this chapter.

VII. Premiums due for coverage after entry of an order of liquidation of an insolvent insurer shall belong to and be payable at the direction of the association, and the association shall be liable for unearned premiums due to policy or contract owners arising after the entry of the order.

VIII. The protection provided by this chapter shall not apply where any guaranty protection is provided to residents of this state by the laws of the domiciliary state or jurisdiction of the impaired or insolvent insurer other than this state.

IX. In carrying out its duties under paragraphs II and III, the association may, subject to approval by the court:

(a) Impose permanent policy or contract liens in connection with any guarantee, assumption, or reinsurance agreement, if the association finds that the amounts which can be assessed under this chapter are less than the amounts needed to assure full and prompt performance of the association's duties under this chapter, or that the economic or financial conditions as they affect member insurers are sufficiently adverse to render the imposition of such permanent policy or contract liens, to be in the public interest.

(b) Impose temporary moratoriums or liens on payments of cash values and policy loans, or any other right to withdraw funds held in conjunction with policies or contracts, in addition to any contractual provisions for deferral of cash or policy loan value.

X. If the association fails to act within a reasonable period of time as provided in paragraphs II(a)(2), III, and IV, the commissioner shall have the powers and duties of the association under this chapter with respect to impaired or insolvent insurers.

XI. The association may render assistance and advice to the commissioner, upon the commissioner's request, concerning rehabilitation, payment of claims, continuance of coverage, or the performance of other contractual obligations of any impaired or insolvent insurer.

XII. The association shall have standing to appear before any court in this state with jurisdiction over an impaired or insolvent insurer concerning which the association is or may become obligated under this chapter. Such standing shall extend to all matters germane to the powers and duties of the association, including, but not limited to, proposals for reinsuring, reissuing, modifying, or guaranteeing the policies or contracts of the impaired or insolvent insurer and the determination of the policies or contracts and contractual obligations. The association shall also have the right to appear or intervene before a court in another state with jurisdiction over an impaired or insolvent insurer for which the association is or may become obligated or with jurisdiction over a third party against whom the association may have rights through subrogation of the insurer's policyholders.

XIII. (a) Any person receiving benefits under this chapter shall be deemed to have assigned the rights under, and any causes of action relating to, the covered policy or contract to the association to the extent of the benefits received because of this chapter, whether the benefits are payments of or on account of contractual obligations, continuation of coverage, or provision of substitute or alternative policies, contracts, or coverages. The association may require an assignment to it of such rights and cause of action by any enrollee, payee, policy or contract owner, beneficiary, insured or annuitant, as a condition precedent to the receipt of any right or benefits conferred by this chapter upon such person.

(b) The subrogation rights of the association under this paragraph shall have the same priority against the assets of the impaired or insolvent insurer as that possessed by the person entitled to receive benefits under this chapter.

(c) In addition to subparagraphs (a) and (b), the association shall have all common law rights of subrogation and any other equitable or legal remedy which would have been available to the impaired or insolvent insurer or owner, beneficiary, enrollee, or payee of a policy or contract with respect to such policy or contracts.

XIV. The association may:

(a) Enter into such contracts as are necessary or proper to carry out the provisions and purposes of this chapter.

(b) Sue or be sued, including taking any legal actions necessary or proper to recover any unpaid assessments under RSA 408-F:9 and to settle claims or potential claims against it.

(c) Borrow money to effect the purposes of this chapter; any notes or other evidence of indebtedness of the association not in default shall be legal investments for domestic member insurers and may be carried as admitted assets.

(d) Employ or retain such persons as are necessary to handle the financial transactions of the association, and to perform such other functions as become necessary or proper under this chapter.

(e) Take such legal action as may be necessary to avoid payment of improper claims.

(f) Exercise, for the purposes of this chapter and to the extent approved by the commissioner, the powers of a domestic life insurer, health insurer, or health maintenance organization, but in no case may the association issue policies or contracts other than those issued to perform its obligations under this chapter.

(g) Unless prohibited by law, in accordance with the terms and conditions of the policy or contract, file for actuarially justified rate or premium increases for any policy or contract for which it provided coverage under this chapter.

XV. The association may join an organization of one or more other state associations of similar purposes, to further the purposes and administer the powers and duties of the association.

XVI. In carrying out its duties in connection with guaranteeing, assuming, reissuing or reinsuring policies or contracts under paragraph I or II, the association may issue substitute coverage for a policy or contract that provides an interest rate, crediting rate, or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value by issuing an alternative policy or contract in accordance with the following provisions:

(a) In lieu of the index or other external reference provided for in the original policy or contract, the alternative policy or contracts provides for:

(1) A fixed interest rate; or

(2) Payment of dividends with minimum guarantees; or

(3) A different method for calculating interest or changes in value;

(b) There is no requirement for evidence of insurability, waiting period or other exclusion that would not have applied under the replaced policy or contract; and

(c) The alternative policy or contract is substantially similar to the replaced policy or contract in all other material terms.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-F:9 Assessments. 

I. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers, separately for each account, at such time and for such amounts as the board finds necessary. Assessments shall be due not less than 30 days after prior written notice to the member insurers.

II. There shall be 2 assessments, as follows:

(a) Class A assessments shall be made for the purpose of meeting administrative and legal costs and other expenses and examinations conducted under the authority of RSA 408-F:12, V. Class A assessments may be made whether or not related to a particular impaired or insolvent insurer.

(b) Class B assessments shall be made to the extent necessary to carry out the powers and duties of the association under RSA 408-F:8 with regard to an impaired or an insolvent insurer.

III. (a) The amount of any Class A assessment shall be determined by the board and may be made on a pro rata or non-pro rata basis. If pro rata, the board may provide that it be credited against future Class B assessments.

(b) The amount of any Class B assessment, except for assessments related to long-term care insurance, shall be allocated for assessment purposes between the accounts and among the subaccounts of the life insurance and annuity account pursuant to an allocation formula which may be based on the premiums or reserves of the impaired or insolvent insurer or any other standard deemed by the board in its sole discretion as being fair and reasonable under the circumstances.

(c) The amount of the Class B assessment for long-term care insurance written by the impaired or insolvent insurer shall be allocated according to a methodology included in the plan of operation and approved by the commissioner. The methodology shall provide for 50 percent of the assessment to be allocated to accident and health member insurers and 50 percent to be allocated to life and annuity member insurers.

(d) Class B assessments against member insurers for each account and subaccount shall be in the proportion that the premiums received on business in this state by each assessed member insurer or policies or contracts covered by each account for the 3 most recent calendar years for which information is available preceding the year in which the member insurer became impaired or insolvent, as the case may be, bears to such premiums received on business in this state for such calendar years by all assessed member insurers.

(e) Assessments for funds to meet the requirements of the association with respect to an impaired or insolvent insurer shall not be made until necessary to implement the purposes of this chapter. Classification of assessments under paragraph II and computation of assessments under this paragraph shall be made with a reasonable degree of accuracy, recognizing that exact determinations may not always be possible.

IV. The association may abate or defer, in whole or in part, the assessment of a member insurer if, in the opinion of the board, payment of the assessment would endanger the ability of the member insurer to fulfill its contractual obligations. In the event an assessment against a member insurer is abated, or deferred in whole or in part, the amount by which the assessment is abated or deferred may be assessed against the other member insurers in a manner consistent with the basis for assessments set forth in this section.

V. (a) Subject to the provisions of subparagraph (b), the total of all assessments authorized by the association with respect to a member insurer for each subaccount of the life insurance and annuity account and for the health account shall not in any one calendar year exceed 2 percent of that member insurer's average annual premiums received in this state on the policies and contracts covered by the subaccount or account during the 3 calendar years preceding the year in which the member insurer became an impaired or insolvent insurer. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in either account an amount sufficient to carry out the responsibilities of the association, the necessary additional funds shall be assessed as soon thereafter as permitted by this chapter.

(b) The board may provide in the plan of operation a method of allocating funds among claims, whether relating to one or more impaired or insolvent insurers, when the maximum assessment will be insufficient to cover anticipated claims.

(c) If a one percent assessment for any subaccount of the life and annuity account in any one year does not provide an amount sufficient to carry out the responsibilities of the association, then pursuant to subparagraph III(b), the board shall access all subaccounts of the life and annuity account for the necessary additional amount, subject to the maximum stated in subparagraph V(a).

VI. The board may, by an equitable method as established in the plan of operation, refund to member insurers, in proportion to the contribution of each member insurer to that account, the amount by which the assets of the account exceed the amount the board finds is necessary to carry out during the coming year the obligations of the association with regard to that account, including assets accruing from assignment, subrogation, net realized gains, and income from investments. A reasonable amount may be retained in any account to provide funds for the continuing expenses of the association and for future losses.

VII. It shall be proper for any member insurer, in determining its premium rates and policy owner dividends as to any kind of insurance or health maintenance organization business within the scope of this chapter, to consider the amount reasonably necessary to meet its assessment obligations under this chapter.

VIII. The association shall issue to each member insurer paying an assessment under this chapter, other than Class A assessment, a certificate of contribution, in a form prescribed by the commissioner, for the amount of the assessment so paid. All outstanding certificates shall be of equal dignity and priority without reference to amounts or dates of issue. A certificate of contribution may be shown by the member insurer in its financial statement as an asset in such form and for such amount, if any, and period of time as the commissioner may approve.


Source. 2019, 314:1, eff. Jan. 1, 2020.

    408-G:1 Definitions. 

In this chapter:

I. "
Annuity issuer
" means an insurer that has issued a contract to fund periodic payments under a structured settlement.

II. "
Assignee
" means a party acquiring or proposing to acquire structured settlement payment rights from a transferee of such rights.

III. "
Dependents
" include a payee's spouse and minor children and all other persons for whom the payee is legally obligated to provide support, including alimony.

IV. "
Discounted present value
" means the present value of future payments determined by discounting such payments to the present using the most recently published applicable federal rate for determining the present value of an annuity, as issued by the United States Internal Revenue Service.

V. "
Gross advance amount
" means the sum payable to the payee or for the payee's account as consideration for a transfer of structured settlement payment rights before any reductions for transfer expenses or other deductions to be made from such consideration.

VI. "
Independent professional advice
" means advice of an attorney, certified public accountant, actuary or other licensed professional adviser.

VII. "
Interested parties
" means, with respect to any structured settlement, the payee, any beneficiary irrevocably designated under the annuity contract to receive payments following the payee's death, the annuity issuer, the structured settlement obligor, and any other party to such structured settlement that has continuing rights or obligations to receive or make payments under such structured settlement.

VIII. "
Net advance amount
" means the gross advance amount less the aggregate amount of the actual and estimated transfer expenses required to be disclosed pursuant to this chapter.

IX. "
Payee
" means an individual who is receiving tax free payments under a structured settlement and proposes to make a transfer of payment rights thereunder.

X. "
Periodic payments
" includes both recurring payments and scheduled future lump sum payments.

XI. "
Qualified assignment agreement
" means an agreement providing for a qualified assignment within the meaning of United States Internal Revenue Code, 26 U.S.C. section 130, as amended.

XII. "
Settled claim
" means the original tort claim resolved by a structured settlement.

XIII. "
Structured settlement
" means an arrangement for periodic payment of damages for personal injuries or sickness established by settlement or judgment in resolution of a tort claim.

XIV. "
Structured settlement agreement
" means the agreement, judgment, stipulation, or release embodying the terms of a structured settlement.

XV. "
Structured settlement obligor
" means, with respect to any structured settlement, the party that has the continuing obligation to make periodic payments to the payee under a structured settlement agreement or a qualified assignment agreement.

XVI. "
Structured settlement payment rights
" means rights to receive periodic payments under a structured settlement, whether from the structured settlement obligor or the annuity issuer, where:

(a) The payee resides in this state; or

(b) The structured settlement agreement was approved by a court in this state.

XVII. "
Terms of the structured settlement
" include, with respect to any structured settlement, the terms of the structured settlement agreement, the annuity contract, any qualified assignment agreement and any order or other approval of any court or other government authority that authorized or approved such structured settlement.

XVIII. "
Transfer
" means any sale, assignment, pledge, hypothecation, or other alienation or encumbrance of structured settlement payment rights made by a payee for consideration; provided that the term "transfer" shall not include the creation or perfection of a security interest in structured settlement payment rights under a blanket security agreement entered into with an insured depository institution, in the absence of any action to redirect the structured settlement payments to such insured depository institution, or an agent or successor in interest thereof, or otherwise to enforce such blanket security interest against the structured settlement payment rights.

XIX. "
Transfer agreement
" means the agreement providing for a transfer of structured settlement payment rights.

XX. "
Transfer expenses
" means all expenses of a transfer that are required under the transfer agreement to be paid by the payee or deducted from the gross advance amount, including, without limitation, court filing fees, attorneys fees, escrow fees, lien recordation fees, judgment and lien search fees, finders' fees, commissions, and other payments to a broker or other intermediary; "transfer expenses" do not include preexisting obligations of the payee payable for the payee's account from the proceeds of a transfer.

XXI. "
Transferee
" means a party acquiring or proposing to acquire structured settlement payment rights through a transfer.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

    408-G:2 Required Disclosure to Payee. 

Not less than 3 days prior to the date on which a payee signs a transfer agreement, the transferee shall provide to the payee a separate disclosure statement, in bold type no smaller than 14 points, setting forth the following:

I. The amounts and due dates of the structured settlement payments to be transferred.

II. The aggregate amount of such payments.

III. The discounted present value of the payments to be transferred, which shall be identified as the "calculation of current value of the transferred structured settlement payments under federal standards for valuing annuities and the amount of the Applicable Federal Rate used in calculating such discounted present value".

IV. The gross advance amount.

V. An itemized listing of all applicable transfer expenses, other than attorneys' fees and related disbursements payable in connection with the transferee's application for approval of the transfer, and the transferee's best estimate of the amount of any such fees and disbursements.

VI. The effective annual interest rate, which must be disclosed in a statement in the following form: "On the basis of the net amount that you will receive from us and the amounts and timing of the structured settlement payments that you are transferring to us, you will, in effect be paying interest to us at a rate of 
______ percent per year."

VII. The net advance amount.

VIII. The amount of any penalties or liquidated damages payable by the payee in the event of any breach of the transfer agreement by the payee.

IX. That the payee has the right to cancel the transfer agreement, without penalty or further obligation, not later than the third business day after the date the agreement is signed by the payee.

X. That the payee has the right to seek and receive independent professional advice regarding the proposed transfer and should consider doing so before agreeing to transfer any structured settlement payment rights.

XI. That the payee has the right to negotiate the purchase price offered by the transferee, and the payee is advised to obtain competing offers from other potential transferees.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

    408-G:3 Approval of Transfers of Structured Settlement Payment Rights. 

No direct or indirect transfer of structured settlement payment rights shall be effective and no structured settlement obligor or annuity issuer shall be required to make any payment directly or indirectly to any transferee or assignee of structured settlement payment rights unless the transfer has been approved in advance in a final court order based on express findings by such court that:

I. The transfer is in the best interest of the payee, taking into account the welfare and support of the payee's dependents; and

II. The payee has been advised in writing by the transferee to seek independent professional advice regarding the transfer and has either received such advice or knowingly waived in writing the opportunity to seek and receive such advice; and

III. The transfer does not contravene any applicable statute or the order of any court or other government authority.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

    408-G:4 Effects of Transfer of Structured Settlement Payment Rights. 

Following a transfer of structured settlement payment rights under this chapter:

I. The structured settlement obligor and the annuity issuer may rely on the court order approving the transfer in redirecting periodic payments to an assignee or transferee in accordance with the order approving the transfer and shall, as to all parties except the transferee or an assignee designated by the transferee, be discharged and released from any and all liability for the redirected payments; and such discharge and release shall not be affected by the failure of any party to the transfer to comply with this chapter or with the court order approving the transfer;

II. The transferee shall be liable to the structured settlement obligor and the annuity issuer:

(a) If the transfer contravenes the terms of the structured settlement, for any taxes incurred by the structured settlement obligor or annuity issuer as a consequence of the transfer; and

(b) For any other liabilities or costs, including reasonable costs and attorneys' fees, arising from compliance by the structured settlement obligor or annuity issuer with the court order approving the transfer or from the failure of any party to the transfer to comply with this chapter;

III. Neither the annuity issuer nor the structured settlement obligor may be required to divide any periodic payment between the payee and any transferee or assignee or between 2 or more transferees or assignees; and

IV. Any further transfer of structured settlement payment rights by the payee may be made only after compliance with all of the requirements of this chapter.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

    408-G:5 Procedure For Approval of Transfers. 

I. An application under this chapter for approval of a transfer of structured settlement payment rights shall be made by the transferee and shall be brought in the superior court in the county in which the payee resides, except that if the payee does not reside in this state, the application may be brought in the court in this state that approved the structured settlement agreement.

II. A timely hearing shall be held on an application for approval of a transfer of structured settlement payment rights. The payee shall appear in person at the hearing unless the court determines that good cause exists to excuse the payee from appearing in person.

III. Not less than 20 days prior to the scheduled hearing on any application for approval of a transfer of structured settlement payment rights under RSA 408-G:3, the transferee shall file with the court and serve on all interested parties, including a parent or other guardian or authorized legal representative of any interested party who is not legally competent, a notice of the proposed transfer and the application for its authorization, including with such notice:

(a) A copy of the transferee's application.

(b) A copy of the transfer agreement.

(c) A copy of the disclosure statement required under RSA 408-G:2.

(d) The payee's name, age, and county of residence and the number and ages of each of the payee's dependents.

(e) A summary of:

(1) Any prior transfers by the payee to the transferee or an affiliate, or through the transferee or an affiliate to an assignee, within the 4 years preceding the date of the transfer agreement and any proposed transfers by the payee to the transferee or an affiliate, or through the transferee or an affiliate, applications for approval of which were denied within the 2 years preceding the date of the transfer agreement; and

(2) Any prior transfers by the payee to any person or entity other than the transferee or an affiliate or an assignee of the transferee or an affiliate within the 3 years preceding the date of the transfer agreement and any prior proposed transfers by the payee to any person or entity other than the transferee or an affiliate or an assignee of a transferee or affiliate, applications for approval of which were denied within the one year preceding the date of the current transfer agreement, to the extent that the transfers or proposed transfers have been disclosed to the transferee by the payee in writing or otherwise are actually known to the transferee.

(f) Notification that any interested party is entitled to support, oppose or otherwise respond to the transferee's application, either in person or by counsel, by submitting written comments to the court or by participating in the hearing.

(g) Notification of the time and place of the hearing and notification of the manner in which and the date by which written responses to the application must be filed, which date shall be not less than 5 days prior to the hearing, in order to be considered by the court.

IV. In determining whether a transfer is in the payee's best interest under RSA 408-G:3, I, the court shall consider, among other matters, whether the payee has compared competing offers for the structured settlement payment rights that the payee proposes to transfer.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

    408-G:6 General Provisions;  Construction. 

I. The provisions of this chapter shall not be waived by any payee.

II. Any transfer agreement entered into on or after the effective date of this chapter by a payee who resides in this state shall provide that disputes under such transfer agreement, including any claim that the payee has breached the agreement, shall be determined in and under the laws of this state. No such transfer agreement shall authorize the transferee or any other party to confess judgment or consent to entry of judgment against the payee.

III. No transfer of structured settlement payment rights shall extend to any payments that are life-contingent unless, prior to the date on which the payee signs the transfer agreement, the transferee has established and has agreed to maintain procedures reasonably satisfactory to the annuity issuer and the structured settlement obligor for periodically confirming the payee's survival, and giving the annuity issuer and the structured settlement obligor prompt written notice in the event of the payee's death.

IV. If the payee cancels a transfer agreement, or if the transfer agreement otherwise terminates, after an application for approval of a transfer of structured settlement payment rights has been filed and before it has been granted or denied, the transferee shall promptly request dismissal of the application.

V. No payee who proposes to make a transfer of structured settlement payment rights shall incur any penalty, forfeit any application fee or other payment, or otherwise incur any liability to the proposed transferee or any assignee based on any failure of such transfer to satisfy the conditions of this chapter.

VI. Nothing contained in this chapter shall be construed to authorize any transfer of structured settlement payment rights in contravention of any applicable law or to imply that any transfer under a transfer agreement entered into prior to the effective date of this chapter is valid or invalid.

VII. Compliance with the requirements set forth in RSA 408-G:2 and fulfillment of the conditions set forth in RSA 408-G:3 shall be solely the responsibility of the transferee in any transfer of structured settlement payment rights, and neither the structured settlement obligor nor the annuity issuer shall bear any responsibility for, or any liability arising from, non-compliance with such requirements or failure to fulfill such conditions.


Source. 2021, 206:2, Pt. IV, Sec. 1, eff. Oct. 9, 2021.

[RSA 408:1 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:1 Married Women. 

Every policy of life or endowment insurance made payable to or for the benefit of a married woman, or after its issue assigned, transferred, or in any way made payable to a married woman or to any person in trust for her or her benefit, whether procured by herself, her husband, or by any other person and whether the assignment or transfer is made by her husband or by any other person, shall enure to her separate use and benefit, and to that of her children, subject to the provisions of law, relative to premiums paid in fraud of creditors.


[RSA 408:1 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:1 Power of Commissioner. 

Notwithstanding any other provision of law, the commissioner shall have sole authority to regulate the issuance and sale of life insurance, annuities, and variable products thereof. The commissioner may adopt rules as necessary to implement the provisions of this chapter. The commissioner may promulgate rules relating to protecting against the exploitation of the elderly and in home solicitation for life insurance policies and annuity contracts.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:10-a effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:10-a Interest Payment on Life Insurance Death Benefits. 

I. Notwithstanding any other provision of law, any life insurance company doing business in this state which fails or refuses to pay the proceeds of, or payments under, any individual or group policy of life insurance issued by it within 30 days after the date of death of the insured shall pay interest, at a rate of interest currently paid by the insurer on proceeds left under the interest settlement option, computed from the date of the insured's death, on any moneys payable and unpaid after the expiration of such 30-day period. This section shall apply only to deaths of insureds which occur on or after January 1, 1986.

II. Nothing in this section shall be construed to allow any life insurance company doing business in this state to withhold payment of money payable under a life insurance policy to any beneficiary for a period longer than reasonably necessary to transmit such payment. Whenever possible, payment shall be made within 30 days after the date of death of the insured.

III. In any case in which interest on the proceeds of, or payments under, any individual or group policy of life insurance becomes payable pursuant to paragraph I, the insurer shall notify each named beneficiary at the last known address that interest will be paid on the proceeds of, or payments under, such policy from the date of death of the named insured if the company does not pay the proceeds of, or payments under, the policy within 30 days of the insured's death. Such notice shall specify the rate of interest to be paid.

IV. This section shall not require the payment of interest in any case in which the beneficiary elects in writing delivered to the insurer to receive the proceeds of, or payments under, the policy by any means other than a lump sum payment.


Source. 1985, 224:1. 1995, 112:1, 2, eff. May 16, 1995.

[RSA 408:10 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:10 Incontestability. 

The policy shall be incontestable after it shall have been in force during the lifetime of the insured for 2 years from its date, except (a) for non-payment of premiums, (b) for violations of the policy relating to naval or military service in time of war, and (c) at the option of the company, for provisions granting or increasing benefits in the event of total and permanent disability and provisions which grant additional insurance specifically against death by accident; provided, however, that this section shall not apply to a policy issued by a life insurance corporation organized under the laws of this state if such policy is issued on the life of a person who is neither a resident nor a citizen of the United States of America, if such policy is delivered to the policyholder outside the continental limits of the United States of America and its territories, and if the laws and regulations of the nation in which the policy is delivered to the policyholder do not prohibit the delivery of a life insurance policy which contains no incontestability clause, so-called.


[RSA 408:10 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:10 Change in Beneficiary. 

Any change in beneficiary in a life insurance policy or annuity contract shall comply with RSA 471-C:7, VII.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:11 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:11 Discrimination. 

No life insurance company doing business in this state shall make or permit any distinction or discrimination in favor of individuals, between insured persons of the same class and equal expectation of life, in the amount or payment of premiums or rates charged for policies of life or endowment insurance, or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of the contracts it makes.


[RSA 408:11 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:11 Interest Payment on Claims for Death Benefits. 

I. Any policy or contract containing a death benefit shall contain a provision for the payment of interest on the death benefit, as follows:

(a) Interest shall accrue and be payable from the date of death.

(b) Interest shall accrue at the rate or rates applicable to the policy for funds left on deposit or, if the company has not established a rate for funds left on deposit, at the Two Year Treasury Constant Maturity Rate as published by the Federal Reserve. In determining the effective annual rate or rates, the company shall use the rate in effect on the date of death.

(c) Interest shall accrue at the effective annual rate determined in subparagraph (b), plus additional interest at a rate of 10 percent annually, beginning with the date that is 31 calendar days from the latest of dates identified in subparagraph (1) or (2), to the date the claim is paid, where it is:

(1) The date that due proof of death is received by the company; or

(2) The date the company receives sufficient information to determine its liability, the extent of the liability, and the beneficiary legally entitled to the proceeds.

II. The insurer has a duty to pay all claims in a timely manner. Nothing in this section shall be construed to allow any life insurance company doing business in this state to withhold payment of money payable under a life insurance policy or annuity contract death benefit to any beneficiary for a period longer than reasonably necessary to transmit such payment.

III. In any case in which interest on the proceeds of, or payments under, any individual or group policy of life insurance or annuity contract death benefit becomes payable pursuant to paragraph I, the insurer shall notify each named beneficiary at the last known address, as evidenced by the business records of the insurer, that interest will be paid on the proceeds of, or payments under, such policy from the date of death of the named insured, if the company does not pay the proceeds of, or payments under, the policy within 30 days of the insured's death. Such notice shall specify the rate of interest to be paid.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:12 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:12 Penalty. 

Any company or person who shall violate any of the provisions of RSA 408:11 shall be fined not more than $500; and the commissioner shall revoke the license of the party offending and shall not renew it for 3 years.


[RSA 408:12 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:12 Electronic Mail. 

Any notice or document required by this chapter to be mailed may be transmitted to the recipient electronically in lieu of mail in accordance with RSA 420-Q:2.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:13 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:13 False Representations. 

Any life insurance agent who shall, by false and fraudulent representations, procure payment or an obligation for the payment of a premium upon a life insurance contract shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person.


[RSA 408:13 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:13 General Policy Requirements for Life Insurance. 

Every life insurance policy subject to this chapter shall comply with the following:

I. Payment of premiums. There shall be a provision relating to the time and place of payment of premiums.

II. Grace period. There shall be a provision that the policyholder is entitled to a grace period for the premium due, except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder has given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period. The commissioner may adopt rules to establish the length of the grace period.

III. Entire contract. There shall be a provision that the policy, together with a copy of the signed and completed application, shall constitute the entire contract between the parties.

IV. Incontestability. There shall be a provision that the policy shall be incontestable by the insurer after it has been in force for 2 years during the lifetime of the insured. However, any increase in the amount of the policy's death benefits subsequent to the policy issue date, which occurred upon a new application or request of the owner and was subject to satisfactory proof of the insured's insurability, shall be incontestable after the increase has been in force, during the lifetime of the insured, for 2 years from the date of issue of increase.

V. Misstatement. If there is a misstatement of age or gender in the policy, the amount of the death benefit shall be that which would be purchased by the most recent mortality charge at the correct age or gender. The commissioner may approve other methods which are deemed satisfactory.

VI. Suicide. If the policy includes a suicide exclusion, such exclusion shall not apply after the second anniversary of the effective date of the policy.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:14 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:14 Fraternal Associations. 

No corporation organized and doing business in its home state or country as a fraternal beneficiary corporation or association, but not entitled to a license to transact business as a fraternal beneficiary association in this state under the laws of this state, shall be licensed to transact business in this state as an assessment insurance company under the provisions of this chapter.


[RSA 408:14 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:14 Group Life Insurance;  Definitions. 

No policy or certificate of group life insurance shall be issued or delivered in this state unless the policy is issued to a group that conforms to one of the following descriptions:

I. A policy issued to an employer, or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:

(a) The employees eligible for insurance under the policy shall be all of the employees of the employer or all of any class or classes thereof, determined by conditions pertaining to their employment. The policy may provide that the term "
employees
" shall include the employees of one or more subsidiary corporations and the employees, individual proprietors, and partners of one or more affiliated corporations, proprietors, or partnerships, if the business of the employer and of such affiliated corporations, proprietors, or partnerships is under common control through stock ownership, contract, or otherwise. The policy may provide that the term "
employees
" shall include the individual proprietor or partners, if the employer is an individual proprietor or a partnership. The policy may provide that the term "
employees
" may include retired employees, former employees, and directors of a corporate employer. A policy issued to insure the employees of a public body may provide that the term "
employee
" shall include elected or appointed officials.

(b) The premium for the policy shall be paid by the policyholder, either from the employer's funds, or from funds contributed by the insured employees, or from both. A policy on which no part of the premium is to be derived from funds contributed by the insured employees shall insure all eligible employees, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

II. A policy issued to a creditor or its parent holding company or to the trustees of a fund established by one or more creditors, which creditor or trustees shall be deemed the policyholder, to insure debtors of the creditor or creditors, subject to the following requirements:

(a) The debtors eligible for insurance under the policy shall be all the debtors of the creditor or creditors or all of any class or classes thereof. The policy may provide that the term "
debtors
" shall include:

(1) Borrowers of money or purchasers or lessees of goods, services, or property for which payment is arranged through a credit transaction;

(2) The debtors of one or more subsidiary corporations; and

(3) The debtors of one or more affiliated corporations, proprietors, or partnerships, if the business of the policyholder and of such affiliated corporations, proprietors, or partnerships is under common control through stock ownership, contract, or otherwise.

(b) The premium for the policy shall be paid by the policyholder, either from the creditor or creditors' funds, or from charges collected from the insured debtors, or from both. A policy on which no part of the premium is to be derived from funds contributed by insured debtors specifically for their insurance shall insure all eligible debtors, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) The amount of insurance on the life of any debtor shall at no time exceed the greater of the scheduled or actual amount of unpaid indebtedness to the creditor.

(d) The insurance shall be payable to the policyholder. Such payment shall reduce or extinguish the unpaid indebtedness of the debtor to the extent of the payment and any excess of the insurance shall be payable to the estate of the insured.

(e) Notwithstanding the provisions of subparagraphs (a)-(d), insurance on agricultural credit transaction commitments may be written up to the amount of the loan commitment on a non-decreasing or level term plan. Insurance on educational credit transaction commitments may be written up to the amount of the loan commitment less the amount of any repayments made on the loan,

III. A policy issued to a labor union or similar employee organization, which shall be deemed the policyholder, to insure members of such union or organization for the benefit of persons other than the union or any of its officials, representatives, or agents, subject to the following requirements:

(a) The members eligible for insurance under the policy shall be all of the members of the union or organization, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the union or organization, or both.

(b) The premium for the policy shall be paid by the policyholder, either wholly from the union's or organization's funds or partly from such funds and partly from funds contributed by the insured members specifically for the insurance. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance shall insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

IV. A policy issued to the trustees of a fund established by 2 or more employers in the same industry or by one or more labor unions or similar employee organizations, which trustees shall be deemed the policyholder, to insure employees of the employers or members of the union(s) or organizations for the benefit of persons other than the employers or the unions, subject to the following requirements:

(a) The persons eligible for insurance shall be all of the employees of the employers or all of the members of the unions, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the unions, or to both. The policy may provide that the term "
employees
" shall include the individual proprietor or partners if an employer is an individual proprietor or a partnership. The policy may provide that the term "
employees
" shall include the trustees or their employees, or both, if their duties are principally connected with such trusteeship. The policy may provide that the term "
employees
" shall include retired employees, former employees, and directors of a corporate employer.

(b) The premiums for the policy shall be paid by the policyholder either wholly from funds contributed by the employers of the insured persons or partly from such funds and partly from funds contributed by the insured employees. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance shall insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

V. A policy issued to a credit union or to the trustees of a fund established by one or more credit unions, which credit union or trustees shall be deemed the policyholder to insure members of such credit union or credit unions for the benefit of persons other than the credit union or credit unions or trustees or any of their officials, subject to the following requirements:

(a) The members eligible for insurance shall be all of the members of the credit union or credit unions, or all of any class or classes thereof determined by conditions pertaining to membership in the credit union or credit unions.

(b) The premium for the policy shall be paid by the policyholder, either wholly from the funds of the credit union or credit unions, or partly from such funds and partly from funds contributed by the insured members specifically for their insurance, or wholly from funds contributed by the insured members specifically for their insurance. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance shall insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

VI. A policy issued to an association or trust of public employees formed for purposes other than obtaining insurance, which association shall be deemed the policyholder, to insure members of such association for the benefit of persons other than the association or any of its officials, subject to the following requirements:

(a) The persons eligible for insurance under the policy shall be all of the members of the association, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the association, or both.

(b) The premium for the policy shall be paid by the policyholder, either from the association's own funds, or charges collected from the insured members specifically for insurance, or from both. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance shall insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) As used herein, "
public employees
" means employees of the United States government, or of any state, county, municipality, or political subdivision, or instrumentality of any of them.

VII. (a) A policy or certificate issued to a resident of this state under a group life insurance policy may be issued to a group other than one described in paragraphs I through VI provided the commissioner finds that:

(1) The issuance or delivery of the policy or certificate is not contrary to the best interest of the public.

(2) The issuance or delivery of the policy or certificate would result in economies of acquisition or administration.

(3) The benefits are reasonable in relation to the premiums charged.

(4) The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both, and shall insure all eligible covered persons, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(b) If the commissioner has approved a discretionary group, it shall be the responsibility of the insurer to verify that the group continues to meet the discretionary group requirements.

(c) Any filing made in relation to a discretionary group life insurance policy or certificate that was approved by the department prior to July 1, 2009 shall be deemed to meet the requirements of this paragraph, unless the commissioner acts at any time to revoke such approval after a hearing pursuant to RSA 400-A:17.

(d) The commissioner may, after a hearing held pursuant to RSA 400-A:17, withdraw approval of a discretionary group if the commissioner finds such a group no longer meets the requirement of this paragraph.

VIII. Notwithstanding the above, any such policy of group life insurance issued pursuant to paragraphs I-VII may be extended to provide group life insurance for an employee, or other member of the group, his or her spouse, child or children, or other dependents.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:15 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:15 Group Life Insurance;  Definitions. 

No policy or certificate of group life insurance shall be issued or delivered in this state unless the policy is issued to a group that conforms to one of the following descriptions:

I. A policy issued to an employer, or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements:

(a) The employees eligible for insurance under the policy shall be all of the employees of the employer, or all of any class or classes thereof determined by conditions pertaining to their employment. The policy may provide that the term "employees" shall include the employees of one or more subsidiary corporations and the employees, individual proprietors, and partners of one or more affiliated corporations, proprietors or partnerships if the business of the employer and of such affiliated corporations, proprietors or partnerships is under common control through stock ownership, contract, or otherwise. The policy may provide that the term "employees" shall include the individual proprietor or partners if the employer is an individual proprietor or a partnership. The policy may provide that the term "employees" shall include retired employees.

(b) The premium for the policy shall be paid by the policyholder, either from the employer's funds, or from funds contributed by the insured employees, or from both. A policy on which no part of the premium is to be derived from funds contributed by the insured employees must insure all eligible employees, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the employees or by the employer or trustees.

II. A policy issued to a creditor or to the trustees of a fund established by one or more creditors, which creditor or trustees shall be deemed the policyholder, to insure debtors of the creditor or creditors, subject to the following requirements:

(a) The debtors eligible for insurance under the policy shall be all the debtors of the creditor or creditors whose indebtedness is repayable in installments, or all of any class or classes thereof determined by conditions pertaining to the indebtedness or to the purchase giving rise to the indebtedness. The policy may provide that the term "debtors" shall include the debtors of one or more subsidiary corporations, and the debtors of one or more affiliated corporations, proprietors or partnerships if the business of the policyholder and of such affiliated corporations, proprietors or partnerships is under common control through stock ownership, contract, or otherwise.

(b) The premium for the policy shall be paid by the policyholder, either from the creditor or creditors' funds, or from charges collected from the insured debtors, or from both. A policy on which part or all of the premium is to be derived from the collection from the insured debtors of identifiable charges not required of uninsured debtors shall not include, in the class or classes of debtors eligible for insurance, debtors under obligations outstanding at its date of issue without evidence of individual insurability unless at least 75 percent of the then eligible debtors of each creditor elect to pay the required charges. A policy on which no part of the premium is to be derived from the collection of such identifiable charges must insure all eligible debtors, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) The policy may be issued only if the group of eligible debtors of each creditor is then receiving new entrants at the rate of at least 100 persons yearly, or may reasonably be expected to receive at least 100 new entrants during the first policy year, and only if the policy reserves to the insurer the right to require evidence of individual insurability if less than 75 percent of the new entrants become insured.

(d) The amount of insurance on the life of any debtor shall at no time exceed the amount owed by him which is repayable in installments to his creditor.

(e) The insurance shall be payable to the policyholder. Such payment shall reduce or extinguish the unpaid indebtedness of the debtor to the extent of such payment.

III. A policy issued to a labor union, which shall be deemed the policyholder, to insure members of such union for the benefit of persons other than the union or any of its officials, representatives or agents, subject to the following requirements:

(a) The members eligible for insurance under the policy shall be all of the members of the union, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the union, or both.

(b) The premium for the policy shall be paid by the policyholder, either wholly from the union's funds, or partly from such funds and partly from funds contributed by the insured members specifically for the insurance. No policy may be issued on which the entire premium is to be derived from funds contributed by the insured members specifically for their insurance. A policy on which part of the premium is to be derived from funds contributed by the insured members specifically for their insurance may be placed in force only if at least 75 percent of the then eligible members, excluding any as to whom evidence of individual insurability is not satisfactory to the insurer, elect to make the required contributions. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) The policy must cover at least 25 members at date of issue.

(d) The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the members or by the union.

IV. A policy issued to the trustees of a fund established by 2 or more employers in the same industry or by 2 or more labor unions, which trustees shall be deemed the policyholder, to insure employees of the employers or members of the unions for the benefit of persons other than the employers or the unions, subject to the following requirements:

(a) The persons eligible for insurance shall be all of the employees of the employers or all of the members of the unions, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the unions, or to both. The policy may provide that the term "employees" shall include the individual proprietor or partners if an employer is an individual proprietor or a partnership. The policy may provide that the term "employees" shall include the trustees or their employees, or both, if their duties are principally connected with such trusteeship. The policy may provide that the term "employees" shall include retired employees.

(b) The premiums for the policy shall be paid by the policyholder either wholly from funds contributed by the employers of the insured persons or partly from such funds and partly from funds contributed by the insured employees.

(c) The policy must cover at least 100 persons at date of issue.

(d) The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the insured persons or by the policyholder, employers, or unions.

V. A policy issued to any non-profit industrial association (to be deemed the policyholder) in existence for a period of at least 10 years and organized for purposes other than obtaining insurance, subject to the following requirements:

(a) If 2 or more members of the association, or any class or classes of members thereof determined by conditions pertaining to insurance, elect to insure their employees or any class or classes of employees determined by conditions pertaining to employment; and

(b) The total number of insured employees must not be less than 100.

(c) The insurance premiums are paid by such members to the association; each member, insofar as applicable to his own employees, may collect part of the premium from insured employees; and the method of apportionment of the premium payment between himself and his employees may be varied as among individual members; and

(d) Not less than 75 percent of the eligible employees of each participating member may be insured where the employees pay a part of the premium. The word "employees" as used in this subparagraph shall also include the individual members and employees of such association.

(e) The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the employees or by the members of the association.

VI. A policy issued to a credit union or to the trustees of a fund established by one or more credit unions, which credit union or trustees shall be deemed the policyholder to insure members of such credit union or credit unions for the benefit of persons other than the credit union or credit unions or trustees or any of their officials, subject to the following requirements:

(a) The members eligible for insurance shall be all of the members of the credit union or credit unions, or all of any class or classes thereof determined by conditions pertaining to membership in the credit union or credit unions.

(b) The premium for the policy shall be paid by the policyholder, either wholly from the funds of the credit union or credit unions, or partly from such funds and partly from funds contributed by the insured members specifically for their insurance, or wholly from funds contributed by the insured members specifically for their insurance. A policy on which all or a part of the premium is to be derived from funds contributed by the insured members specifically for their insurance may be placed in force only if at least 75 percent of the then eligible members of each credit union, excluding any as to whom evidence of insurability is not satisfactory to the insurer, elect to make the required contributions. A policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(c) The policy must cover at least 25 members at date of issue.

(d) The amounts of insurance under the policy must be based upon some plan precluding individual selection either by the members or by the credit union or credit unions.

VII. A policy issued to an association of public employees formed for purposes other than obtaining insurance and having, when the policy is placed in force, a membership in the classes eligible for insurance of not less than 75 percent of the number of employees eligible for membership in such classes, which association shall be deemed the policyholder, to insure members of such association for the benefit of persons other than the association or any of its officials, subject to the following requirements:

(a) The persons eligible for insurance under the policy shall be all of the members of the association, or all of any class or classes thereof determined by conditions pertaining to their employment, or to membership in the association, or both.

(b) The premium for the policy shall be paid by the policyholder, either from the association's own funds, or charges collected from the insured members specifically for insurance, or from both. No policy may be placed in force unless and until at least 75 percent of the then eligible members of the association, excluding any as to whom evidence of individual insurability is not satisfactory to the insurer, have elected to be covered.

(c) The policy must cover at least 25 persons at date of issue.

(d) The amounts of insurance under the policy must be based upon some plan precluding individual selection by the members.

(e) As used herein, "public employees" means employees of the United States government, or of any state, county, municipality, or political subdivision or instrumentality of any of them.

VIII. (a) A policy or certificate issued to a resident of this state under a group life insurance policy may be issued to a group other than one described in paragraphs I through VII provided the commissioner finds that:

(1) The issuance or delivery of the policy or certificate is not contrary to the best interest of the public.

(2) The issuance or delivery of the policy or certificate would result in economies of acquisition or administration.

(3) The benefits are reasonable in relation to the premiums charged.

(4) The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both, and shall insure all eligible covered persons, or all except any as to whom evidence of individual insurability is not satisfactory to the insurer.

(b) Any filing made in relation to a discretionary group life insurance policy or certificate that was approved by the department prior to July 1, 2009 shall be deemed to meet the requirements of this paragraph, unless the commissioner acts at any time to revoke such approval after a hearing pursuant to RSA 400-A:17.

IX. Notwithstanding the above, any such policy of group life insurance issued pursuant to paragraphs I-VII may be extended to provide group life insurance for an employee, or other member of the group, his or her spouse, child or children, or other dependents.


[RSA 408:15 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:15 Group Standard Provisions. 

No policy or certificate of group life insurance, or any form attached to a policy or certificate of group life insurance, shall be delivered or issued for delivery in this state to a resident of this state unless it contains in substance the following provisions, or provisions which in the opinion of the commissioner are more favorable to the persons insured, or at least as favorable to the persons insured and more favorable to the policyholder or certificate holder, provided, however, that (a) provisions in paragraphs II-VIII inclusive shall not apply to policies issued to a creditor to insure debtors of such creditor or to policies issued to a credit union to insure members of such credit union; and (b) if the group life insurance policy is on a plan of insurance other than the term plan, it shall contain a nonforfeiture provision or provisions which, in the opinion of the commissioner, is or are equitable to the insured persons and to the policyholder or certificate holder, but nothing herein shall be construed to require that group life insurance policies and certificates contain the same nonforfeiture provisions as are required for individual life insurance policies:

I. A provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of his or her coverage.

II. A provision that any sum becoming due, by reason of the death of the person insured, shall be payable to the beneficiary designated by the person insured, subject to the provisions of the policy. In the event there is no living designated beneficiary as to all or any part of such sum at the death of the person insured, the insurer may, subject to any right reserved by the insurer in the policy and set forth in the certificate, pay at its option a part of such sum, not exceeding $2,000, to any person appearing to the insurer to be equitably entitled thereto by reason of having incurred funeral or other expenses incident to the last illness or death of the person insured.

III. A provision that the insurer will issue to the policyholder, for delivery to each person insured, an individual certificate setting forth a statement as to the insurance protection to which he or she is entitled, to whom the insurance benefits are payable, and the rights and conditions set forth in paragraphs IV, V, VI, and VII following.

IV. A provision that if the insurance, or any portion of it, on a person covered under the policy, or on the dependent of a person covered, ceases because of termination of employment or of membership in the class or classes eligible for coverage under the policy, such person shall be entitled to a right of conversion. The right of conversion entitles such person to have an individual life insurance policy issued by the insurer, without evidence of insurability and without disability or other supplementary benefits.

(a) Application for the individual policy shall be made, and the first premium paid to the insurer, within 31 days after such termination.

(b) The individual policy shall, at the option of such person, be on any one of the forms, except term insurance, then customarily issued by the insurer at the age and for the amount applied for.

(c) The individual policy shall be in an amount not in excess of the amount of life insurance which ceases because of such termination, provided that any amount of insurance which shall have matured, on or before the date of such termination, as an endowment payable to the person insured, whether in one sum or in installments in the form of an annuity, shall not, for the purposes of this provision, be included in the amount which is considered to cease because of such termination.

(d) The premium on the individual policy shall be at the insurer's then customary rate applicable to the form and amount of the individual policy, to the class of risk to which such person then belongs, and to the person's age attained on the effective date of the individual policy. Subject to the same conditions set forth in subparagraphs (a)-(c), the conversion privilege shall be available:

(1) To a surviving dependent, if any, at the death of the employee or member, with respect to the coverage under the group policy that terminates by reason of the death; and

(2) To the dependent of the employee or member upon termination of coverage of the dependent, while the employee or member remains insured under the group policy, by reason of the dependent ceasing to be a qualified family member under the group policy.

(e) The suicide provision of the individual policy shall no longer apply after the second anniversary of the effective date of the group life insurance from which the conversion was made.

(f) The individual policy shall not be contestable after the second anniversary of the effective date of the group life insurance from which conversion was made.

V. A portability option, including for term insurance, may be offered, in addition to and not in lieu of the conversion right, when coverage ceases because of termination of employment or of membership in the class or classes eligible for coverage under the group policy, provided the subsequent policy, certificate, and group meet all the requirements in this chapter. The portability option, if offered, shall be made available to all employees or members, without evidence of insurability and regardless of the reason for the termination of employment or of membership in the class or classes eligible for coverage. Portability may be provided through a group life portability trust, established and maintained in New Hampshire and solely for the purpose of making ported life insurance available to employees or members whose coverage would terminate under the group life policy, provided it meets the requirements of a discretionary group as provided under RSA 408:14, VII and is approved by the commissioner.

VI. A provision that, if the group policy terminates or is amended so as to terminate the insurance of any class of insured persons, every person insured thereunder at the date of such termination whose insurance terminates, including the insured dependent of a covered person, and who has been so insured for at least 5 years prior to such termination date shall be entitled to have issued by the insurer an individual policy of life insurance, subject to the same conditions and limitations as are provided by paragraph IV, except that the group policy may provide that the amount of such individual policy shall not exceed the smaller of:

(a) The amount of the person's life insurance protection ceasing because of the termination or amendment of the group policy, less the amount of life insurance for which he or she is or becomes eligible under any group policy issued or reinstated by the same or another insurer within 31 days after such termination, or

(b) $10,000.

VII. If an individual insured under a group life insurance policy hereafter delivered in this state becomes entitled under the terms of the policy to have an individual policy or ported coverage certificate of life insurance issued without evidence of insurability, subject to making an application and payment of the first premium within the period specified in the policy, and if the individual is not given notice of the existence of the right at least 15 days prior to the expiration date of the period, then in that event, the individual shall have an additional period within which to exercise the right, but nothing herein contained shall be construed to continue any insurance beyond the period provided in the policy. This additional period shall expire 15 days after the individual is given notice, but in no event shall the additional period extend beyond 60 days after the expiration date of the period provided in the policy. It shall be the responsibility of the insurer to notify the individual of the right to elect conversion coverage. Written notice presented to the individual or mailed by the policyholder to the last known address of the individual or mailed by the insurer to the last known address of the individual as furnished by the policyholder shall constitute adequate notice for the purpose of this paragraph.

VIII. A provision that if a person insured under the group policy dies during the period within which he or she would have been entitled to have an individual policy or ported coverage certificate issued to him or her in accordance with paragraph IV, V, or VI, and before such coverage shall have become effective, the amount of life insurance which he or she would have been entitled to have issued to him or her shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made.

IX. Whenever any policy of group life insurance extends group life insurance to the spouse, child or children, or other dependents of an employee, or other member of the group, and if the coverage of any dependent of any employee or member of the group insured by such policy who is mentally or physically incapable of earning a living on the date as of which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another group policy as long as such incapacity continues and as long as the dependent remains chiefly financially dependent on the employee or member of the group or the employee or the employee's estate is chargeable for the care of the dependent, provided that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause, if such privilege is afforded by the policy, provided that such dependent has not attained the limiting age, if any, for conversion of adults specified in the policy.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:16-a effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16-a Assignment of Interest. 

Subject to the terms of the policies relating to assignment of incidents of ownership thereunder, a person whose life is insured under a group life insurance policy may assign any and all incidents of ownership granted him under such policy or by law, including but not limited to the right to designate a beneficiary, to exercise the conversion privilege, to have an individual policy issued to him and to pay premiums. This provision shall be construed as declaring the law as it existed prior to its enactment and not as modifying it.


Source. 1973, 509:5, eff. Aug. 31, 1973.

[RSA 408:16-b effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16-b Continuation of Coverage During Labor Disputes. 

Any employee whose compensation includes group life insurance, the premiums for which are paid in full or in part by an employer including the state of New Hampshire, its political subdivisions, or municipal corporations, or paid by payroll deduction, may pay the premiums as they become due directly to the policyholder whenever the employee's compensation is suspended or terminated directly or indirectly as the result of a strike, lockout, or other labor dispute for a period not exceeding 6 months and at the rate and coverages as the policy provides.

I. During said 6-month period, the policy may not be altered or changed, except that nothing in this section shall be deemed to impair the right of the insurer to make normal decreases or increases of the premium rate upon expiration and renewal of the policy, in accordance with the provisions of the policy.

II. When the employee's compensation is so suspended or terminated, the employee shall be notified immediately by the policyholder in writing, by mail addressed to the address last on record with the policyholder, that the employee may pay the premiums to the policyholder as they become due as provided in this section.

III. The policyholder shall remit any premiums paid by the employees on a timely basis to the insurer.

IV. Nothing herein shall be deemed to require the continuation of any such group coverage to any individual employee beyond the time that he takes full-time employment with another employer; nor shall anything herein be deemed to require continuation of the group coverage more than 6 months after compensation is suspended or terminated as the result of a labor dispute, nor to require the insurer to continue coverage as to any employee for whose coverage premiums have not been remitted in accordance with the provisions of the policy.

V. After said 6-month period, if the group insurance coverage is no longer available, then the employee shall have the right to convert to an individual policy in accordance with the provisions of RSA 408:16, IX.


Source. 1979, 418:2, eff. Aug. 22, 1979.

[RSA 408:16-c effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16-c Prohibited Provisions. 

No group life insurance policy or certificate shall contain any provision that reduces or denies any benefit otherwise payable because a pre-existing medical or health condition contributed to the death or disability of the insured. No group life insurance policy or certificate shall contain any provisions that exclude benefits for specified illnesses or medical conditions of the insured or which impose additional waiting periods for pre-existing conditions or specified illnesses or medical conditions of the insured. An insurer may require that an insured be actively at work in order to be eligible for any benefits of the policy or certificate.


Source. 1996, 188:2, eff. Jan. 1, 1997.

[RSA 408:16-d effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16-d Disapproval of Forms. 

I. No policy shall be issued or delivered to any person in this state until a copy of the form thereof has been submitted to the commissioner for review under state law and such reasonable rules and regulations as the commissioner shall make concerning the provisions in such contracts and their submission for approval.

II. The commissioner may, within 30 days after the filing of any such form, disapprove such form:

(a) If it contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive, or encourage misrepresentation of such policy; or

(b) If it does not comply with the requirements of title XXXVII.

III. If the commissioner notifies the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for the insurer to issue the form or use it in connection with any policy. In the notice the commissioner shall specify the reasons for disapproval and state that a hearing shall be granted within 20 days after request in writing by the insurer.


Source. 2010, 12:1. 2017, 218:2, eff. July 10, 2017.

[RSA 408:16-e effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16-e Subsequent Disapproval. 

The commissioner may at any time, after a hearing of which not less than 20 days' written notice shall have been given to the insurer, withdraw his or her approval of any such form on any of the grounds stated in this chapter. It shall be unlawful for the insurer to issue the form or use it in connection with any policy after the effective date of such withdrawal of approval. The notice of any hearing called under this section shall specify the matters to be considered at the hearing and any decision affirming disapproval or directing withdrawal of approval under this chapter shall be in writing and shall specify the reasons for the disapproval.


Source. 2010, 12:1, eff. July 6, 2010.

[RSA 408:16 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:16 Group Standard Provisions. 

No policy or certificates of group life insurance or any form attached to a policy or certificate of group life insurance shall be delivered or issued for delivery in this state to a resident of this state unless it contains in substance the following provisions, or provisions which in the opinion of the commissioner are more favorable to the persons insured, or at least as favorable to the persons insured and more favorable to the policyholder, or certificate holder, provided, however, (a) that provisions in paragraphs VI-X inclusive shall not apply to policies issued to a creditor to insure debtors of such creditor, or policies issued to a credit union to insure members of such credit union; (b) that standard provisions which may be required for individual life insurance policies shall not apply to group life insurance policies; and (c) that if the group life insurance policy is on a plan of insurance other than the term plan, it shall contain a nonforfeiture provision or provisions which in the opinion of the commissioner is or are equitable to the insured persons and to the policyholder or certificate holder, but nothing herein shall be construed to require that group life insurance policies and certificates contain the same nonforfeiture provisions as are required for individual life insurance policies:

I. A provision that the policyholder is entitled to a grace period of 31 days for the payment of any premium due except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder shall have given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period.

II. A provision that the validity of the policy shall not be contested, except for nonpayment of premiums, after it has been in force for 2 years from its date of issue; and that no statement made by any person insured under the policy relating to his insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person's lifetime nor unless it is contained in a written instrument signed by him.

III. A provision that a copy of the application, if any, of the policyholder shall be attached to the policy when issued, that all statements made by the policyholder or by the persons insured shall be deemed representations and not warranties, and that no statement made by any person insured shall be used in any contest unless a copy of the instrument containing the statement is or has been furnished to such person or to his beneficiary.

IV. A provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of his coverage.

V. A provision specifying an equitable adjustment of premiums or of benefits or of both to be made in the event the age of a person insured has been misstated, such provision to contain a clear statement of the method of adjustment to be used.

VI. A provision that any sum becoming due by reason of the death of the person insured shall be payable to the beneficiary designated by the person insured, subject to the provisions of the policy in the event there is no designated beneficiary as to all or any part of such sum living at the death of the person insured, and subject to any right reserved by the insurer in the policy and set forth in the certificate to pay at its option a part of such sum not exceeding $250 to any person appearing to the insurer to be equitably entitled thereto by reason of having incurred funeral or other expenses incident to the last illness or death of the person insured.

VII. A provision that the insurer will issue to the policyholder for delivery to each person insured an individual certificate setting forth a statement as to the insurance protection to which he is entitled, to whom the insurance benefits are payable, and the rights and conditions set forth in paragraphs VIII, IX and X following.

VIII. A provision that if the insurance, or any portion of it, on a person covered under the policy ceases because of termination of employment or of membership in the class or classes eligible for coverage under the policy, such person shall be entitled to have issued to the person by the insurer, without evidence of insurability, an individual policy of life insurance without disability or other supplementary benefits, provided application for the individual policy shall be made, and the first premium paid to the insurer, within 31 days after such termination, and provided further that:

(a) The individual policy shall, at the option of such person, be on any one of the forms, except term insurance, then customarily issued by the insurer at the age and for the amount applied for;

(b) The individual policy shall be in an amount not in excess of the amount of life insurance which ceases because of such termination, provided that any amount of insurance which shall have matured on or before the date of such termination as an endowment payable to the person insured, whether in one sum or in installments in the form of an annuity, shall not, for the purposes of this provision, be included in the amount which is considered to cease because of such termination;

(c) The premium on the individual policy shall be at the insurer's then customary rate applicable to the form and amount of the individual policy, to the class of risk to which such person then belongs, and to the person's age attained on the effective date of the individual policy;

(d) The suicide provision of the individual policy shall no longer apply after the second anniversary of the effective date of the group life insurance from which the conversion was made; and

(e) The individual policy shall not be contestable after the second anniversary of the effective date of the group life insurance from which conversion was made.

IX. A provision that if the group policy terminates or is amended so as to terminate the insurance of any class of insured persons, every person insured thereunder at the date of such termination whose insurance terminates and who has been so insured for at least 5 years prior to such termination date shall be entitled to have issued by the insurer an individual policy of life insurance, subject to the same conditions and limitations as are provided by paragraph VIII above, except that the group policy may provide that the amount of such individual policy shall not exceed the smaller of (a) the amount of the person's life insurance protection ceasing because of the termination or amendment of the group policy, less the amount of life insurance for which he or she is or becomes eligible under any group policy issued or reinstated by the same or another insurer within 31 days after such termination, and (b) $10,000. Each insured person shall be given written notice of this conversion privilege and its duration within 15 days after the date of termination of the group contract or policy. If this notice is given more than 15 days after the date of termination, the time allowed for the exercise of the privilege of conversion shall be extended for a period of 15 days following the date of the written notice. Such notice shall be mailed by the insurer to the insured person at the last address furnished to the insurer by the policyholder.

X. A provision that if a person insured under the group policy dies during the period within which he would have been entitled to have an individual policy issued to him in accordance with paragraph VIII or IX above and before such an individual policy shall have become effective, the amount of life insurance which he would have been entitled to have issued to him under such individual policy shall be payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made.

XI. Whenever any policy of group life insurance extends group life insurance to the spouse, child or children, or other dependents of an employee, or other member of the group, and if the coverage of any dependent of any employee or member of the group insured by such policy who is mentally or physically incapable of earning a living on the date as of which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another group policy as long as such incapacity continues and as long as the dependent remains chiefly financially dependent on the employee or member of the group or the employee or the employee's estate is chargeable for the care of the dependent, provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy, provided that such dependent has not attained the limiting age, if any, for conversion of adults specified in the policy.


[RSA 408:16 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:16 Assignment of Interest. 

Subject to the terms of the policies relating to assignment of incidents of ownership thereunder, a person whose life is insured under a group life insurance policy may assign any and all incidents of ownership granted him or her under such policy or by law, including but not limited to the right to designate a beneficiary, to exercise the conversion privilege, to have an individual policy issued to him or her, and to pay premiums. This provision shall be construed as declaring the law as it existed prior to its enactment and not as modifying it.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:17 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:17 Requirements. 

Any corporation organized under the authority of any other state or country, and engaged in the business of casualty insurance upon the assessment plan, whether a mutual or joint stock company, which does not contract to pay living policyholders or members any fixed benefit save for bodily injury or physical disability from any cause, shall, upon filing with the insurance commissioner copies, statements, and agreements, and upon payment of fees and taxes as required of foreign insurance companies, be licensed by the commissioner to do business in this state, upon furnishing, in addition to other requirements, a certificate, under oath of its president and secretary, that it is paying, and for the 12 months then next preceding has paid, the maximum amount named in its policies or certificates in full and that an assessment upon its policyholders or members will produce a sum at least equal to the maximum policy or certificate written by the corporation, evidence that it has accumulated and maintains as a trust for the benefit of policy or certificate holders only, a fund equal at least to the amount which one assessment call upon said certificate or policyholders would produce, and of not less than $10,000, invested as provided in RSA 405:2, and a certificate from the proper authority of its home state or country that corporations of this state, engaged in the business of casualty insurance on the assessment plan, are legally entitled to do business in such state or country.


[RSA 408:17 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:17 Continuation of Coverage During Labor Disputes. 

Any employee whose compensation includes group life insurance, the premiums for which are paid in full or in part by an employer, including the state of New Hampshire, its political subdivisions, or municipal corporations, or paid by payroll deduction, may pay the premiums as they become due directly to the policyholder whenever the employee's compensation is suspended or terminated directly or indirectly, as the result of a strike, lockout, or other labor dispute, for a period not exceeding 6 months and at the rate and coverages as the policy provides.

I. During said 6-month period, the policy may not be altered or changed, except that nothing in this section shall be deemed to impair the right of the insurer to make normal decreases or increases of the premium rate upon expiration and renewal of the policy, in accordance with the provisions of the policy.

II. When the employee's compensation is so suspended or terminated, the employee shall be notified immediately by the policyholder in writing, by mail addressed to the last address on record with the policyholder, that the employee may pay the premiums to the policyholder as they become due as provided in this section.

III. The policyholder shall remit any premiums paid by the employees on a timely basis to the insurer.

IV. Nothing herein shall be deemed to require the continuation of any such group coverage to any individual employee beyond the time that he or she takes full-time employment with another employer, nor shall anything herein be deemed to require continuation of the group coverage more than 6 months after compensation is suspended or terminated as the result of a labor dispute, nor to require the insurer to continue coverage as to any employee for whose coverage premiums have not been remitted in accordance with the provisions of the policy.

V. After said 6-month period, if the group insurance coverage is no longer available, then the employee shall have the right to convert to an individual policy in accordance with the provisions of RSA 408:15, IV.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:18 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:18 Limitation Upon Licenses. 

No corporation organized under the authority of any other state or country and engaged in the business of casualty insurance upon the assessment plan shall be licensed under the provisions of RSA 408:17 except as hereinafter provided; but any such corporation whose license under said provisions was in full force on June 1, 1939, may have said license to do business in this state renewed so long as the commissioner deems the corporation safe, reliable, and entitled to confidence.


[RSA 408:18 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:18 Prohibited Provisions. 

No group life insurance policy or certificate shall contain any provision that reduces or denies any benefit otherwise payable because a pre-existing medical or health condition contributed to the death or disability of the insured. No group life insurance policy or certificate shall contain any provisions that exclude benefits for specified illnesses or medical conditions of the insured or which impose additional waiting periods for pre-existing conditions or specified illnesses or medical conditions of the insured. An insurer may require that an insured be actively at work in order to be eligible for any benefits of the policy or certificate.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:19 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:19 Provisions Applicable. 

All companies, after they are licensed under the provisions of this subdivision, shall in all respects be subject to the provisions of this chapter.


[RSA 408:19 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:19 General Contract Requirements for Annuities. 

Every annuity contract subject to this chapter shall comply with the following:

I. Payment of premiums. There shall be a provision relating to the time and place of payment of premiums.

II. Grace period. There shall be a provision that the contract holder is entitled to a grace period for the premium due, except the first, during which grace period the death benefit coverage shall continue in force, unless the contract holder gives the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the contract. The contract may provide that the contract holder shall be liable to the insurer for the payment of a pro rata premium for the time the contract was in force during such grace period. The commissioner shall adopt rules to establish the length of the grace period.

III. Entire contract. There shall be a provision that the annuity contract, together with a copy of the signed and completed application, shall constitute the entire contract between the parties.

IV. Incontestability. A provision that the contract shall be incontestable by the insurer after it has been in force for 2 years during the lifetime of the insured. However, any increase in the amount of the contract's death benefits subsequent to the contract issue date, which occurred upon a new application or request of the owner and was subject to satisfactory proof of the insured's insurability, shall be incontestable after the increase has been in force, during the lifetime of the insured, for 2 years from the date of issue of increase.

V. Misstatement. If there is a misstatement of age or gender in the contract, the amount of the death benefit shall be that which would be purchased by the most recent mortality charge at the correct age or gender. The commissioner may approve other methods which are deemed satisfactory.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:2-a effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:2-a Charitable Gifts of Life Insurance. 

I. A life insurance policy may be issued with the person paying the premiums for such insurance having no insurable interest in the life of the insured, providing a charitable, benevolent, educational, or religious institution or any other organization which qualifies for a charitable deduction under the Internal Revenue Code is designated irrevocably as the owner and beneficiary of the policy.

II. A life insurance policy may be issued with the person paying the premiums designated in the application as owner and insuring the premium payer's own life and designating a charitable, benevolent, educational, or religious institution or any other organization which qualifies for a charitable deduction under the Internal Revenue Code as the irrevocable beneficiary of the policy.

III. Nothing in this section shall affect the right of any person to effectuate life insurance on such person's own life, or by a person or any business entity on another life if there exists any reasonable expectation of pecuniary benefit or advantage, direct or indirect, in the continued life of the other person.

IV. No life insurance policy may be issued under this section unless the insured has consented in writing to the issuance of such policy.


Source. 1993, 207:1, eff. June 9, 1993.

[RSA 408:2-b effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:2-b Subsequent Disapproval;  Individual Policies. 

The commissioner may at any time, after a hearing of which not less than 20 days' written notice shall have been given to the insurer, withdraw his or her approval of any such form on any of the grounds stated in this chapter. It shall be unlawful for the insurer to issue the form or use it in connection with any policy after the effective date of such withdrawal of approval. The notice of any hearing called under this section shall specify the matters to be considered at the hearing and any decision affirming disapproval or directing withdrawal of approval under this chapter shall be in writing and shall specify the reasons for the disapproval.


Source. 2010, 12:2, eff. July 6, 2010.

[RSA 408:2-c effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:2-c Disapproval of Forms;  Individual Policies. 

I. No policy shall be issued or delivered to any person in this state until a copy of the form thereof has been submitted to the commissioner for review under state law and such reasonable rules and regulations as the commissioner shall make concerning the provisions in such contracts and their submission for approval.

II. The commissioner may, within 30 days after the filing of any such form, disapprove such form:

(a) If it contains a provision which is unjust, unfair, inequitable, misleading, deceptive, or encourages misrepresentation of such policy; or

(b) If it does not comply with the requirements of Title XXXVII.

III. If the commissioner notifies the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for the insurer to issue the form or use it in connection with any policy. In the notice, the commissioner shall specify the reasons for disapproval and state that a hearing shall be granted within 20 days after request in writing by the insurer.


Source. 2011, 189:3. 2017, 218:1, eff. July 10, 2017.

[RSA 408:2 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:2 Third Person. 

If a policy of life or endowment insurance is effected by any person on his own life or on another life, in favor of a person other than himself having an insurable interest therein, the lawful beneficiary thereof other than himself or his legal representatives, shall be entitled to its proceeds and all other benefits against creditors and representatives of the person effecting the same; provided, that, subject to the statute of limitations, the amount of any premiums for said insurance paid in fraud of creditors, with interest thereon, shall enure to their benefit from the proceeds of the policy.


[RSA 408:2 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:2 Certificate of Authority. 

No person may issue a life insurance policy or annuity contract without first obtaining a certificate of authority from the commissioner.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:20 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:20 Trust Fund. 

Of the trust fund or reserve required to be accumulated and maintained by RSA 408:17 such corporation shall deposit in trust with the commissioner, before being licensed as aforesaid, and shall keep on deposit with him, securities at least equal in value to the amount which one assessment call upon its certificate or policyholders would produce; but the corporation shall have at all times, on approval of the commissioner, the right to exchange any part of said securities for others of like amount and character.


[RSA 408:20 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:20 Group Annuities Defined. 

No group annuity may be delivered or issued for delivery in this state to a group which does not meet the definition of group annuity as defined in rules. The commissioner may promulgate rules defining groups for annuities.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:21 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:21 Exception. 

RSA 408:20 shall not apply to any corporation which produces evidence satisfactory to the commissioner that it is required by the law of its home state or country to keep on deposit, and that it has deposited, securities to a like amount with the treasurer or other fiscal officer of such state or country.


[RSA 408:21 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:21 Definitions. 

I. "
Separate account
" shall mean a segregated investment account maintained by an insurance company.

II. "
Variable products
 " shall mean any life insurance policy or annuity contract issued by an insurance company which provides that the dollar amount of benefits or other contractual payments thereunder may vary according to the investment experience of any separate account or accounts maintained by the insurance company in which amounts received in connection with such policies or contracts have been placed. Variable products shall not be deemed subject to RSA 421-B.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:22 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:22 Rule. 

All bonds or other evidences of debt, having a fixed term and rate, held by any insurance company, assessment life association, or fraternal beneficiary association authorized to do business in this state may, if amply secured and not in default as to principal and interest, be valued as follows: If purchased at par, at the par value; if purchased above or below par, on the basis of the purchase price adjusted so as to bring the value to par at maturity and so as to yield in the meantime the effective rate of interest at which the purchase was made; provided, that the purchase price shall in no case be taken at a higher figure than the actual market value at the time of purchase, and that the commissioner shall have full discretion in determining the method of calculating values according to the foregoing rule.


[RSA 408:22 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:22 Authorization. 

A domestic life insurance company may establish one or more separate accounts, and may allocate thereto amounts, including, without limitation, proceeds applied under optional modes of settlement or under dividend options, to provide for life insurance or annuities and benefits incidental thereto, payable in fixed or variable amounts or both.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:23 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:23 Definition. 

A "separate account" shall mean a segregated investment account maintained by an insurance company in accordance with RSA 408:24 to 408:27, inclusive.


[RSA 408:23 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:23 Operation of Separate Accounts. 

I. The income, gains, and losses, realized or unrealized, from assets allocated to a separate account shall be credited to or charged against the account, without regard to other income, gains, or losses of the company.

II. Notwithstanding any inconsistent provision in this chapter or in any section of the general statutes, the amounts allocated to any separate account and accumulations thereon may be invested and reinvested without regard to any requirements or limitations prescribed by the laws of this state governing the investments of life insurance companies, and the investments in such separate account or accounts shall not be taken into account in applying the investment limitations otherwise applicable to the investments of the company.

III. Except with the approval of the commissioner and under such conditions as to investments and other matters as the commissioner may prescribe, which shall recognize the guaranteed nature of the benefits provided, reserves for benefits guaranteed as to dollar amount and duration, and funds guaranteed as to principal amount or stated rate of interest, shall not be maintained in a separate account.

IV. Unless otherwise approved by the commissioner, assets allocated to a separate account shall be valued at their market value on the date of valuation, or if there is no readily available market, then as provided under the terms of the contract or the rules or other written agreement applicable to the separate account, provided that, unless otherwise approved by the commissioner, the portion, if any, of the assets of the separate account equal to the company's reserve liability, with regard to the guaranteed benefits and funds referred to in paragraph III, shall be valued in accordance with the rules otherwise applicable to the company's assets.

V. No sale, exchange, or other transfer of assets may be made by a company between any of its separate accounts or between any other investment account and one or more of its separate accounts unless, in case of a transfer into a separate account, the transfer is made solely to establish the account or to support the operation of the contracts, with respect to the separate account to which the transfer is made, and unless the transfer, whether into or from a separate account, is made by a transfer of cash or by a transfer of securities having a readily determinable market value, provided that the transfer of securities is approved by the commissioner. The commissioner may approve other transfers among the accounts if, in his or her opinion, the transfers would not be inequitable.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:24 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:24 Authorization. 

A domestic life insurance company may establish one or more separate accounts, and may allocate thereto amounts (including without limitation proceeds applied under optional modes of settlement or under dividend options) to provide for life insurance or annuities (and benefits incidental thereto), payable in fixed or variable amounts or both.
408:24 Insurance Company Not a Trustee. 

Amounts allocated by an insurance company to separate accounts in the exercise of the power granted by this chapter shall be owned by the insurance company, and the insurance company shall not be, or hold itself out to be, a trustee in respect to such amounts. To the extent so provided under the applicable contracts, that portion of the assets of any such separate account equal to the reserves and other contract liabilities, with respect to the account, shall not be chargeable with liabilities arising out of any other business the insurance company may conduct.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:25 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:25 Operation of Separate Accounts. 

I. The income, gains and losses, realized or unrealized, from assets allocated to a separate account shall be credited to or charged against the account, without regard to other income, gains or losses of the company.

II. Notwithstanding any inconsistent provision in this chapter or in any section of the general statutes, the amounts allocated to any separate account and accumulations thereon may be invested and reinvested without regard to any requirements or limitations prescribed by the laws of this state governing the investments of life insurance companies and the investments in such separate account or accounts shall not be taken into account in applying the investment limitations otherwise applicable to the investments of the company.


[RSA 408:25 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:25 Managing Business of Separate Account. 

To the extent the insurance company deems it necessary to comply with any applicable federal or state laws, the insurance company, with respect to a separate account, including, without limitation, any separate account that is a management investment company or a unit investment trust, may provide for persons, having an interest therein appropriate, voting and other rights and special procedures for the conduct of the business of the account, including, without limitation, special rights and procedures relating to investment policy, investment advisory services, selection of independent public accountants, and the selection of a committee, the members of which need not be otherwise affiliated with the company, to manage the business of the account.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:26 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:26 Company Not a Trustee. 

Amounts allocated by an insurance company to separate accounts in the exercise of the power granted by this chapter shall be owned by the company, and the company shall not be, or hold itself out to be, a trustee in respect to such amounts.


[RSA 408:26 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:26 Qualification of Companies;  Subsidiaries and Affiliates. 

I. No company shall issue for delivery within this state variable products unless it is licensed to do so in this state.

II. A variable product license will only be issued to a company licensed in this state to conduct life insurance and annuity business if the commissioner is satisfied that the life insurance company's condition or method of operation in connection with the issuance of variable products will not render its operation hazardous to the public or its policyholders in this state. In this connection, the commissioner shall consider, among other things:

(a) The history and financial condition of the company;

(b) The character, responsibility, and fitness of the officers and directors of the company; and

(c) The law and regulation under which the company is authorized in the state of domicile to issue variable products. The state of entry of an alien company shall be deemed its place of domicile for this purpose.

III. If the company is a subsidiary of an admitted life insurance company, or affiliated with such company through common management or ownership, it may be deemed by the commissioner to have met the provisions of this section if either it or the parent or the affiliated company meets the requirements hereof.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:27 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:27 Definition. 

A "
variable contract
" shall mean any life insurance policy or annuity contract issued by an insurance company which provides that the dollar amount of benefits or other contractual payments thereunder may vary according to the investment experience of any separate account or accounts maintained by the insurance company in which amounts received in connection with such policies or contracts have been placed. Variable contracts shall not be deemed subject to RSA 421-B.


[RSA 408:27 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:27 Certificate. 

Upon licensure of any insurance company to issue variable products, a certificate shall be issued stating the name and the fact that the company has been licensed as a life insurance company authorized to issue variable products. The certificate shall be in such form as the commissioner may determine but shall state in bold type that the commissioner does not recommend and assumes no responsibility for variable products offered by the licensee. Certified copies of this certificate shall be furnished to the licensee for a fee as specified in RSA 400-A:29.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:28 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:28 Qualification of Companies;  Subsidiaries and Affiliates. 

I. No company shall issue for delivery within this state variable contracts unless it is licensed or organized to do a life insurance or annuity business in this state, and the commissioner is satisfied that its condition or method of operation in connection with the issuance of such contracts will not render its operation hazardous to the public or its policyholders in this state. In this connection, the commissioner shall consider among other things:

(a) The history and financial condition of the company;

(b) The character, responsibility and fitness of the officers and directors of the company; and

(c) The law and regulation under which the company is authorized in the state of domicile to issue variable contracts. The state of entry of an alien company shall be deemed its place of domicile for this purpose.

II. If the company is a subsidiary of an admitted life insurance company, or affiliated with such company through common management or ownership, it may be deemed by the commissioner to have met the provisions of this section if either it or the parent or the affiliated company meets the requirements hereof.


[RSA 408:28 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:28 Variable Product Provisions. 

Any variable product issued or delivered in this state, and any certificate evidencing variable benefits issued pursuant to any such product on a group basis, shall contain a statement of the essential features of the procedure to be followed by the insurance company in determining the dollar amount of the variable benefits, or other contractual payments or values thereunder, and shall state in clear terms that such amount may decrease or increase according to such procedure. Any such product issued or delivered in this state and any such certificate shall contain on its first page, in a prominent position, a clear statement that the benefits, or other contractual payments or values thereunder, are on a variable basis.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:29 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:29 Contract Provisions. 

Any variable contract issued or delivered in this state and any certificate evidencing variable benefits issued pursuant to any such contract on a group basis shall contain a statement of the essential features of the procedure to be followed by the insurance company in determining the dollar amount of the variable benefits or other contractual payments or values thereunder and shall state in clear terms that such amount may decrease or increase according to such procedure. Any such contract issued or delivered in this state and any such certificate shall contain on its first page, in a prominent position, a clear statement that the benefits or other contractual payments or values thereunder are on a variable basis.


[RSA 408:29 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:29 Variable Products and Separate Accounts. 

Any domestic life insurance company which issues variable products shall establish one or more separate accounts known as variable product accounts. Variable product accounts shall comply with all the requirements of separate accounts, pursuant to RSA 408:21-25.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:3 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:3 Intent to Defraud. 

If it appears that the policy was procured with the intent and effect of defrauding creditors of the person procuring the same, the party receiving the money secured by the policy shall be liable to such creditors for the amount of all premiums paid for such insurance with interest thereon. The company issuing the policy shall be discharged of all liability thereon by payment of its proceeds in accordance with its terms, unless before such payment the company shall have written notice, by or on behalf of a creditor, of a claim to recover for certain premiums paid in fraud of creditors with the certification of the amount claimed.


[RSA 408:3 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:3 Insurable Interest. 

I. For the purpose of life insurance and annuities:

(a) An individual has an unlimited insurable interest in his or her own life, body, and health, and may lawfully take out a policy of insurance on his or her own life, body, and health, and have the policy made payable to whomsoever he or she pleases, regardless of whether the beneficiary designated has an insurable interest.

(b) A policyholder has an insurable interest in the life of an individual if such policyholder has a lawful and substantial interest in the continued life of the insured, as distinguished from an interest that would arise only from, or would be enhanced in value by, the death of the individual insured.

(c) An organization which qualifies for a charitable deduction under the Internal Revenue Code has an insurable interest in the life of any person who consents in writing to the organization's ownership or purchase of that insurance.

(d) A life insurance policy or annuity may be issued to a business entity as the owner and beneficiary on the life of a key employee or partner if there exists a reasonable and substantial expectation of pecuniary benefit or advantage, direct or indirect, in the continued life of the other person.

(e) A trustee, sponsor, or custodian of assets held in any plan governed by the Employee Retirement Income Security Act of 1974, 29 U.S.C. 1001 et seq., or in any other retirement or employee benefit plan has an insurable interest in the lives of its employees, former employees and retirees for the purpose of funding, in the aggregate, all or part of the entity's cost for preretirement and postretirement medical, death, disability and pension benefits to its employees, former employees, retirees or their beneficiaries, as long as an insurance program used to finance these employee benefits includes former employees, retirees or a broad class of employees selected by objective standards related to service, or category of employment and that the proceeds created by that insurance program are used for the sole purpose of funding the corporation's preretirement or postretirement benefit programs covering at least a broad class of employees.

(1) Employers shall notify eligible employees of their proposed participation in the plan and the employees shall be given an opportunity to refuse to participate. On a prospective basis, employers shall obtain written consent of each individual being insured. Consent shall include an acknowledgment that the employer may maintain the life insurance coverage even after the insured individual's employment has terminated and the employee may not revoke their consent.

(2) An employer shall not retaliate in any manner against an employee or a retired employee for refusing to consent to be insured.

(3) For non-key or non-managerial employees, the amount of coverage shall be reasonably related to the benefits provided to the employees.

(4) With respect to employer provided pension and welfare benefit plans, the life insurance coverage purchased to finance the plans should only be allowed on the lives of those employees and retirees who, at the time their lives are first insured under the plan, would be eligible to participate in the plan.

II. An insurable interest shall exist at the time the policy or contract is issued. No policy or annuity can exist without an insurable interest.

III. No life insurance policy or annuity contract may be issued unless the insured has consented in writing to the issuance of such policy. The insured shall have the right to revoke their consent at any time, except for plans issued as described in subparagraph I(e).

IV. If the beneficiary, assignee, or other payee under any contract made in violation of this section receives from the insurer any benefits thereunder accruing upon the death, disablement, or injury of the individual insured, the individual insured, or his or her executor or administrator, as the case may be, may maintain an action to recover those benefits from the person so receiving them.

V. Any device, scheme, or artifice designed to give the appearance of an insurable interest where there is no legitimate insurable interest violates this title and shall constitute insurance fraud.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:30 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:30 Separate Accounts. 

I. Any domestic life insurance corporation which issues variable contracts shall establish one or more separate accounts known as variable contract accounts. Any amounts received by the company which are required by the variable contracts to be applied to provide variable benefits shall be added to the appropriate variable contract account, and the assets of any such variable contract account shall not be chargeable with liabilities arising out of any other business the company may conduct. The company shall not, however, be a trustee with respect to such amounts. If at any time there should be a deficit in any such variable contract account because of mortality experience, the company shall make additions to such an account, at least as often as annually, so that the assets of such account shall be sufficient to satisfy the company's mortality obligation for such variable benefits. If at any time there should be a surplus in any such variable contract account because of mortality experience, the company may make withdrawals from such an account, not more frequently than annually, so that the assets of such account shall equal the amount required to satisfy the company's mortality obligation for such variable benefits.

II. No sale, exchange or other transfer of assets may be made by a company between any of its variable contract accounts or between any other investment account and one or more of its variable contract accounts unless, in case of a transfer into a variable contract account, such transfer is made solely to establish the account or to support the operation of the contracts with respect to the variable contract account to which the transfer is made, and unless such transfer, whether into or from a variable contract account, is made (a) by a transfer of cash, or (b) by a transfer of securities having a readily determinable market value, provided that such transfer of securities is approved by the commissioner. The commissioner may approve other transfers among such accounts if, in his opinion, such transfers would not be inequitable.

III. To the extent such company deems it necessary to comply with any applicable federal or state laws, such company, with respect to any variable contract account, including without limitation any variable contract account which is a management investment company or a unit investment trust, may provide for persons having an interest therein appropriate voting and other rights and special procedures for the conduct of business of such account, including without limitation special rights and procedures relating to investment policy, investment advisory services, selection of independent public accountants, and the selection of a committee, the members of which need not be otherwise affiliated with such company, to manage the business of such account.

IV. If and to the extent so provided under the applicable contracts, that portion of the assets of any such variable contract account equal to the reserves and other contract liabilities with respect to such account shall not be chargeable with liabilities arising out of any other business the company may conduct.


[RSA 408:30 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:30 Limitations. 

Investments and liabilities of a variable product account shall at all times be clearly identifiable and distinguishable from the other investments and liabilities of the company. No investments of a variable product account shall be pledged or transferred as collateral for a loan.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:31 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:31 Limitations. 

Investments and liabilities of a variable contract account shall at all times be clearly identifiable and distinguishable from the other investments and liabilities of the corporation. No investments of a variable contract account shall be pledged or transferred as collateral for a loan.


[RSA 408:31 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:31 Investments. 

I. The assets of a variable product account may be invested in any real estate or tangible or intangible personal property which is a legal investment for a life insurance company, and, in addition, such assets may be invested wholly or partly in common stock, in preferred stocks, or in other equities which are, at the time of their purchase, either listed or admitted to trading on a security exchange located in the United States of America or Canada, or are publicly traded on the over-the-counter market and as to which market quotations are available, provided that no more than 5 percent of the assets in any variable product account may be invested in the securities of any one company and not more than 10 percent of any class of securities of any company shall be acquired.

II. Unless otherwise approved by the commissioner, assets allocated to a variable product account shall be valued at their market value on the date of valuation or, if there is no readily available market, as provided under the terms of the contract or policy, or the rules or other written agreement applicable to such variable product account, provided that, unless otherwise approved by the commissioner, the portion, if any, of the assets of such variable product account equal to the company's reserve liability, with regard to the guaranteed benefits and funds referred to in RSA 408:32, shall be valued in accordance with the rules otherwise applicable to the company's assets.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:32 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:32 Investments. 

I. The assets of a variable contract account may be invested in any real estate or tangible or intangible personal property which is a legal investment for a life insurance company, and in addition such assets may be invested wholly or partly in common stock, in preferred stocks or in other equities which are, at the time of their purchase, either listed or admitted to trading on a security exchange located in the United States of America or Canada, or are publicly traded on the over-the-counter market and as to which market quotations are available, provided that no more than 5 percent of the assets in any variable contract account may be invested in the securities of any one company and not more than 10 percent of any class of securities of any company shall be acquired.

II. Unless otherwise approved by the commissioner, assets allocated to a variable contract account shall be valued at their market value on the date of valuation, or if there is no readily available market, then as provided under the terms of the contract or the rules or other written agreement applicable to such variable contract account; provided, that unless otherwise approved by the commissioner, the portion if any of the assets of such variable contract account equal to the company's reserve liability with regard to the guaranteed benefits and funds referred to in RSA 408:33 shall be valued in accordance with the rules otherwise applicable to the company's assets.


[RSA 408:32 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:32 Reserves. 

Except with the approval of the commissioner and under such conditions as to investments and other matters as he or she may prescribe, which shall recognize the guaranteed nature of the benefits provided, reserves for (a) benefits guaranteed as to dollar amount and duration and (b) funds guaranteed as to principal amount or stated rate of interest shall not be maintained in a variable product account. The reserve liability for variable products shall be established by the insurance commissioner pursuant to the requirements of RSA 410, the standard valuation law, in accordance with actuarial procedures that recognize the variable nature of the benefits provided.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:33 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:33 Reserves. 

Except with the approval of the commissioner and under such conditions as to investments and other matters as he may prescribe, which shall recognize the guaranteed nature of the benefits provided, reserves for (a) benefits guaranteed as to dollar amount and duration and (b) funds guaranteed as to principal amount or stated rate of interest shall not be maintained in a variable contract account. The reserve liability for variable contracts shall be established by the insurance commissioner pursuant to the requirements of RSA 410, the Standard Valuation Law, in accordance with actuarial procedures that recognize the variable nature of the benefits provided.


[RSA 408:33 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:33 Deposit of Securities. 

Any company organized under the laws of this state, which has been authorized by the commissioner to issue variable products, shall deposit all securities representing the assets of a segregated fund for a variable product account, and all uninvested cash of such a fund, with a custodian which shall be a bank or trust company, either within or without the state of New Hampshire, approved by the commissioner.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:34 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:34 Deposit of Securities. 

Any corporation organized under the laws of this state which has been authorized by the commissioner to issue variable contracts shall deposit all securities representing the assets of a segregated fund for a variable contract account and all uninvested cash of such a fund with a custodian which shall be a bank or trust company, either within or without the state of New Hampshire, approved by the commissioner.


[RSA 408:34 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:34 Advertising. 

I. Only a life insurance company licensed to issue variable products in this state may, in this state, by direct solicitation or through agents or producers, or by letter, circular, or advertising, sell, offer for sale, or invite offers for or inquiries about variable products and only if it is licensed to do so under the provisions of this chapter.

II. No insurance company or producer authorized to issue variable products shall advertise publicly the fact of his or her license or use such fact or the license certificate in connection with any sale or effort to sell variable products, except by statement of the fact or by exhibiting the certificate or a certified copy thereof.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:35 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:35 Registration Required. 

Only a life insurance corporation licensed to do business in this state may, in this state, by direct solicitation or through agents or salesmen, or by letter, circular, or advertising sell, offer for sale, or invite offers for or inquiries about variable contracts and only if it is registered to do so under the provisions of this chapter.


[RSA 408:35 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:35 Prohibiting Sales. 

If the commissioner is of the opinion that any variable product is of such a character that there is a serious financial danger to the purchaser in buying it, or that the circulars and advertisements do not disclose pertinent facts sufficient to enable intending purchasers to form a correct judgment of the nature and value of the variable product, the commissioner may prohibit the sale or advertisement of said variable product.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:36 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:36 Application Fee. 

Any such life insurance corporation desiring registration shall file written application therefor with the insurance commissioner, accompanied by a registration fee in accordance with RSA 400-A:29, which is not to be returned if the application is not granted.


[RSA 408:36 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:36 Qualification of Variable Products. 

Except for RSA 409:2, in the case of a variable life insurance policy, and except as otherwise provided in this chapter, all pertinent provisions of Title XXXVII shall apply to separate accounts and products relating thereto. Any variable life insurance or annuity contract delivered or issued for delivery in this state shall comply with all respective requirements of this chapter.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:37 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:37 Form, etc. 

The application shall be in such form as may be prescribed by the commissioner, and shall state in writing the principal place of business, the name or style of doing business, the date from which it has been licensed to do the business of life insurance in this state and such other documentary evidence of condition and responsibility as the commissioner may require to determine the applicant's good repute. The commissioner may make such other and further investigation thereof as he may deem desirable.


[RSA 408:37 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:37 False Statement. 

I. Whoever violates any provisions of RSA 408:26-36, inclusive, or knowingly files with the commissioner, or furnishes to him or her any false or misleading statements or information, shall be guilty of a class B felony, if a natural person, or guilty of a felony if any other person.

II. Any false or misleading statements or information furnished to the commissioner shall be evidence that any sales of such variable products made thereafter were made on false representation in a suit to recover damages on account of loss sustained through the purchase thereof.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:38 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:38 Registration. 

Upon being satisfied of the applicant's good repute, financial standing, reliability, and right to public confidence, the commissioner shall register the applicant to issue variable contracts.


Source. 1967, 272:2. 1977, 264:5, eff. Aug. 21, 1977.

[RSA 408:39 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:39 Hearing. 

If the commissioner shall not be satisfied of the applicant's good repute, or if such objection shall be made, the commissioner shall give notice of either fact to the applicant, and upon request from him shall fix a time and place for hearing, of which 14 days' notice shall be given by mail to the applicant and to the objectors. At such hearing opportunity shall be given to said applicant and to any other persons interested or objecting, to offer further evidence as to the applicant's character and repute. If satisfied as a result of such hearing of the applicant's good character and repute in business the commissioner shall thereupon register the applicant to issue variable contracts.


Source. 1967, 272:2. 1977, 264:5, eff. Aug. 21, 1977.

[RSA 408:4 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:4 Exception. 

The provisions of RSA 408:1-3 do not apply to claims of creditors of any person effecting any life or endowment insurance which arise out of, or are based upon, any obligation created before May 9, 1931.


[RSA 408:4 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:4 Form Review. 

I. No policy, contract, certificate, document, or other form related to life insurance or annuities shall be issued or delivered to any person in this state until a copy thereof has been submitted to the commissioner for review to determine whether it is in compliance with Title XXXVII and rules adopted thereunder.

II. The commissioner may, within 30 days after the filing of any such form, disapprove such form:

(a) If it contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive, or encourage misrepresentation of such policy; or

(b) If it does not comply with the requirements of Title XXXVII or rules adopted thereunder.

III. If the commissioner disapproves a form, it shall be unlawful thereafter for the insurer to issue the form or use it in connection with any policy, contract, or certificate. The commissioner shall issue a notice of disapproval, specify the reasons for disapproval in the notice, and state that a hearing shall be granted in accordance with RSA 400-A:17 upon request in writing by the insurer.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:40 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:40 Certificate. 

Upon registration of any insurance corporation to issue variable contracts a certificate shall be issued stating the name, principal place of business, and address of the registrant, the names, residences, and business addresses of all persons interested in the business as principals, officers, directors, or managing agents, and the fact that the registrant has been registered as a life insurance corporation authorized to issue variable contracts. The certificate shall in other respects be in such form as the commissioner may determine, but shall state in bold type that the commissioner does not recommend and assumes no responsibility for, variable contracts offered by the registrant. Certified copies of this certificate shall be furnished to the registrant at $5 each.


Source. 1967, 272:2. 1969, 366:10. 1977, 264:5, eff. Aug. 21, 1977.

[RSA 408:41 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:41 Changes in Certificate. 

Changes in the certificate necessitated by changes in the personnel of the principals, officers, directors, or managing agents of any registrant, may be made at any time upon written application to the commissioner, accompanied by a statement of change within 5 days after such a change is made. Upon the issue of the amended certificate the original certificate shall be promptly surrendered to the commissioner for cancellation.


Source. 1967, 272:2.

[RSA 408:42 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:42 Registration Required. 

No salesman or agent shall in this state, in behalf of any insurance corporation authorized to issue variable contracts, sell, offer for sale, or invite offers for or inquiries about variable contracts unless registered as a salesman or agent of such insurance corporation under the provisions of this chapter. As a condition to such registration the commissioner can require that a salesman or agent pass a written examination.


Source. 1967, 272:2. 1977, 264:6, eff. Aug. 21, 1977.

[RSA 408:43 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:43 Appointment. 

Pursuant to the provisions of RSA 402-J, a registered insurance corporation may make a lifetime appointment of a producer to issue variable contracts.


Source. 1967, 272:2. 1969, 336:11. 1971, 244:5. 2001, 95:6, eff. Aug. 20, 2001.

[RSA 408:44 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:44 Form. 

The appointment shall be in such form as the commissioner may prescribe.


Source. 1967, 272:2. 2001, 95:7, eff. Aug. 20, 2001.

[RSA 408:45 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:45 Appointment Record. 

The commissioner shall record that each person is so appointed as producer of the said corporation. Such appointment does not intend or imply that the commissioner recommends or assumes any responsibility for variable contracts offered by the registered insurance corporation or the said appointed producers.


Source. 1967, 272:2. 1977, 264:7. 2001, 95:8, eff. Aug. 20, 2001.

[RSA 408:46 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:46 Cancellation of Appointments. 

Upon proper request and submission of a cancellation fee pursuant to the provisions of RSA 402-J by the registered insurance corporation the appointment of any producers shall be cancelled.


Source. 1967, 272:2. 2001, 95:9, eff. Aug. 20, 2001.

[RSA 408:47 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:47 Expiration of Registration. 

All registrations of life insurance corporations authorized to issue variable contracts or agents shall expire annually on June 14.


Source. 1967, 272:2. 1977, 264:8. 2011, 189:4, eff. Aug. 13, 2011.

[RSA 408:48 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:48 Renewal of Registrations. 

New registration of any such corporation for the succeeding year may be issued as of course without the filing of further statements or furnishing any further information, unless specifically requested by the commissioner, upon written application of the said insurance corporation and payment of the proper fee for each registration.


Source. 1967, 272:2. 1969, 366:12. 1971, 244:6, eff. Aug. 17, 1971.

    408:49 Repealed by 2001, 95:14, eff. Aug. 20, 2001. 

[RSA 408:5 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:5 Agents. 

A person who solicits insurance on behalf of a life insurance company, or transmits for a person other than himself an application for a policy of life insurance to or from such company, or offers or assumes to act in the negotiation of such insurance, shall be deemed a life insurance agent, and shall be liable to all the duties, requirements, liabilities, and penalties to which such agents are subject.


[RSA 408:5 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:5 Subsequent Withdrawal of Approval. 

The commissioner may at any time, after a hearing noticed in accordance with RSA 400-A:18, withdraw approval of any such form that does not comply with the requirements of Title XXXVII or rules adopted thereunder. It shall be unlawful for the insurer to issue the form or use it in connection with any policy after the effective date of such withdrawal of approval.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:50 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:50 Examination. 

The commissioner may require an insurance corporation authorized to issue variable contracts to file with him copies of all variable contract forms which it is at the time offering or is about to offer for sale or any other facts he may deem pertinent in relation to any of the variable contracts offered or to be offered by the registrant; and may require the filing of copies of any or all printed or otherwise reduplicated circulars or printed advertisements relating to variable contracts which the registrant has within 6 months offered for sale, or shall thereafter offer for sale.


Source. 1967, 272:2. 1977, 264:10, eff. Aug. 21, 1977.

[RSA 408:51 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:51 Prohibiting Sales. 

If the commissioner is of the opinion that any such variable contract is of such a character that there is a serious financial danger to the purchaser in buying it, or that the circulars and advertisements do not disclose pertinent facts sufficient to enable intending purchasers to form a correct judgment of the nature and value of the variable contract, he may prohibit the registrant from selling or offering the said variable contracts, or in any way advertising the same.


Source. 1967, 272:2. 1977, 264:11, eff. Aug. 21, 1977.

[RSA 408:52 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:52 Qualification of Variable Contracts. 

I. No registered insurance corporation or its salesmen or agents shall sell or offer for sale any form of variable contract unless the sale of such form of contract has been approved by the commissioner. Such a corporation desiring to qualify such variable contract form shall submit to the commissioner such descriptive statistical, or documentary information as he may require. The commissioner shall after examination of such information approve or disapprove the sale of such variable contract in the said form. A fee in accordance with RSA 400-A:29 shall be charged for the examination of material submitted to obtain the qualification of a new variable contract form.

II. Notwithstanding any other provision of law, the commissioner shall have sole authority to regulate the issuance and sale of variable contracts by a company, its agents and employees and to issue such reasonable rules and regulations as may be appropriate to carry out the purposes and provisions of this chapter.

III. Except for RSA 409:2 in the case of a variable life insurance policy and except as otherwise provided in this chapter, all pertinent provisions of Title XXXVII shall apply to separate accounts and contracts relating thereto. Any individual variable life insurance contract, delivered or issued for delivery in this state, shall contain grace, reinstatement and nonforfeiture provisions appropriate to such a contract.


Source. 1967, 272:2. 1971, 244:7. 1977, 264:12, eff. Aug. 21, 1977.

[RSA 408:53 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:53 Revocation, Insurance Corporation. 

The commissioner may, unless furnished with satisfactory evidence as provided in RSA 408:50 and RSA 408:52, or in case of violation of any provision of this chapter, or in any case of dishonest, deceitful, or fraudulent conduct on the part of any insurance corporation authorized to issue variable contracts in connection with the carrying on of the business, revoke such corporation's registration, and may, having reasonable cause to believe that such facts exist, suspend such corporation's registration until satisfied to the contrary.


Source. 1967, 272:2. 1977, 264:13, eff. Aug. 21, 1977.

[RSA 408:54 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:54 Effect. 

The revocation or suspension of the insurance corporation's registration shall constitute a revocation or suspension of the registration of any of its agents or salesmen.


Source. 1967, 272:2, eff. Jan. 1, 1968.

[RSA 408:55 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:55 Revocation, Agent, etc. 

The commissioner may, in case of violation of any provision of this chapter, or in case of dishonest, deceitful, or fraudulent conduct on the part of any agent or salesman in connection with the business, revoke such agent's or salesman's registration; and may, having reasonable cause to believe that such facts exist, suspend the agent's or salesman's registration until satisfied to the contrary.


Source. 1967, 272:2, eff. Jan. 1, 1968.

[RSA 408:56 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:56 Effect of Revocation. 

In any case of the revocation or suspension of a registration the insurance corporation, agent or salesman shall not be regarded as registered under the provisions of this chapter until restored to registration by the commissioner.


Source. 1967, 272:2, eff. Jan. 1, 1968.

[RSA 408:57 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:57 Information to be Furnished. 

The commissioner shall at any time on request, by mail or otherwise, inform any inquirer as to any individual, partnership, corporation, or association which is registered either as insurance corporation authorized to issue variable contracts, agent or salesman.


Source. 1967, 272:2. 1977, 264:14, eff. Aug. 21, 1977.

[RSA 408:58 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:58 Limitations. 

No limitations on the authority of the agent of any insurance corporation authorized to issue variable contracts, not customary in the business, shall be effective to protect the insurance corporation from liability to innocent third persons dealing with such agent.


Source. 1967, 272:2. 1977, 264:15, eff. Aug. 21, 1977.

[RSA 408:59 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:59 Possession of Certificate. 

Any insurance corporation authorized to issue variable contracts and any person named in a registration certificate as above provided may, in behalf of any such corporation, sell, offer for sale or invite offers for or inquiries about variable contracts in this state, but shall at all times when so engaged carry with him the registration certificate, or a copy thereof certified by the commissioner, which shall at any time be shown to any prospective customer upon request.


Source. 1967, 272:2. 1977, 264:16, eff. Aug. 21, 1977.

[RSA 408:6 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:6 Receipt of Premiums. 

A life insurance agent who acts for a person other than himself in negotiating a contract of life insurance shall, for the purpose of receiving the premium therefor, be held to be the company's agent, whatever conditions or stipulations may be contained in the policy or contract.


[RSA 408:6 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:6 Third Party Proceeds from Death Benefits. 

The lawful beneficiary of a life insurance policy or annuity contract death benefit shall be entitled to its proceeds and all other benefits against creditors and representatives of the insured person provided that, subject to the statute of limitations, the amount of any premiums for said insurance paid in fraud of creditors, with interest thereon, shall inure to the creditors' benefit from the proceeds of the policy.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:60 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:60 Advertising Registration. 

No insurance corporation authorized to issue variable contracts, agent or salesman shall advertise publicly the fact of his registration, or use such fact or the registration certificate in connection with any sale or effort to sell variable contracts, except by statement of the fact or by exhibiting the certificate or a certified copy thereof.


Source. 1967, 272:2. 1977, 264:17, eff. Aug. 21, 1977.

[RSA 408:61 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:61 Notice of Commissioner's Requirements or Decisions. 

Notice of any requirement or decision of the commissioner shall be sufficient if sent by mail addressed to the insurance corporation authorized to issue variable contracts, agent or salesman, as the case may be, at the address designated in the application for registration.


Source. 1967, 272:2. 1977, 264:18, eff. Aug. 21, 1977.

[RSA 408:62 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:62 False Statement. 

Whoever violates any provisions of RSA 408:28-61 inclusive, or knowingly files with the commissioner or furnishes to him any false or misleading statements or information, shall be guilty of a class B felony if a natural person, or guilty of a felony if any other person.


Source. 1967, 272:2. 1973, 528:285, eff. Oct. 31, 1973 at 11:59 p.m.

[RSA 408:63 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:63 Evidence. 

Such false or misleading statements or information so furnished shall be evidence that any sales of such variable contracts made thereafter were made on false representation, in a suit to recover damages, on account of loss sustained through the purchase thereof.


Source. 1967, 272:2. 1977, 264:19, eff. Aug. 21, 1977.

[RSA 408:7 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:7 Soliciting Agent;  Altering Application. 

I. Any person who shall solicit an application for insurance upon the life of another shall, in any controversy between the insured, or his or her beneficiary, and the company issuing any policy upon such application, be regarded as the agent of the company and not the agent of the insured.

II. No alteration of any written application for any life insurance policy or annuity contract shall be made by any person other than the applicant without his or her written consent, except that insertions may be made by the insurer, for administrative purposes only in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant.


[RSA 408:7 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:7 Intent to Defraud. 

If it appears that the life insurance policy or annuity contract was procured with the intent and effect of defrauding creditors of the person procuring the same, the party receiving the money secured by the policy shall be liable to such creditors for the amount of all premiums paid for such insurance with interest thereon. The company issuing the policy shall be discharged of all liability thereon by payment of its proceeds in accordance with its terms, unless before such payment, the company shall have written notice, by or on behalf of a creditor, of a claim to recover for certain premiums paid in fraud of creditors with the certification of the amount claimed.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:8 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:8 Penalties. 

Any person who shall assume to act as an agent of a life insurance company, without license therefor as provided by law shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person. Any person who shall unlawfully act in any manner in the negotiation of insurance with a foreign life insurance company not admitted to do business in this state, or who as principal or agent shall violate any provision of the laws of the state in regard to the negotiation or effecting of contracts of life insurance, when no other penalty is provided, shall be fined not more than $500.


[RSA 408:8 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:8 Penalty. 

Any person who violates any provision of this chapter or any rule adopted thereunder shall be subject to penalties as provided under RSA 400-A:15, III.



Source. 2022, 144:1, eff. Jan. 1, 2023.

[RSA 408:9 effective until January 1, 2023. For provisions relating to life insurance effective January 1, 2023, see RSA 408:1 to 408:37.]
    408:9 Policy Contract. 

Every policy of insurance issued or delivered within this state by any life insurance corporation doing business within the state, together with the application therefor, a copy of which application shall be endorsed upon or attached to the policy and made a part thereof, shall constitute the entire contract between the parties.


[RSA 408:9 effective January 1, 2023. For provisions relating to life insurance effective until January 1, 2023, see RSA 408:1 to 408:63.]



408:9 Retained Asset Accounts. 

I. "
Retained asset account
" means any mechanism whereby the settlement of death benefits payable under a life insurance policy or annuity contract is accomplished pursuant to a disclosure document with the beneficiary, or the beneficiary's legal representative, by the insurer, or an entity acting on behalf of the insurer, depositing the proceeds into an account with check or draft writing privileges pursuant to a disclosure document.

II. An insurer may not transfer funds to a retained asset account unless the beneficiary or the beneficiary's legal representative has elected to receive funds through a retained asset account after receiving written information describing the settlement options available under the policy or contract and any other option available to the beneficiary for the receipt of proceeds.

III. The insurer shall provide written disclosures to the beneficiary, or the beneficiary's legal representative, of the death benefit that clearly provides the rights of the beneficiary and the obligations of the insurer before the retained asset account is selected. Such disclosures shall include the following:

(a) Payment of the full benefit amount is accomplished by delivery of the draft book or check book;

(b) One draft or check may be written to access the entire amount, including interest, of the retained asset account at any time;

(c) Whether other available settlement options are preserved until the entire balance is withdrawn or the balance drops below the insurer's minimum balance requirements;

(d) A statement identifying the account as either a checking account or a draft account and an explanation of how the account works;

(e) Information about the account services provided and contact information where the beneficiary may request and obtain more details about such services;

(f) A description of services provided at no charge and which services involve a fee, if applicable;

(g) The frequency of statements showing the current account balance, the interest credited, drafts or checks written, and any other account activity;

(h) The minimum interest rate to be credited to the account and how the actual interest rate will be determined;

(i) The interest earned on the account may be taxable;

(j) Retained asset account funds held by insurance companies are not insured by the Federal Deposit Insurance Corporation but are guaranteed by the state guaranty association. The beneficiary should be advised to contact the National Organization of Life and Health Insurance Guaranty Associations via the association's website to learn more about the coverage limitations to the account under a state guaranty association;

(k) A description of the insurer's policy regarding retained asset accounts that become inactive;

(l) The contact information, including Internet website address, a telephone number, and address, where the beneficiary may obtain additional information and answers to any questions;

(m) The recommendation to consult a tax, investment, or other financial advisor regarding tax liability and investment options; and

(n) A beneficiary for the account may be designated if no designation has previously been made.

IV. The insurer shall deliver periodic statements to the beneficiary at least quarterly detailing the account balance and any transactions.



Source. 2022, 144:1, eff. Jan. 1, 2023.

    409-A:1 Short Title. 

This chapter shall be known as the Standard Nonforfeiture Law For Individual Deferred Annuities.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:10 Operative Date. 

After August 1, 1979, any company may file with the commissioner a written notice of its election to comply with the provisions of this chapter after a specified date before August 1, 1981. After filing of such notice, then upon such specified date, which shall be the operative date of this chapter for such company, this chapter shall become operative with respect to annuity contracts thereafter issued by such company. If a company makes no such election, the operative date of this chapter for such company shall be August 1, 1981.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:2 Exemptions. 

This chapter shall not apply to any reinsurance group annuity purchased under a retirement plan or plan of deferred compensation established or maintained by an employer (including a partnership or sole proprietorship) or by an employee organization, or by both, other than a plan providing individual retirement accounts or individual retirement annuities under section 408 of the Internal Revenue Code, as now or hereafter amended, premium deposit fund, variable annuity, investment annuity, immediate annuity, any deferred annuity contract after annuity payments have commenced, or reversionary annuity, nor to any contract which shall be delivered outside this state through an agent or other representative of the company issuing the contract.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:3 Compulsory Contract Provisions. 

I. In the case of contracts issued on or after the operative date of this chapter as defined in RSA 409-A:10, no contract of annuity, except as stated in RSA 409-A:2, shall be delivered or issued for delivery in this state unless it contains in substance the following provisions, or corresponding provisions which in the opinion of the commissioner are at least as favorable to the contract holder, upon cessation of payment of considerations under the contract:

(a) That upon cessation of payment of considerations under a contract, the company will grant a paid-up annuity benefit on a plan stipulated in the contract of such value as is specified in RSA 409-A:5, 409-A:6, 409-A:7, 409-A:8 and 409-A:9, I.

(b) If a contract provides for a lump sum settlement at maturity, or at any other time, that upon surrender of the contract at or prior to the commencement of any annuity payments, the company will pay in lieu of any paid-up annuity benefit a cash surrender benefit of such amount as is specified in RSA 409-A:5, 409-A:6, 409-A:8 and 409-A:9, I. The company shall reserve the right to defer the payment of such cash surrender benefit for a period of 6 months after demand therefor with surrender of the contract.

(c) A statement of the mortality table, if any, and interest rates used in calculating any minimum paid-up annuity, cash surrender or death benefits that are guaranteed under the contract, together with sufficient information to determine the amounts of such benefits.

(d) A statement that any paid-up annuity, cash surrender or death benefits that may be available under the contract are not less than the minimum benefits required by any statute of the state in which the contract is delivered and an explanation of the manner in which such benefits are altered by the existence of any additional amounts credited by the company to the contract, any indebtedness to the company on the contract or any prior withdrawals from or partial surrenders of the contract.

II. Notwithstanding the requirements of this section, any deferred annuity contract may provide that if no considerations have been received under a contract for a period of 2 full years and the portion of the paid-up annuity benefit at maturity on the plan stipulated in the contract arising from considerations paid prior to such period would be less than $20 monthly, the company may at its option terminate such contract by payment in cash of the then present value of such portion of the paid-up annuity benefit, calculated on the basis of the mortality table, if any, and interest rate specified in the contract for determining the paid-up annuity benefit, and by such payment shall be relieved of any further obligation under such contract.

III. Any contract which does not provide cash surrender benefits or does not provide death benefits at least equal to the minimum nonforfeiture amount prior to the commencement of any annuity payments shall include a statement in a prominent place in the contract that such benefits are not provided.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:4 Minimum Nonforfeiture Amounts. 

The minimum values as specified in RSA 409-A:5, 409-A:6, 409-A:7, 409-A:8 and 409-A:9, I of any paid-up annuity, cash surrender, or death benefits available under an annuity contract shall be based upon minimum nonforfeiture amounts as defined in this section.

I. The minimum nonforfeiture amount at any time at or prior to the commencement of any annuity payments shall be equal to an accumulation up to such time at rates of interest as indicated in paragraph III of the net considerations, paid prior to such time, decreased by the sum of subparagraphs (a) through (d):

(a) Any prior withdrawals from or partial surrenders of the contract accumulated at rates of interest as indicated in paragraph III;

(b) An annual contract charge of $50, accumulated at rates of interest as indicated in paragraph III;

(c) Any premium tax paid by the company for the contract, accumulated at rates of interest as indicated in paragraph III; and

(d) The amount of any indebtedness to the company on the contract, including interest due and accrued.

II. The net considerations for a given contract year used to define the minimum nonforfeiture amount shall be an amount equal to 87
1/2 percent of the gross considerations credited to the contract during that contract year.

III. The interest rate used in determining minimum nonforfeiture amounts shall be an annual rate of interest determined as the lesser of 3 percent per annum and the following, which shall be specified in the contract if the interest rate will be reset:

(a) The 5-year Constant Maturity Treasury Rate reported by the Federal Reserve as of a date, or average over a period, rounded to the nearest 
1/20th of one percent, specified in the contract no longer than 15 months prior to the contract issue date or redetermination date under subparagraph III(d);

(b) Reduced by 125 basis points;

(c) Where the resulting interest rate is not less than 15 basis points (0.15 percent); and

(d) The interest rate shall apply for an initial period and may be redetermined for additional periods. The redetermination date, basis, and period, if any, shall be stated in the contract. The basis is the date or average over a specified period that produces the value of the 5-year Constant Maturity Treasury Rate to be used at each redetermination date.

IV. During the period or term that a contract provides substantive participation in an equity indexed benefit, it may increase the reduction described in subparagraph III(b) by up to an additional 100 basis points to reflect the value of the equity index benefit. The present value at the contract issue date, and at each redetermination date thereafter, of the additional reduction shall not exceed the market value of the benefit. The commissioner may require a demonstration that the present value of the additional reduction does not exceed the market value of the benefit. Lacking such a demonstration that is acceptable to the commissioner, the commissioner may disallow or limit the additional reduction.

V. The commissioner may adopt rules, pursuant to RSA 541-A, as necessary to implement the provisions of paragraph IV and to provide for further adjustments to the calculation of minimum nonforfeiture amounts for contracts that provide substantive participation in an equity index benefit and for other contracts that the commissioner determines adjustments are justified.


Source. 1979, 360:4. 2002, 207:44. 2004, 187:3, eff. June 30, 2004. 2022, 105:1, eff. July 26, 2022.

    409-A:5 Computation of Annuity Benefit. 

Any paid-up annuity benefit available under a contract shall be such that its present value on the date annuity payments are to commence is at least equal to the minimum nonforfeiture amount on that date. Such present value shall be computed using the mortality table, if any, and the interest rate specified in the contract for determining the minimum paid-up annuity benefits guaranteed in the contract.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:6 Computation of Cash Surrender Benefits. 

For contracts which provide cash surrender benefits, such cash surrender benefits available prior to maturity shall not be less than the present value as of the date of surrender of that portion of the maturity value of the paid-up annuity benefit which would be provided under the contract at maturity arising from considerations paid prior to the time of cash surrender reduced by the amount appropriate to reflect any prior withdrawals from or partial surrenders of the contract, such present value being calculated on the basis of an interest rate not more than one percent higher than the interest rate specified in the contract for accumulating the net considerations to determine such maturity value, decreased by the amount of any indebtedness to the company on the contract, including interest due and accrued, and increased by any existing additional amounts credited by the company to the contract. In no event shall any cash surrender benefit be less than the minimum nonforfeiture amount at that time. The death benefit under such contracts shall be at least equal to the cash surrender benefit.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:7 Computation of Paid-up Annuity Nonforfeiture Benefits. 

For contracts which do not provide cash surrender benefits, the present value of any paid-up annuity benefit available as a nonforfeiture option at any time prior to maturity shall not be less than the present value of that portion of the maturity value of the paid-up annuity benefit provided under the contract arising from considerations paid prior to the time the contract is surrendered in exchange for, or changed to, a deferred paid-up annuity, such present value being calculated for the period prior to the maturity date on the basis of the interest rate specified in the contract for accumulating the net considerations to determine such maturity value, and increased by any existing additional amounts credited by the company to the contract. For contracts which do not provide any death benefits prior to the commencement of any annuity payments, such present values shall be calculated on the basis of such interest rate and the mortality table specified in the contract for determining the maturity value of the paid-up annuity benefit. However, in no event shall the present value of a paid-up annuity benefit be less than the minimum nonforfeiture amount at that time.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:8 Determination of Maturity Date. 

For the purpose of determining the benefits calculated under RSA 409-A:6 and 409-A:7, in the case of annuity contracts under which an election may be made to have annuity payments commence at optional maturity dates, the maturity date shall be deemed to be the latest date for which election shall be permitted by the contract, but shall not be deemed to be later than the anniversary of the contract next following the annuitant's seventieth birthday or the tenth anniversary of the contract, whichever is later.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409-A:9 Calculations of Values;  Supplemental Rules. 

I. Any paid-up annuity, cash surrender or death benefits available at any time, other than on the contract anniversary under any contract with fixed scheduled considerations, shall be calculated with allowance for the lapse of time and the payment of any scheduled considerations beyond the beginning of the contract year in which cessation of payment of considerations under the contract occurs.

II. For any contract which provides, within the same contract by rider or supplemental contract provision, both annuity benefits and life insurance benefits that are in excess of the greater of cash surrender benefits or a return of the gross considerations with interest, the minimum nonforfeiture benefits shall be equal to the sum of the minimum nonforfeiture benefits for the annuity portion and the minimum nonforfeiture benefits, if any, for the life insurance portion computed as if each portion were a separate contract. Notwithstanding the provisions of RSA 409-A:5, 409-A:6, 409-A:7, 409-A:8 and 409-A:9, I, additional benefits payable (a) in the event of total and permanent disability, (b) as reversionary annuity or deferred reversionary annuity benefits, or (c) as other policy benefits additional to life insurance, endowment and annuity benefits, shall be disregarded in ascertaining the minimum nonforfeiture amounts, paid-up annuity, cash surrender and death benefits that may be required by this chapter. The inclusion of such additional benefits shall not be required in any paid-up benefits, unless such additional benefits separately would require minimum nonforfeiture amounts, paid-up annuity, cash surrender and death benefits.


Source. 1979, 360:4, eff. Aug. 22, 1979.

    409:1-a Definition. 

In this chapter, "
operative date of the valuation manual
" means the January 1 of the first calendar year that the valuation manual as defined in RSA 410:2, XII is effective.


Source. 2013, 221:2, eff. Jan. 1, 2014.

    409:1 Short Title. 

This chapter shall be known as the Standard Nonforfeiture Law For Life Insurance.


Source. 1943, 89:1, par. 1. RSA 409:1. 1979, 360:2, eff. Aug. 22, 1979.

    409:2 Nonforfeiture Provisions Required. 

I. In the case of policies issued on and after the operative date as defined in RSA 409:8, no policy of life insurance, except as stated in RSA 409:7, shall be delivered or issued for delivery in this state unless it shall contain in substance the following provisions, or corresponding provisions which in the opinion of the commissioner are at least as favorable to the defaulting or surrendering policyholder as are the minimum requirements specified in this section and are essentially in compliance with RSA 409:6-a:

(a) That, in the event of default in any premium payment, the company will grant, upon proper request not later than 60 days after the due date of the premium in default, a paid-up nonforfeiture benefit on a plan stipulated in the policy, effective as of such due date, of such amount as may be specified in this chapter. In lieu of such stipulated paid-up nonforfeiture benefit, the company may substitute, upon proper request, not later than 60 days after the due date of the premium in default, an actuarially equivalent alternative paid-up nonforfeiture benefit which provides a greater amount or longer period of death benefits or, if applicable, a greater amount or earlier payment of endowment benefits.

(b) That, upon surrender of the policy within 60 days after the due date of any premium payment in default after premiums have been paid for at least 3 full years in the case of ordinary insurance or 5 full years in the case of industrial insurance, the company will pay, in lieu of any paid-up nonforfeiture benefit, a cash surrender value of such amount as may be specified in this chapter.

(c) That a specified paid-up nonforfeiture benefit shall become effective as specified in the policy unless the person entitled to make such election elects another available option not later than 60 days after the due date of the premium in default.

(d) That, if the policy shall have become paid-up by completion of all premium payments or if it is continued under any paid-up nonforfeiture benefit which became effective on or after the third policy anniversary in the case of ordinary insurance or the fifth policy anniversary in the case of industrial insurance, the company will pay, upon surrender of the policy within 30 days after any policy anniversary, a cash surrender value of such amount as may be specified in this chapter.

(e) In the case of policies which cause on a basis guaranteed in the policy unscheduled changes in benefits or premiums, or which provide an option for changes in benefits or premiums other than a change to a new policy, a statement of the mortality table, interest rate, and method used in calculating cash surrender values and the paid-up nonforfeiture benefits available under the policy. In the case of all other policies, a statement of the mortality table and interest rate used in calculating the cash surrender values and the paid-up nonforfeiture benefits available under the policy, together with a table showing the cash surrender value, if any, and paid-up nonforfeiture benefit, if any, available under the policy on each policy anniversary either during the first 20 policy years or during the term of the policy, whichever is shorter, such values and benefits to be calculated upon the assumption that there are no dividends or paid-up additions credited to the policy and that there is no indebtedness to the company on the policy.

(f) A statement that the cash surrender values and the paid-up nonforfeiture benefits available under the policy are not less than the minimum values and benefits required by or pursuant to the insurance law of the state in which the policy is delivered; an explanation of the manner in which the cash surrender values and the paid-up nonforfeiture benefits are altered by the existence of any paid-up additions credited to the policy or any indebtedness to the company on the policy; if a detailed statement of the method of computation of the values and benefits shown in the policy is not stated in the policy, a statement that such method of computation has been filed with the insurance supervisory official of the state in which the policy is delivered; and a statement of the method to be used in calculating the cash surrender value and paid-up nonforfeiture benefit available under the policy on any policy anniversary beyond the last anniversary for which such values and benefits are consecutively shown in the policy.

II. Any of the foregoing provisions or portions of those provisions not applicable by reason of the plan of insurance may, to the extent inapplicable, be omitted from the policy.

III. The company shall reserve the right to defer the payment of any cash surrender value for a period of 6 months after demand for such payment with surrender of the policy.


Source. 1943, 89:1, par. 2. RSA 409:2. 1961, 75:1. 1981, 182:9, eff. Aug. 1, 1981.

    409:3 Minimum Cash Surrender Values. 

I. Any cash surrender value available under the policy in the event of default in a premium payment due on any policy anniversary, whether or not required by RSA 409:2, shall be an amount not less than the excess, if any, of the present value, on such anniversary, of the future guaranteed benefits which would have been provided for by the policy, including any existing paid-up additions, if there had been no default, over the sum of: (a) the then present value of the adjusted premiums as defined in RSA 409:5, RSA 409:5-a and RSA 409:5-b, corresponding to premiums which would have fallen due on and after such anniversary, and (b) the amount of any indebtedness to the company on the policy.

II. Provided, however, that for any policy issued on or after the operative date of RSA 409:5-b as defined in that section, which provides supplemental life insurance or annuity benefits at the option of the insured and for an identifiable additional premium by rider or supplemental policy provision, the cash surrender value referred to in paragraph I of this section shall be an amount not less than the sum of the cash surrender value as defined in such paragraph for an otherwise similar policy issued at the same age without such rider or supplemental policy provision and the cash surrender value as defined in such paragraph for a policy which provides only the benefits otherwise provided by such rider or supplemental policy provision.

III. Provided, further, that for any family policy issued on or after the operative date of RSA 409:5-b as defined in that section, which defines a primary insured and provides term insurance on the life of the spouse of the primary insured expiring before the spouse's age 71, the cash surrender value referred to in paragraph I of this section shall be an amount not less than the sum of the cash surrender value as defined in such paragraph for an otherwise similar policy issued at the same age without such term insurance on the life of the spouse and the cash surrender value as defined in such paragraph for a policy which provides only the benefits otherwise provided by such term insurance on the life of the spouse.

IV. Any cash surrender value available within 30 days after any policy anniversary under any policy paid-up by completion of all premium payments or any policy continued under any paid-up nonforfeiture benefit, whether or not required by RSA 409:2, shall be an amount not less than the present value, on such anniversary, of the future guaranteed benefits provided for by the policy, including any existing paid-up additions, decreased by any indebtedness to the company on the policy.


Source. 1943, 89:1, par. 3. RSA 409:3. 1959, 161:1. 1981, 182:10, eff. Aug. 1, 1981.

    409:4 Minimum Nonforfeiture Benefits. 

Any paid-up nonforfeiture benefit available under the policy in the event of default in a premium payment due on any policy anniversary shall be such that its present value as of such anniversary shall be at least equal to the cash surrender value then provided for by the policy or, if none is provided for, that cash surrender value which would have been required by this chapter in the absence of the condition that premiums shall have been paid for at least a specified period.


Source. 1943, 89:1, par. 4, eff. Jan. 1, 1948.

    409:5-a Adjusted Premiums After Certain Dates. 

I. This paragraph shall not apply to ordinary policies issued on or after the operative date of RSA 409:5-b as defined in that section. In the case of ordinary policies issued on or after the operative date of this paragraph as defined in this paragraph, all adjusted premiums and present values referred to in this chapter shall be calculated on the basis of the Commissioner's 1958 Standard Ordinary Mortality Table and the rate of interest specified in the policy for calculating cash surrender values and paid-up nonforfeiture benefits, provided that such rate of interest shall not exceed 3
1/2 percent per annum, except that a rate of interest not exceeding 4 percent per annum may be used for policies issued on or after September 1, 1973, and prior to August 1, 1979, and a rate of interest not exceeding 5
1/2 percent per annum may be used for policies issued on or after August 1, 1979, and provided that for any category of ordinary insurance issued on female risks, adjusted premiums and present values may be calculated according to an age not more than 6 years younger than the actual age of the insured. Provided, however, that, in calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may not be more than those shown in the Commissioner's 1958 Extended Term Insurance Table. Provided, further, that for insurance issued on a substandard basis, the calculation of any such adjusted premiums and present values may be based on such other table of mortality as may be specified by the company and approved by the commissioner. After August 21, 1959, any company may file with the insurance commissioner a written notice of its election to comply with the provisions of this paragraph after a specified date before January 1, 1966. After the filing of such notice, then upon such specified date (which shall be the operative date of this paragraph for such company), this paragraph shall become operative with respect to the ordinary policies issued after such specified date by such company. If a company makes no such election, the operative date of this paragraph for such company shall be January 1, 1966.

II. This paragraph shall not apply to industrial policies issued on or after the operative date of RSA 409:5-b as defined in that section. In the case of industrial policies issued on or after the operative date of this paragraph as defined in this paragraph, all adjusted premiums and present values referred to in this chapter shall be calculated on the basis of the Commissioner's 1961 Standard Industrial Mortality Table and the rate of interest specified in the policy for calculating cash surrender values and paid-up nonforfeiture benefits, provided that such rate of interest shall not exceed 3
1/2 percent per annum, except that a rate of interest not exceeding 4 percent per annum may be used for policies issued on or after September 1, 1973, and prior to August 1, 1979, and a rate of interest not exceeding 5
1/2 percent per annum may be used for policies issued on or after August 1, 1979. Provided, however, that in calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may be not less than those shown in the Commissioner's 1961 Industrial Extended Term Insurance Table. Provided, further, that for insurance issued on a substandard basis, the calculations of any such adjusted premiums and present values may be based on such other table of mortality as may be specified by the company and approved by the commissioner. After August 21, 1959, any company may file with the insurance commissioner a written notice of its election to comply with the provisions of this paragraph after a specified date before January 1, 1968. After the filing of such notice, then upon such specified date (which shall be the operative date of this paragraph for such company), this paragraph shall become operative with respect to the industrial policies thereafter issued by such company. If a company makes no such election, the operative date of this paragraph for such company shall be January 1, 1968.


Source. 1959, 161:3. 1963, 34:2. 1973, 221:1. 1979, 360:3. 1981, 182:12, eff. Aug. 1, 1981.

    409:5-b Adjusted Premium After Later Dates. 

I. This section shall apply to all policies issued on or after the operative date of this section as defined in this section. Except as provided in paragraph VII of this section, the adjusted premiums for any policy shall be calculated on an annual basis and shall be such uniform percentage of the respective premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments or special hazards and also excluding any uniform annual contract charge or policy fee specified in the policy in a statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits, that the present value, at the date of issue of the policy, of all adjusted premiums shall be equal to the sum of: (a) the then present value of the future guaranteed benefits provided for by the policy; (b) one percent of either the amount of insurance, if the insurance be uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years; and (c) 125 percent of the nonforfeiture net level premium as hereafter defined. Provided, however, that in applying the percentage specified in subparagraph (c), no nonforfeiture net level premium shall be deemed to exceed 4 percent of either the amount of insurance, if the insurance is uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years. The date of issue of a policy for the purpose of this section shall be the date as of which the rated age of the insured is determined.

II. The nonforfeiture net level premium shall be equal to the present value, at the date of issue of the policy, of the guaranteed benefits provided for by the policy divided by the present value, at the date of issue of the policy, of an annuity of one per annum payable on the date of issue of the policy and on each anniversary of such policy on which a premium falls due.

III. In the case of policies which cause on a basis guaranteed in the policy unscheduled changes in benefits or premiums, or which provide an option for changes in benefits or premiums other than a change to a new policy, the adjusted premiums and present values shall initially be calculated on the assumption that future benefits and premiums do not change from those stipulated at the date of issue of the policy. At the time of any such change in the benefits or premiums, the future adjusted premiums, nonforfeiture net level premiums and present values shall be recalculated on the assumption that future benefits and premiums do not change from those stipulated by the policy immediately after the change.

IV. Except as otherwise provided in paragraph VII of this section, the recalculated future adjusted premiums for any such policy shall be such uniform percentage of the respective future premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments and special hazards, and also excluding any uniform annual contract charge or policy fee specified in the policy in a statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits, that the present value, at the time of change to the newly defined benefits or premiums, of all such future adjusted premiums shall be equal to the excess of:

(a) The sum of (1) the then present value of the then future guaranteed benefits provided for by the policy, and (2) the additional expense allowance, if any, over

(b) The then cash surrender value, if any, or present value of any paid-up nonforfeiture benefit under the policy.

V. The additional expense allowance, at the time of the change to the newly defined benefits or premiums, shall be the sum of:

(a) One percent of the excess, if positive, of the average amount of insurance at the beginning of each of the first 10 policy years subsequent to the change over the average amount of insurance prior to the change at the beginning of each of the first 10 policy years subsequent to the time of the most recent previous change, or, if there has been no previous change, the date of issue of the policy; and

(b) 125 percent of the increase, if positive, in the nonforfeiture net level premium.

VI. The recalculated nonforfeiture net level premium shall be equal to the result obtained by dividing (a) by (b) where:

(a) Equals the sum of

(1) The nonforfeiture net level premium applicable prior to the change times the present value of an annuity of one percent per annum payable on each anniversary of the policy on or subsequent to the date of the change on which a premium would have fallen due had the change not occurred, and

(2) The present value of the increase in future guaranteed benefits provided for by policy, and

(b) Equals the present value of an annuity of one percent per annum payable on each anniversary of the policy on or subsequent to the date of change on which a premium falls due.

VII. Notwithstanding any other provisions of this section to the contrary, in the case of a policy issued on a substandard basis which provides reduced graded amounts of insurance so that, in each policy year, such policy has the same tabular mortality cost as an otherwise similar policy issued on the standard basis which provides higher uniform amounts of insurance, adjusted premiums and present values for such substandard policy may be calculated as if it were issued to provide such higher uniform amounts of insurance on the standard basis.

VIII. All adjusted premiums and present values referred to in this chapter shall for all policies of ordinary insurance be calculated on the basis of the Commissioner's 1980 Standard Ordinary Mortality Table or, at the election of the company for any one or more specified plans of life insurance, the Commissioner's 1980 Standard Ordinary Mortality Table with Ten-Year Select Mortality Factors; for all policies of industrial insurance, be calculated on the basis of the Commissioner's 1961 Standard Industrial Mortality Table; and, for all policies issued in a particular calendar year, be calculated on the basis of a rate of interest not exceeding the nonforfeiture interest rate as defined in this section, for policies issued in that calendar year. Provided, however, that:

(a) At the option of the company, calculations for all policies issued in a particular calendar year may be made on the basis of a rate of interest not exceeding the nonforfeiture interest rate, as defined in this section, for policies issued in the immediately preceding calendar year.

(b) Under any paid-up nonforfeiture benefit, including any paid-up dividend additions, any cash surrender value available, whether or not required by RSA 409:2, shall be calculated on the basis of the mortality table and rate of interest used in determining the amount of such paid-up nonforfeiture benefit and paid-up dividend additions, if any.

(c) A company may calculate the amount of any guaranteed paid-up nonforfeiture benefit including any paid-up additions under the policy on the basis of an interest rate no lower than that specified in the policy for calculating cash surrender values.

(d) In calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may be not more than those shown in the Commissioner's 1980 Extended Term Insurance Table for policies of ordinary insurance, and not more than the Commissioner's 1961 Industrial Extended Term Insurance Table for policies of industrial insurance.

(e) For insurance issued on a substandard basis, the calculation of any such adjusted premiums and present values may be based on appropriate modifications of the tables previously mentioned in this section.

(f)(1) For policies issued prior to the operative date of the valuation manual, any Commissioner's Standard Ordinary Mortality Tables, adopted after 1980 by the National Association of Insurance Commissioners, that are approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum nonforfeiture standard may be substituted for the Commissioner's 1980 Standard Ordinary Mortality Table with or without Ten-Year Select Mortality Factors or for the Commissioner's 1980 Extended Term Insurance Table.

(2) For policies issued on or after the operative date of the valuation manual, the valuation manual shall provide the Standard Ordinary Mortality Table for use in determining the minimum nonforfeiture standard that may be substituted for the Commissioner's 1980 Standard Ordinary Mortality Table with or without Ten-Year Select Mortality Factors or for the Commissioner's 1980 Extended Term Insurance Table. If the commissioner approves by regulation any Commissioner's Standard Ordinary Mortality Table adopted by the National Association of Insurance Commissioners for use in determining the minimum nonforfeiture standard for policies issued on or after the operative date of the valuation manual then that minimum nonforfeiture standard supersedes the minimum nonforfeiture standard provided by the valuation manual.

(g)(1) For policies issued prior to the operative date of the valuation manual, any commissioner's standard industrial mortality tables, adopted after 1980 by the National Association of Insurance Commissioners, that are approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum nonforfeiture standard may be substituted for the Commissioner's 1961 Standard Industrial Mortality Table or the Commissioner's 1961 Industrial Extended Term Insurance Table.

(2) For policies issued on or after the operative date of the valuation manual the valuation manual shall provide the Commissioner's Standard Mortality Table for use in determining the minimum nonforfeiture standard that may be substituted for the Commissioner's 1961 Standard Industrial Mortality Table or the Commissioner's 1961 Industrial Extended Term Insurance Table. If the commissioner approves by regulation any Commissioner's Standard Industrial Mortality Table adopted by the National Association of Insurance Commissioners for use in determining the minimum nonforfeiture standard for policies issued on or after the operative date of the valuation manual then that minimum nonforfeiture standard supersedes the minimum nonforfeiture standard provided by the valuation manual.

IX. The nonforfeiture interest rate is defined below:

(1) For policies issued prior to the operative date of the valuation manual, the nonforfeiture interest rate per annum for any policy issued in a particular calendar year shall be equal to 125 percent of the calendar year statutory valuation interest rate for such policy as defined in RSA 410 rounded to the nearer 
1/4 of one percent.

(2) For policies issued on or after the operative date of the valuation manual the nonforfeiture interest rate per annum for any policy issued in a particular calendar year shall be provided by the valuation manual.

X. Notwithstanding any other provision of law to the contrary, any refiling of nonforfeiture values or their methods of computation for any previously approved policy form which involves only a change in the interest rate or mortality table used to compute nonforfeiture values shall not require refiling of any other provisions of that policy form.

XI. After August 1, 1981, any company may file with the commissioner a written notice of its election to comply with the provision of this section after a specified date before January 1, 1989, which shall be the operative date of this section for such company. If a company makes no such election, the operative date of this section for such company shall be January 1, 1989.


Source. 1981, 182:13. 2013, 221:3, 4, eff. Jan. 1, 2014.

    409:5-c Commissioner's Authority to Approve Certain Plans. 

In the case of any plan of life insurance which provides for future premium determination, the amounts of which are to be determined by the insurance company based on then estimates of future experience, or in the case of any plan of life insurance which is of such a nature that minimum values cannot be determined by the methods described in RSA 409:2, 409:4, 409:5, 409:5-a, or 409:5-b, then:

I. The commissioner must be satisfied that the benefits provided under the plan are substantially as favorable to policyholders and insureds as the minimum benefits otherwise required by RSA 409:2, 409:3, 409:4, 409:5, 409:5-a, or 409:5-b;

II. The commissioner must be satisfied that the benefits and the pattern of premiums of that plan are not such as to mislead prospective policyholders or insureds;

III. The cash surrender values and paid-up nonforfeiture benefits provided by such plan must not be less than the minimum values and benefits required for the plan computed by a method consistent with the principles of this chapter, as determined by rules adopted by the commissioner pursuant to RSA 541-A.


Source. 1981, 182:13, eff. Aug. 1, 1981.

    409:5 Adjusted Premiums. 

I. This section shall not apply to policies issued on or after the operative date of RSA 409:5-b as defined in that section. Except as provided in paragraph III of this section, the adjusted premiums for any policy shall be calculated on an annual basis and shall be such uniform percentage of the respective premiums specified in the policy for each policy year, excluding amounts stated in the policy as extra premiums to cover impairments or special hazards, that the present value, at the date of issue of the policy, of all such adjusted premiums shall be equal to the sum of (a) the then present value of the future guaranteed benefits provided for by the policy; (b) 2 percent of the amount of insurance, if the insurance be uniform in amount, or of the equivalent uniform amount, as hereinafter defined, if the amount of insurance varies with duration of the policy; (c) 40 percent of the adjusted premium for the first policy year; (d) 25 percent of either the adjusted premium for the first policy year or the adjusted premium for a whole life policy of the same uniform or equivalent uniform amount with uniform premiums for the whole of life issued at the same age for the same amount of insurance, whichever is less. Provided, however, that in applying the percentages specified in subparagraphs (c) and (d), no adjusted premium shall be deemed to exceed 4 percent of the amount of insurance or level amount equivalent to such percentage. The date of issue of a policy for the purpose of this section shall be the date as of which the rated age of the insured is determined.

II. In the case of a policy providing an amount of insurance varying with duration of the policy, the equivalent level amount of such insurance for the purpose of this section shall be deemed to be the level amount of insurance provided by an otherwise similar policy, containing the same endowment benefit or benefits, if any, issued at the same age and for the same term, the amount of which does not vary with duration and the benefits under which have the same present value at the inception of the insurance as the benefits under the policy; provided, however, that, in the case of a policy providing a varying amount of insurance issued on the life of a child under age 10, the equivalent uniform amount may be computed as though the amount of insurance provided by the policy prior to the attainment of age 10 were the amount provided by such policy at age 10.

III. The adjusted premiums for any policy providing term insurance benefits by rider or supplemental policy provision shall be equal to: (a) the adjusted premiums for an otherwise similar policy issued at the same age without such term insurance benefits, increased, during the period for which premiums for such term insurance benefits are payable, by (b) the adjusted premiums for such term insurance, the foregoing items (a) and (b) being calculated separately and as specified in paragraphs I and II of this section except that, for the purposes of (b), (c) and (d) of paragraph I, the amount of insurance or equivalent uniform amount of insurance used in the calculation of the adjusted premiums referred to in subparagraph (b) of this paragraph shall be equal to the excess of the corresponding amount determined for the entire policy over the amount used in the calculation of the adjusted premiums in subparagraph (a) of this paragraph.

IV. Except as otherwise provided in RSA 409:5-a, all adjusted premiums and present values referred to in this chapter shall, for all policies of ordinary insurance, be calculated on the basis of the Commissioner's 1941 Standard Ordinary Mortality Table, provided that for any category of ordinary insurance issued on female risks, adjusted premiums and present values may be calculated according to an age not more than 3 years younger than the actual age of the insured, and such calculations for all policies of industrial insurance shall be made on the basis of the 1941 Standard Industrial Mortality Table. All calculations shall be made on the basis of the rate of interest, not exceeding 3-
1/2 percent per annum, specified in the policy for calculating cash surrender values and paid-up nonforfeiture benefits. Provided, however, that in calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may be not more than 130 percent of the rates of mortality according to such applicable table. Provided, further, that for insurance issued on a substandard basis, the calculation of any such adjusted premiums and present values may be based on such other table of mortality as may be specified by the company and approved by the commissioner.


Source. 1943, 89:1, par. 5. RSA 409:5. 1959, 161:2. 1961, 75:2. 1963, 34:1. 1981, 182:11, eff. Aug. 1, 1981.

    409:6-a Additional Standards. 

I. This section, in addition to all other applicable sections of this chapter, shall apply to all policies issued on or after January 1, 1985. Any cash surrender value available under the policy in the event of default in a premium payment due on any policy anniversary shall be in the amount which does not differ by more than 
2/10 of one percent of either the amount of insurance, if the insurance is uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years, from the sum of:

(a) The greater of zero and the basic cash value hereafter specified, and

(b) The present value of any existing paid-up additions less the amount of any indebtedness to the company under the policy.

II. The basic cash value shall be equal to the present value, on such anniversary, of the future guaranteed benefits which would have been provided for by the policy, excluding any existing paid-up additions and before deduction of any indebtedness to the company, if there had been no default, less the then present value of the nonforfeiture factors, as defined in paragraph III, corresponding to premiums which would have fallen due on and after such anniversary. Provided, however, that the effects on the basic cash value of supplemental life insurance or annuity benefits or of family coverage, as described in RSA 409:3 or 409:5, whichever is applicable, shall be the same as are the effects specified in RSA 409:3 or 409:5, whichever is applicable, on the cash surrender values defined in those sections.

III. The nonforfeiture factor for each policy year shall be an amount equal to a percentage of the adjusted premium for the policy year, as defined in RSA 409:5 or 409:5-b, whichever is applicable. Except as is required by paragraph IV of this section, such percentage:

(a) Must be the same percentage for each policy year between the second policy anniversary and the later of (1) the fifth policy anniversary, and (2) the first policy anniversary at which there is available under the policy a cash surrender value in an amount, before including any paid-up additions and before deducting any indebtedness, of at least 
2/10 of one percent of either the amount of insurance, if the insurance be uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years; and

(b) Must be such that no percentage after the later of the 2 policy anniversaries specified in subparagraph (a) may apply to fewer than 5 consecutive policy years.

IV. Provided, that no basic cash value may be less than the value which would be obtained if the adjusted premiums for the policy, as defined in RSA 409:5 or 409:5-b, whichever is applicable, were substituted for the nonforfeiture factors in the calculation of the basic cash value.

V. All adjusted premiums and present values referred to in this section shall for a particular policy be calculated on the same mortality and interest bases as are used in demonstrating the policy's compliance with the other sections of this chapter. The cash surrender values referred to in this section shall include any endowment benefits provided for by the policy.

VI. Any cash surrender value available other than in the event of default in a premium payment due on a policy anniversary, and the amount of any paid-up nonforfeiture benefit available under the policy in the event of default in a premium payment shall be determined in manners consistent with the manners specified for determining the analogous minimum amounts in RSA 409:2, 409:3, 409:4, 409:5-b and 409:6. The amounts of any cash surrender values and of any paid-up nonforfeiture benefits granted in connection with additional benefits such as those listed in RSA 409:6, I-VI, shall conform with the principles of this section.


Source. 1981, 182:15, eff. Aug. 1, 1981.

    409:6 Method of Calculating Cash Surrender Values and Nonforfeiture Benefits. 

Any cash surrender value and any paid-up nonforfeiture benefit, available under the policy in the event of default in a premium payment due at any time other than on the policy anniversary shall be calculated with allowance for the lapse of time and the payment of fractional premiums beyond the last preceding policy anniversary. All values referred to in RSA 409:3, 409:4, 409:5, 409:5-a, and 409:5-b may be calculated upon the assumption that any death benefit is payable at the end of the policy year of death. The net value of any paid-up additions, other than paid-up term additions, shall be not less than the amounts used to provide such additions. Notwithstanding the provisions of RSA 409:3, additional benefits under the following circumstances shall be disregarded in ascertaining cash surrender values and nonforfeiture benefits required by this chapter; and no such additional benefits shall be required to be included in any paid-up nonforfeiture benefits:

I. In the event of death or dismemberment by accident or accidental means;

II. In the event of total and permanent disability;

III. As reversionary annuity or deferred reversionary annuity benefits;

IV. As term insurance benefits provided by a rider or supplemental policy provision to which, if issued as a separate policy, this chapter would not apply;

V. As term insurance on the life of a child or on the lives of children provided in a policy on the life of a parent of the child, if such term insurance expires before the child's age is 26, is uniform in amount after the child's age is one, and has not become paid-up by reason of the death of a parent of the child; and

VI. As other policy benefits additional to life insurance and endowment benefits, and premiums for all such additional benefits.


Source. 1943, 89:1, par. 6. RSA 409:6. 1959, 161:4. 1961, 75:3. 1981, 182:14, eff. Aug. 1, 1981.

    409:7 Chapter Not Applicable to Certain Contracts. 

I. This chapter shall not apply to any of the following:

(a) Reinsurance;

(b) Group insurance;

(c) Pure endowment;

(d) Annuity or reversionary annuity contract;

(e) Term policy of uniform amount, which provides no guaranteed nonforfeiture or endowment benefits, or renewal thereof, of 20 years or less expiring before age 71, for which uniform premiums are payable during the entire term of the policy;

(f) Term policy of decreasing amount, which provides no guaranteed nonforfeiture or endowment benefits, on which each adjusted premium, calculated as specified in RSA 409:5, 409:5-a, and 409:5-b, is less than the adjusted premium so calculated, on a term policy of uniform amount, or renewal of such policy, which provides no guaranteed nonforfeiture or endowment benefits, issued at the same age and for the same initial amount of insurance and for a term of 20 years or less expiring before age 71, for which uniform premiums are payable during the entire term of the policy;

(g) Policy, which provides no guaranteed nonforfeiture or endowment benefits, for which no cash surrender value, if any, or present value of any paid-up nonforfeiture benefit, at the beginning of any policy year, calculated as specified in RSA 409:3, 409:4, 409:5, 409:5-a, and 409:5-b, exceeds 2
1/2 percent of the amount of insurance at the beginning of the same policy year; nor

(h) Policy which shall be delivered outside this state through an agent or other representative of the company issuing the policy.

II. For purposes of determining the applicability of this chapter, the age at expiry for a joint term life insurance policy shall be the age at expiry of the oldest life.


Source. 1943, 89:1, par. 7. RSA 409:7. 1959, 161:5. 1981, 182:16, eff. Aug. 1, 1981.

    409:8 Operative Date Defined. 

Except as otherwise provided in RSA 409:5-a and 5-b, any life insurance company authorized to do business in this state may file with the insurance commissioner a written notice of its intention to comply with the provisions of this chapter on and after a specified date prior to January 1, 1948. After the filing of such notice, then upon such specified date, which shall be the operative date of this chapter for such company, this chapter shall become operative with respect to policies issued after such date by such company. As to such companies making no such election, the operative date of this chapter shall be January 1, 1948.


Source. 1943, 89:1, par. 8. RSA 409:8. 1959, 161:6. 1981, 182:17, eff. Aug. 1, 1981.

    410:1 Short Title. 

This chapter shall be known as the Standard Valuation Law.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:10 Minimum Reserves. 

I. In no event shall a company's aggregate reserves for all life insurance policies, excluding disability and accidental death benefits, issued on or after the effective date of this chapter, be less than the aggregate reserves calculated in accordance with the methods set forth in RSA 410:8, RSA 410:9, RSA 410:12 and RSA 410:13 and the mortality table or tables and rate or rates of interest used in calculating nonforfeiture benefits for the policies.

II. In no event shall the aggregate reserves for all policies, contracts, and benefits be less than the aggregate reserves determined by the appointed actuary to be necessary to render the opinion required by RSA 410:4.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:11 Optional Reserve Calculation. 

I. Reserves for policies and contracts issued prior to the effective date of this chapter may be calculated, at the option of the company, according to any standards that produce greater aggregate reserves for all such policies and contracts than the minimum reserves required by the laws in effect immediately prior to that date.

II. Reserves for any category of policies, contracts, or benefits as established by the commissioner, issued on or after the effective date of this chapter, may be calculated, at the option of the company, according to any standards that produce greater aggregate reserves for the category than those calculated according to the minimum standard provided herein, but the rate or rates of interest used for policies and contracts, other than annuity and pure endowment contracts, shall not be greater than the corresponding rate or rates of interest used in calculating any nonforfeiture benefits provided for in the policies or contract.

III. A company, which adopts at any time a standard of valuation producing greater aggregate reserves than those calculated according to the minimum standard provided under this chapter may adopt a lower standard of valuation with the approval of the commissioner, but not lower than the minimum provided herein. Provided that, for the purposes of this section, the holding of additional reserves previously determined by the appointed actuary to be necessary to render the opinion required by RSA 410:4 shall not be deemed to be the adoption of a higher standard of valuation.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:12 Reserve Calculation;  Valuation Net Premium Exceeding the Gross Premium Charged. 

I. If in any contract year the gross premium charged by a company on any policy or contract is less than the valuation net premium for the policy or contract calculated by the method used in calculating the reserve but using the minimum valuation standards of mortality and rate of interest, the minimum reserve required for the policy or contract shall be the greater of either the reserve calculated according to the mortality table, rate of interest, and method actually used for the policy or contract, or the reserve calculated by the method actually used for the policy or contract but using the minimum valuation standards of mortality and rate of interest and replacing the valuation net premium by the actual gross premium in each contract year for which the valuation net premium exceeds the actual gross premium. The minimum valuation standards of mortality and rate of interest referred to in this section are those standards stated in RSA 410:5 and RSA 410:7.

II. For a life insurance policy issued on or after January 1, 1985, for which the gross premium in the first policy year exceeds that of the second year and for which no comparable additional benefit is provided in the first year for the excess and which provides an endowment benefit or a cash surrender value or a combination in an amount greater than the excess premium, the provisions of this section shall be applied as if the method actually used in calculating the reserve for such policy were the method described in RSA 410:8, I. The minimum reserve at each policy anniversary of such a policy shall be the greater of the minimum reserve calculated in accordance with RSA 410:8, I and II, and the minimum reserve calculated in accordance with this section.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:13 Reserve Calculation;  Indeterminate Premium Plans. 

In the case of a plan of life insurance that provides for future premium determination, the amounts of which are to be determined by the insurance company based on its estimates of future experience, or in the case of a plan of life insurance or annuity that is of such a nature that the minimum reserves cannot be determined by the methods described in RSA 410:8, 410:9 and 410:12, the reserves that are held under the plan shall:

I. Be appropriate in relation to the benefits and the pattern of premiums for that plan; and

II. Be computed by a method that is consistent with the principles of this chapter as determined by rules adopted by the commissioner pursuant to RSA 541-A.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:14 Minimum Standard for Accident and Health Insurance Contracts. 

For accident and health insurance contracts used on or after the operative date of the valuation manual, the standard prescribed in the valuation manual is the minimum standard of valuation required under RSA 410:3, II. For insurance contracts issued on or after April 7, 1943 and prior to the operative date of the valuation manual the minimum standard of valuation is the standard adopted by the commissioner by rule.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:15 Valuation Manual for Policies Issued On or After the Operative Date of the Valuation Manual. 

I. For policies issued on or after the operative date of the valuation manual, the standard prescribed in the valuation manual is the minimum standard of valuation required under RSA 410:3, II, except as provided under RSA 410:15, V or VII.

II. The operative date of the valuation manual is January 1 of the first calendar year following the first July 1 as of which all of the following have occurred:

(a) The valuation manual has been adopted by the NAIC by an affirmative vote of at least 42 members, or 
3/4 of the members voting, whichever is greater.

(b) The standard valuation law, as amended by the NAIC in 2009, or legislation including substantially similar terms and provisions, has been enacted by states representing greater than 75 percent of the direct premiums written as reported in the following annual statements submitted for 2008: life, accident and health annual statements; health annual statements; or fraternal annual statements.

(c) The standard valuation law, as amended by the NAIC in 2009, or legislation including substantially similar terms and provisions, has been enacted by at least 42 states of the following 55 jurisdictions: The 50 states of the United States, American Samoa, the American Virgin Islands, the District of Columbia, Guam, and Puerto Rico.

III. Unless a change in the valuation manual specifies a later effective date, changes to the valuation manual shall be effective on January 1 following the date when the change to the valuation manual has been adopted by the NAIC by an affirmative vote representing:

(a) At least 
3/4 of the members of the NAIC voting, but not less than a majority of the total membership; and

(b) Members of the NAIC representing jurisdictions totaling greater than 75 percent of the direct premiums written as reported in the following annual statements most recently available prior to the vote in subparagraph III(a): life, accident and health annual statements, health annual statements, or fraternal annual statements.

IV. The valuation manual shall specify all of the following:

(a) Minimum valuation standards for and definitions of the policies or contracts subject to RSA 410:3, II. Such minimum valuation standards shall be:

(1) The commissioner's reserve valuation method for life insurance contracts, other than annuity contracts, subject to RSA 410:3, II;

(2) The commissioner's annuity reserve valuation method for annuity contracts subject to RSA 410:3, II; and

(3) Minimum reserves for all other policies or contracts subject to RSA 410:3, II.

(b) Which policies or contracts or types of policies or contracts are subject to the requirements of a principle-based valuation in RSA 410:16, I and the minimum valuation standards consistent with those requirements.

(c) For policies and contracts subject to a principle-based valuation under RSA 410:16:

(1) Requirements for the format of reports to the commissioner under RSA 410:16, II(c) and which shall include information necessary to determine if the valuation is appropriate and in compliance with this chapter;

(2) Assumptions which shall be prescribed for risks over which the company does not have significant control or influence;

(3) Procedures for corporate governance and oversight of the actuarial function, and a process for appropriate waiver or modification of such procedures.

(d) For policies not subject to a principle-based valuation under RSA 410:16 the minimum valuation standard shall either:

(1) Be consistent with the minimum standard of valuation prior to the operative date of the valuation manual; or

(2) Develop reserves that quantify the benefits and guarantees, and the funding, associated with the contracts and their risks at a level of conservatism that reflects conditions that include unfavorable events that have a reasonable probability of occurring.

(e) Other requirements, including, but not limited to, those relating to reserve methods, models for measuring risk, generation of economic scenarios, assumptions, margins, use of company experience, risk measurement, disclosure, certifications, reports, actuarial opinions and memorandums, transition rules and internal controls; and

(f) The data and form of the data required under RSA 410:17, with whom the data must be submitted, and may specify other requirements including data analyses and reporting of analyses.

V. In the absence of a specific valuation requirement or if a specific valuation requirement in the valuation manual is not, in the opinion of the commissioner, in compliance with this chapter, then the company shall, with respect to such requirements, comply with minimum valuation standards adopted by the commissioner by rule.

VI. The commissioner may engage a qualified actuary, at the expense of the company, to perform an actuarial examination of the company and comment on the appropriateness of any reserve assumption or method used by the company, or to review and comment on a company's compliance with any requirement set forth in this chapter. The commissioner may rely upon the opinion, regarding provisions contained within this chapter, from a qualified actuary engaged by the commissioner of another state, district or territory of the United States. In this paragraph, the term "
engage
" includes employment and contracting.

VII. The commissioner may require a company to change any assumption or method that in the opinion of the commissioner is necessary in order to comply with the requirements of the valuation manual or this chapter; and the company shall adjust the reserves as required by the commissioner. The commissioner may take other disciplinary action as permitted pursuant to RSA 400-A:15, III and RSA 400-A:16, V.


Source. 2013, 221:1. 2014, 84:2, eff. Aug. 10, 2014.

    410:16 Requirements of a Principle-Based Valuation. 

I. A company shall establish reserves using a principle-based valuation that meets the following conditions for policies or contracts as specified in the valuation manual:

(a) Quantify the benefits and guarantees, and the funding, associated with the contracts and their risks at a level of conservatism that reflects conditions that include unfavorable events that have a reasonable probability of occurring during the lifetime of the contracts. For policies or contracts with significant tail risk, reflects conditions appropriately adverse to quantify the tail risk.

(b) Incorporate assumptions, risk analysis methods and financial models and management techniques that are consistent with, but not necessarily identical to, those utilized within the company's overall risk assessment process, while recognizing potential differences in financial reporting structures and any prescribed assumptions or methods.

(c) Incorporate assumptions that are derived in one of the following manners:

(1) The assumption is prescribed in the valuation manual.

(2) For assumptions that are not prescribed, the assumption shall:

(A) Be established utilizing the company's available experience, to the extent it is relevant and statistically credible; or

(B) To the extent that company data is not available, relevant, or statistically credible, be established utilizing other relevant, statistically credible experience.

II. A company using a principle-based valuation for one or more policies or contracts subject to this section as specified in the valuation manual shall:

(a) Establish procedures for corporate governance and oversight of the actuarial valuation function consistent with those described in the valuation manual.

(b) Provide to the commissioner and the board of directors an annual certification of the effectiveness of the internal controls with respect to the principle-based evaluation. Such controls shall be designed to assure that all material risks inherent in the liabilities and associated assets subject to such valuation are included in the valuation, and that valuations are made in accordance with the valuation manual. The certification shall be based on the controls in place as of the end of the preceding calendar year.

(c) Develop, and file with the commissioner upon request, a principle-based valuation report that complies with standards prescribed in the valuation manual.

III. A principle-based valuation may include a prescribed formulaic reserve component.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:17 Experience Reporting for Policies in Force On or After the Operative Date of the Valuation Manual. 

A company shall submit mortality, morbidity, policyholder behavior, or expense experience and other data as prescribed in the valuation manual.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:18 Confidentiality. 

I. In this section, "
confidential information
" means:

(a) A memorandum in support of an opinion submitted under RSA 410:4 and any other document, materials and other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in connection with such memorandum;

(b) All documents, materials and other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in the course of an examination made under RSA 410:15, VI; provided, however, that if an examination report or other material prepared in connection with an examination made under RSA 410:15, VI is not held as private and confidential information under RSA 400-A:37, an examination report or other material prepared in connection with an examination made under RSA 410:15, VI shall not be "confidential information" to the same extent as if such examination report or other material had been prepared under RSA 400-A:37;

(c) Any reports, documents, materials and other information developed by a company in support of, or in connection with, an annual certification by the company under RSA 410:16, II(b) evaluating the effectiveness of the company's internal controls with respect to a principle-based valuation and any other documents, materials and other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in connection with such reports, documents, materials and other information;

(d) Any principle-based valuation report developed under RSA 410:16, II(c) and any other documents, materials and other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in connection with such report; and

(e) Any documents, materials, data, and other information submitted by a company under RSA 410:17, collectively, "experience data," and any other documents, materials, data, and other information, including, but not limited to, all working papers, and copies thereof, created or produced in connection with such experience data, in each case that include any potentially company-identifying or personally identifiable information, that is provided to or obtained by the commissioner (together with any "experience data," the "experience materials") and any other documents, materials, data, and other information, including, but not limited to, all working papers, and copies thereof, created, produced or obtained by or disclosed to the commissioner or any other person in connection with such experience materials.

II. Privilege for, and Confidentiality of, Confidential Information.

(a) Except as provided in RSA 410:18, a company's confidential information is confidential by law and privileged, and shall not be subject to RSA 91-A, shall not be subject to subpoena and shall not be subject to discovery or admissible in evidence in any private civil action; provided, however, that the commissioner is authorized to use the confidential information in the furtherance of any regulatory or legal action brought against the company as a part of the commissioner's official duties.

(b) Neither the commissioner nor any person who received confidential information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential information.

(c) In order to assist in the performance of the commissioner's duties, the commissioner may share confidential information (1) with other state, federal, and international regulatory agencies and with the NAIC and its affiliates and subsidiaries and (2) in the case of confidential information specified in RSA 410:18 I(a) and (d) only, with the actuarial board for counseling and discipline or its successor upon request stating that the confidential information is required for the purpose of professional disciplinary proceedings and with state, federal and international law enforcements officials; in the case of (1) and (2), provided that such recipient agrees, and has the legal authority to agree, to maintain the confidentiality and privileged status of such documents, materials, data and other information in the same manner and to the same extent as required for the commissioner.

(d) The commissioner may receive documents, materials, data, and other information, including otherwise confidential and privileged documents, materials, data or information, from the NAIC and its affiliates and subsidiaries, from regulatory or law enforcement officials of other foreign or domestic jurisdictions and from the actuarial board for counseling and discipline or its successor and shall maintain as confidential or privileged any document, material, data, or other information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or other information.

(e) The commissioner may enter into agreements governing sharing and use of information consistent with RSA 410:18, II.

(f) No waiver of any applicable privilege or claim of confidentiality in the confidential information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in RSA 410:18, II(c).

(g) A privilege established under the law of any state or jurisdiction that is substantially similar to the privilege established under RSA 410:18, II shall be available and enforced in any proceeding in, and in any court of, this state.

(h) In this section "regulatory agency," "law enforcement agency" and the "NAIC" include, but are not limited to, their employees, agents, consultants and contractors.

III. Notwithstanding RSA 410:18, II, any confidential information specified in RSA 410:18, I(a) and (d):

(a) May be subject to subpoena for the purpose of defending an action seeking damages from the appointed actuary submitting the related memorandum in support of an opinion submitted under RSA 410:4 or principle-based valuation report developed under RSA 410:16, II(c) by reason of an action required by this chapter or by rules adopted under this chapter;

(b) May otherwise be released by the commissioner with the written consent of the company; and

(c) Once any portion of a memorandum in support of an opinion submitted under RSA 410:4 or a principle-based valuation report developed under RSA 410:16, II(c) is cited by the company in its marketing or is publicly volunteered to or before a governmental agency other than a state insurance department or is released by the company to the news media, all portions of such memorandum or report shall no longer be confidential.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:2 Definitions. 

In this chapter:

I. "
Accident and health insurance
" means contracts that incorporate morbidity risk and provide protection against economic loss resulting from accident, sickness, or medical conditions and as may be specified in the valuation manual.

II. "
Appointed actuary
" means a qualified actuary who is appointed in accordance with the valuation manual to prepare the actuarial opinion required in RSA 410:4, II.

III. "
Company
" means an entity which:

(a) Has written, issued, or reinsured life insurance contracts, accident and health insurance contracts, or deposit-type contracts in this state and has at least one such policy in force or on claim; or

(b) Has written, issued, or reinsured life insurance contracts, accident and health insurance contracts, or deposit-type contracts in any state and is required to hold a certificate of authority to write life insurance, accident and health insurance, or deposit-type contracts in this state.

IV. "
Commissioner
" means the insurance commissioner.

V. "
Deposit-type contract
" means contracts that do not incorporate mortality or morbidity risks and as may be specified in the valuation manual.

VI. "
Life insurance
" means contracts that incorporate mortality risk, including annuity and pure endowment contracts, and as may be specified in the valuation manual.

VII. "
NAIC
" means the National Association of Insurance Commissioners.

VIII. "
Policyholder behavior
" means any action a policyholder, contract holder or any other person with the right to elect options, such as a certificate holder, may take under a policy or contract subject to this chapter including, but not limited to, lapse, withdrawal, transfer, deposit, premium payment, loan, annuitization, or benefit elections prescribed by the policy or contract but excluding events of mortality or morbidity that result in benefits prescribed in their essential aspects by the terms of the policy or contract.

IX. "
Principle-based valuation
" means a reserve valuation that uses one or more methods or one or more assumptions determined by the insurer and is required to comply with RSA 410:16 as specified in the valuation manual.

X. "
Qualified actuary
" means an individual who is qualified to sign the applicable statement of actuarial opinion in accordance with the American Academy of Actuaries qualification standards for actuaries signing such statements and who meets the requirements specified in the valuation manual.

XI. "
Tail risk
" means a risk that occurs either where the frequency of low probability events is higher than expected under a normal probability distribution or where there are observed events of very significant size or magnitude.

XII. "
Valuation manual
" means the manual of valuation instructions adopted by the NAIC as specified in this chapter or as subsequently amended.


Source. 2013, 221:1. 2014, 84:1, eff. Aug. 10, 2014.

    410:3 Reserve Valuation. 

I. Policies and Contracts Issued Prior to the Operative Date of the Valuation Manual.

(a) The insurance commissioner shall annually value, or cause to be valued, the reserve liabilities (hereinafter called reserves) for all outstanding life insurance policies and annuity and pure endowment contracts of every life insurance company doing business in this state, except that in the case of an alien company, such valuation shall be limited to its United States business, issued on or after April 7, 1943 and prior to the operative date of the valuation manual. In calculating reserves, the commissioner may use group methods and approximate averages for fractions of a year or otherwise. In lieu of the valuation of the reserves required of a foreign or alien company, the commissioner may accept any valuation made, or caused to be made, by the insurance supervisory official of any state or other jurisdiction when the valuation complies with the minimum standard provided in this chapter.

(b) The provisions set forth in RSA 410:5 through RSA 410:14 of this chapter shall apply to all policies and contracts, as appropriate, subject to this chapter issued on or after April 7, 1943 and prior to the operative date of the valuation manual and the provisions set forth in RSA 410:15 and RSA 410:16 of this chapter shall not apply to any such policies and contracts.

(c) The minimum standard for the valuation of policies and contracts issued prior to April 7, 1943 shall be that provided by the laws in effect immediately prior to that date.

II. Policies and Contracts Issued On or After the Operative Date of the Valuation Manual.

(a) The commissioner shall annually value, or cause to be valued, the reserve liabilities (hereinafter called reserves) for all outstanding life insurance contracts, annuity and pure endowment contracts, accident and health contracts, and deposit-type contracts of every company issued on or after the operative date of the valuation manual. In lieu of the valuation of the reserves required of a foreign or alien company, the commissioner may accept a valuation made, or caused to be made, by the insurance supervisory official of any state or other jurisdiction when the valuation complies with the minimum standard provided in this chapter.

(b) The provisions set forth in RSA 410:15 and RSA 410:16 of this chapter shall apply to all policies and contracts issued on or after the operative date of the valuation manual.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:4 Actuarial Opinion of Reserves. 

I. Actuarial Opinion Prior to Operative Date of the Valuation Manual.

(a) General. Every life insurance company doing business in this state shall annually submit the opinion of a qualified actuary as to whether the reserves and related actuarial items held in support of the policies and contracts specified by the commissioner by rule are computed appropriately, are based on assumptions that satisfy contractual provisions, are consistent with prior reported amounts, and comply with applicable laws of this state. The commissioner shall define by rule the specifics of this opinion and add any other items deemed to be necessary to its scope.

(b) Actuarial Analysis of Reserves and Assets Supporting Reserves.

(1) Every life insurance company, except as exempted by rule, shall also annually include in the opinion required by paragraph I, an opinion of the same qualified actuary as to whether the reserves and related actuarial items held in support of the policies and contracts specified by the commissioner by rule, when considered in light of the assets held by the company with respect to the reserves and related actuarial items, including but not limited to the investment earnings on the assets and the considerations anticipated to be received and retained under the policies and contracts, make adequate provision for the company's obligations under the policies and contracts, including but not limited to the benefits under and expenses associated with the policies and contracts.

(2) The commissioner may provide by rule for a transition period for establishing any higher reserves that the qualified actuary may deem necessary in order to render the opinion required by this section.

(c) Requirement for Opinion Under Paragraph II. Each opinion required by paragraph II shall be governed by the following provisions:

(1) A memorandum, in form and substance acceptable to the commissioner as specified by rule, shall be prepared to support each actuarial opinion.

(2) If the insurance company fails to provide a supporting memorandum at the request of the commissioner within a period specified by rule or the commissioner determines that the supporting memorandum provided by the insurance company fails to meet the standards prescribed by the rules or is otherwise unacceptable to the commissioner, the commissioner may engage a qualified actuary at the expense of the company to review the opinion and the basis for the opinion and prepare such supporting memorandum as is required by the commissioner.

(d) Requirement for All Opinions Subject to RSA 410:4, I. Every opinion required by RSA 410:4, I shall be governed by the following provisions:

(1) The opinion shall be submitted with the annual statement reflecting the valuation of such reserve liabilities for each year ending on or after December 31, 1996.

(2) The opinion shall apply to all business in force including individual and group health insurance plans, in form and substance acceptable to the commissioner as specified by rule.

(3) The opinion shall be based on standards adopted from time to time by the Actuarial Standards Board and on such additional standards as the commissioner may by rule prescribe.

(4) In the case of an opinion required to be submitted by a foreign or alien company, the commissioner may accept the opinion filed by that company with the insurance supervisory official of another state if the commissioner determines that the opinion reasonably meets the requirements applicable to a company domiciled in this state.

(5) For the purposes of this section, "
qualified actuary
" means a member in good standing of the American Academy of Actuaries who meets the requirements set forth in the regulation.

(6) Except in cases of fraud or willful misconduct, the qualified actuary shall not be liable for damages to any person, other than the insurance company and the commissioner, for any act, error, omission, decision or conduct with respect to the actuary's opinion.

(7) Disciplinary action by the commissioner against the company or the qualified actuary shall be defined in rules by the commissioner.

(8) Except as provided in subparagraphs (12), (13) and (14), documents, materials or other information in the possession or control of the insurance department that are a memorandum in support of the opinion, and any other material provided by the company to the commissioner in connection with the memorandum, shall be kept confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's official duties.

(9) Neither the commissioner nor any person who received documents, materials or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials or information subject to subparagraph (8).

(10) In order to assist in the performance of the commissioner's duties, the commissioner:

(A) May share documents, materials or other information, including the confidential and privileged documents, materials or information subject to paragraph (8) with other state, federal and international regulatory agencies, with the National Association of Insurance Commissioners and its affiliates and subsidiaries, and with state, federal and international law enforcement authorities, provided that the recipient agrees to maintain the confidentiality and privileged status of the document, material or other information;

(B) May receive documents, materials or information, including otherwise confidential and privileged documents, materials or information, from the National Association of Insurance Commissioners and its affiliates and subsidiaries, and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material or information; and

(C) May enter into agreements governing sharing and use of information consistent with subparagraphs (8) to (10).

(11) No waiver of any applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in subparagraph (10).

(12) A memorandum in support of the opinion, and any other material provided by the company to the commissioner in connection with the memorandum, may be subject to subpoena for the purpose of defending an action seeking damages from the actuary submitting the memorandum by reason of an action required by this section or by rules adopted pursuant to this section.

(13) The memorandum or other material may otherwise be released by the commissioner with the written consent of the company or to the American Academy of Actuaries upon request stating that the memorandum or other material is required for the purpose of professional disciplinary proceedings and setting forth procedures satisfactory to the commissioner for preserving the confidentiality of the memorandum or other material.

(14) Once any portion of the confidential memorandum is cited by the company in its marketing or is cited before a governmental agency other than a state insurance department or is released by the company to the news media, all portions of the confidential memorandum shall be no longer confidential.

II. Actuarial Opinion of Reserves After the Operative Date of the Valuation Manual.

(a) General. Every company with outstanding life insurance contracts, accident and health insurance contracts or deposit-type contracts in this state and subject to regulation by the commissioner shall annually submit the opinion of the appointed actuary as to whether the reserves and related actuarial items held in support of the policies and contracts are computed appropriately, are based on assumptions that satisfy contractual provisions, are consistent with prior reported amounts and comply with applicable laws of this state. The valuation manual will prescribe the specifics of this opinion including any items deemed to be necessary to its scope.

(b) Actuarial Analysis of Reserves and Assets Supporting Reserves. Every company with outstanding life insurance contracts, accident and health insurance contracts or deposit-type contracts in this state and subject to regulation by the commissioner, except as exempted in the valuation manual, shall also annually include in the opinion required by subparagraph (a), an opinion of the same appointed actuary as to whether the reserves and related actuarial items held in support of the policies and contracts specified in the valuation manual, when considered in light of the assets held by the company with respect to the services and related actuarial items, including, but not limited to, the investment earnings on the assets and the considerations anticipated to be received and retained under the policies and contracts, make adequate provision for the company's obligations under the policies and contracts, including but not limited to the benefits under and expenses associated with the policies and contracts.

(c) Requirements for Opinions Subject to RSA 410:4, II(b). Each opinion required by paragraph II shall be governed by the following provisions:

(1) A memorandum, in form and substance as specified in the valuation manual, and acceptable to the commissioner, shall be prepared to support each actuarial opinion.

(2) If the insurance company fails to provide a supporting memorandum at the request of the commissioner within a period specified in the valuation manual or the commissioner determines that the supporting memorandum provided by the insurance company fails to meet the standards prescribed by the valuation manual or is otherwise unacceptable to the commissioner, the commissioner may engage a qualified actuary at the expense of the company to review the opinion and the basis for the opinion and prepare the supporting memorandum required by the commissioner.

(d) Requirement for All Opinions Subject to RSA 410:4, II. Every opinion shall be governed by the following provisions:

(1) The opinion shall be in form and substance as specified in the valuation manual and acceptable to the commissioner.

(2) The opinion shall be submitted with the annual statement reflecting the valuation of such reserve liabilities for each year ending on or after the operative date of the valuation manual.

(3) The opinion shall apply to all policies and contracts subject to RSA 410:4, II(b), plus other actuarial liabilities as may be specified in the valuation manual.

(4) The opinion shall be based on standards adopted from time to time by the Actuarial Standards Board or its successor, and on such additional standards as may be prescribed in the valuation manual.

(5) In the case of an opinion required to be submitted by a foreign or alien company, the commissioner may accept the opinion filed by that company with the insurance supervisory official of another state if the commissioner determines that the opinion reasonably meets the requirements applicable to a company domiciled in this state.

(6) Except in cases of fraud or willful misconduct, the appointed actuary shall not be liable for damages to any person (other than the insurance company and the commissioner) for any act, error, omission, decision or conduct with respect to the appointed actuary's opinion.

(7) Disciplinary action by the commissioner against the company or the appointed actuary shall be defined in rules by the commissioner.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:5 Computation of Minimum Standards. 

Except as provided in paragraphs I and II and RSA 410:14, the minimum standard for the valuation of policies and contracts issued prior to April 7, 1943, except group annuity and pure endowment contracts, shall be that provided by the laws in effect immediately prior to that date. Except as provided in RSA 410:6 and RSA 410:7, the minimum standard for the valuation of group annuity and pure endowment contracts issued prior to April 7, 1943, shall be that provided by the laws in effect immediately prior to such date except that the interest rate specified shall be 5 percent per annum for all such contracts. Except as otherwise provided in RSA 410:6, RSA 410:7, and RSA 410:14 the minimum standard for the valuation of all policies and contracts issued on or after April 7, 1943, shall be the commissioner's reserve valuation methods defined in RSA 410:8, RSA 410:9, RSA 410:12 and RSA 410:14, 5 percent interest for group annuity and pure endowment contracts and 3
1/2 percent interest for all other such policies and contracts, or in the case of life insurance policies and contracts, other than annuity and pure endowment contracts, issued on or after September 1, 1943, 4 percent interest for policies issued prior to August 1, 1979, 5
1/2 percent interest for single premium life insurance policies and 4
1/2 percent interest for all other policies issued on or after August 1, 1979 and the following tables:

I. For all ordinary policies of life insurance issued on the standard basis, excluding any disability and accidental death benefits in such policies: the Commissioner's 1941 Standard Ordinary Mortality Table for policies issued prior to the operative date of RSA 409:5-a, I; the Commissioner's 1958 Standard Ordinary Mortality Table for such policies issued on or after the operative date of RSA 409:5-a, I, and prior to the operative date of RSA 409:5-b; provided that for any category of policies issued on female risks, all modified net premiums and present values referred to in this chapter may be calculated according to an age not more than 6 years younger than the actual age of the insured; and for policies issued on or after the operative date of RSA 409:5-b, of the Standard Nonforfeiture Law for Life Insurance as amended.

(a) The Commissioner's 1980 Standard Ordinary Mortality Table;

(b) At the election of the company for any one or more specified plans of life insurance, the Commissioner's 1980 Standard Ordinary Mortality Table with Ten-Year Select Mortality Factors; or

(c) Any ordinary mortality table, adopted after 1980 by the National Association of Insurance Commissioners, which is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for such policies.

II. For all industrial life insurance policies issued on the standard basis, excluding any disability and accidental death benefits in the policies; the 1941 Standard Industrial Mortality Table for policies issued prior to the operative date of RSA 409:5-a, II, and for policies issued on or after the operative date, the Commissioner's 1961 Standard Industrial Mortality Table or any industrial mortality table adopted after 1980 by the National Association of Insurance Commissioners that is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for the policies.

III. For individual annuity and pure endowment contracts, excluding any disability and accidental death benefits in the policies the 1937 Standard Annuity Mortality Table or at the option of the company, the Annuity Mortality Table for 1949, Ultimate, or any modification of either of these tables approved by the commissioner.

IV. For group annuity and pure endowment contracts, excluding any disability and accidental death benefits in the policies: the Group Annuity Mortality Table for 1951, a modification of the table approved by the commissioner, or at the option of the company, any of the tables or modifications of tables specified for individual annuity and pure endowment contracts.

V. For total and permanent disability benefits in or supplementary to ordinary policies or contracts: for policies or contracts issued on or after January 1, 1966, the tables of Period 2 disablement rates and the 1930 to 1950 termination rates of the 1952 Disability Study of the Society of Actuaries, with due regard to the type of benefit or any tables of disablement rates and termination rates adopted after 1980 by the National Association of Insurance Commissioners, that are approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for those policies; for policies or contracts issued on or after January 1, 1961 and prior to January 1, 1966, either those tables or, at the option of the company, the Class (3) Disability Table (1926); and for policies issued prior to January 1, 1961, the Class (3) Disability Table (1926). Any such table shall, for active lives, be combined with a mortality table permitted for calculating the reserves for life insurance policies.

VI. For accidental death benefits in or supplementary to policies issued on or after January 1, 1966: the 1959 Accidental Death Benefits Table or any accidental death benefits table adopted after 1980 by the National Association of Insurance Commissioners that is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for those policies; for policies issued on or after January 1, 1961 and prior to January 1, 1966, either that table or, at the option of the company, the Inter-Company Double Indemnity Mortality Table; and for policies issued prior to January 1, 1961, the Inter-Company Double Indemnity Mortality Table. Either table shall be combined with a mortality table permitted for calculating the reserves for life insurance policies.

VII. For group life insurance, life insurance issued on the substandard basis and other special benefits; tables approved by the commissioner.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:6 Computation of Minimum Standards for Annuities. 

I. Except as provided in RSA 410:7, the minimum standard for the valuation for individual annuity and pure endowment contracts issued on or after the operative date of this section and for annuities and pure endowments purchased on or after the operative date under group annuity and pure endowment contracts, shall be the commissioner's reserve valuation methods defined in RSA 410:8 and 410:9 and the following tables and interest rates:

(a) For individual annuity and pure endowment contracts issued prior to August 1, 1979, excluding any disability and accidental death benefits in those contracts: the 1971 Individual Annuity Mortality Table, or any modification of this table approved by the commissioner, and 6 percent interest for single premium immediate annuity contracts and 4 percent interest for all other individual annuity and pure endowment contracts.

(b) For individual single premium immediate annuity contracts issued on or after August 1, 1979, excluding any disability and accidental death benefits in those contracts: the 1971 Individual Annuity Mortality Table or any individual annuity mortality table adopted after 1980 by the National Association of Insurance Commissioners, that is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for these contracts, or any modification of these tables approved by the commissioner, and 7
1/2 percent interest.

(c) For individual annuity and pure endowment contracts issued on or after August 1, 1979, other than single premium immediate annuity contracts, excluding any disability and accidental death benefits in those contracts: the 1971 Individual Annuity Mortality Table or any individual annuity mortality table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for these contracts, or any modification of these tables approved by the commissioner, and 5
1/2 percent interest for single premium deferred annuity and pure endowment contracts and 4
1/2 percent interest for all other individual annuity and pure endowment contracts.

(d) For all annuities and pure endowments purchased prior to August 1, 1979, under group annuity and pure endowment contracts, excluding any disability and accidental death benefits purchased under those contracts: the 1971 Group Annuity Mortality Table or any modification of this table approved by the commissioner, and 6 percent interest.

(e) For all annuities and pure endowments purchased on or after August 1, 1979, under group annuity and pure endowment contracts, excluding any disability and accidental death benefits purchased under those contracts: the 1971 Group Annuity Mortality Table, or any group annuity mortality table adopted after 1980 by the National Association of Insurance Commissioners, that is approved by rule adopted by the commissioner pursuant to RSA 541-A for use in determining the minimum standard of valuation for annuities and pure endowments, or any modification of these tables approved by the commissioner, and 7
1/2 percent interest.

II. After September 1, 1973, any company may file with the commissioner a written notice of its election to comply with the provisions of this section after a specified date before January 1, 1979, which shall be the operative date of this section for that company. If a company makes no election, the operative date of this section for that company shall be January 1, 1979.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:7 Computation of Minimum Standard by Calendar Year of Issue. 

I. The interest rates used in determining the minimum standard for the valuation of the following shall be the calendar year statutory valuation interest rates as defined in this section:

(a) Life insurance policies issued in a particular calendar year, on or after the operative date of RSA 409:5-b;

(b) Individual annuity and pure endowment contracts issued in a particular calendar year on or after January 1, 1982;

(c) Annuities and pure endowments purchased in a particular calendar year on or after January 1, 1982, under group annuity and pure endowment contracts; and

(d) The net increase, if any, in a particular calendar year after January 1, 1982, in amounts held under guaranteed interest contracts.

II. The calendar year statutory valuation interest rates shall be as follows:

(a) The calendar year statutory valuation interest rates, I, shall be determined as follows and the results rounded to the nearest 
1/4 of one percent:

(1) For life insurance

 
 I = .03 + W (R
1 - .03 +
 W.
 (R
2 - .09);
 
___
 
 
 
 2
 
 


(2) For single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and from guaranteed interest contracts with cash settlement options,

I = .03 + W (R - .03)

Where R
1 is the lesser of R and .09,

R
2is the greater of R and .09,

R is the reference interest rate defined in this section,

W is the weighting factor defined in this section,

(3) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on an issue year basis, except as stated in subparagraph (2), the formula for life insurance stated in subparagraph (1) shall apply to annuities and guaranteed interest contracts with guarantee durations in excess of 10 years and the formula for single premium immediate annuities stated in subparagraph (2) shall apply to annuities and guaranteed interest contracts with guarantee duration of 10 years or less,

(4) For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the formula for single premium immediate annuities stated in subparagraph (2) shall apply,

(5) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a change in fund basis, the formula for single premium immediate annuities stated in subparagraph (2) shall apply.

(b) However, if the calendar year statutory valuation interest rate for life insurance policies issued in any calendar year determined without reference to this subparagraph differs from the corresponding actual rate for similar policies issued in the immediately preceding calendar year by less than 
1/2 of one percent, the calendar year statutory valuation interest rate for the life insurance policies shall be equal to the corresponding actual rate for the immediately preceding calendar year. For purposes of applying this subparagraph, the calendar year statutory valuation interest rate for life insurance policies issued in a calendar year shall be determined for 1980 (using the reference interest rate defined in 1979) and shall be determined for each subsequent calendar year regardless of when RSA 409:5-b becomes operative.

III. The weighting factors referred to in the formulas in paragraph II are given in the following tables:

(a) Weighting factors for life insurance:

 
 
Guarantee
 
Weighting
 Duration
 Factors
 (Years)
 
 10 or less
 .50
 More than 10, but not more than 20
 .45
 More than 20
 .35
 


For life insurance, the guarantee duration is the maximum number of years the life insurance can remain in force on a basis guaranteed in the policy or under options to convert to plans of life insurance with premium rates or nonforfeiture values or both which are guaranteed in the original policy;

(b) Weighting factor for single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and guaranteed interest contracts with cash settlement options:

.80

(c) Weighting factors for other annuities and for guaranteed interest contracts, except as stated in subparagraph (b), shall be as specified in subparagraphs (c)(1), (2), and (3), according to the rules and definitions in subparagraphs (c)(4), (5) and (6):

(1) For annuities and guaranteed interest contracts valued on an issue year basis:

 
 Guarantee
 
Weighting Factor
 Duration
 
for Plan Type
 
 
(Years)
 
A
 
B
 
C
 5 or less:
 .80
 .60
 .50
 More than 5, but not more than 10:
 .75
 .60
 .50
 More than 10, but not more than 20:
 .65
 .50
 .45
 More than 20:
 .45
 .35
 .35
 


(2) For annuities and guaranteed interest contracts valued on a change in fund basis, the factors shown in subparagraph (1) increased by:

 
 
Plan Type
 
 
A
 
B
 
C
 .15
 .25
 .05
 


(3) For annuities and guaranteed interest contracts valued on an issue year basis (other than those with no cash settlement options) that do not guarantee interest on considerations received more than one year after issue or purchase and for annuities and guaranteed interest contracts valued on a change in fund basis that do not guarantee interest rates on considerations received more than 12 months beyond the valuation date, the factors shown in subparagraph (1) or derived in subparagraph (2) increased by:

 
 
Plan Type
 
 
A
 
B
 
C
 .05
 .05
 .05
 


(4) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, the guarantee duration is the number of years for which the contract guarantees interest rates in excess of the calendar year statutory valuation interest rate for life insurance policies with guarantee duration in excess of 20 years. For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the guarantee duration is the number of years from the date of issue or date of purchase to the date annuity benefits are scheduled to commence.

(5) 
Plan type
 as used in the above tables is defined as follows:

Plan type A: At any time policyholder may withdraw funds only (i) with an adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company, or (ii) without such adjustment but in installments over 5 years or more, or (iii) as an immediate life annuity, or (iv) no withdrawal permitted.

Plan type B: Before expiration of the interest rate guarantee, policyholder may withdraw funds only (i) with adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company, or (ii) without an adjustment but in installments over 5 years or more, or (iii) no withdrawal permitted. At the end of interest rate guarantee, funds may be withdrawn without an adjustment in a single sum or installments over less than 5 years.

Plan type C: Policyholder may withdraw funds before expiration of interest rate guarantee in a single sum or installments over less than 5 years either (i) without adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company, or (ii) subject only to a fixed surrender charge stipulated in the contract as a percentage of the fund.

(6) A company may elect to value guaranteed interest contracts with cash settlement options and annuities with cash settlement options on either an issue year basis or on a change in fund basis. Guaranteed interest contracts with no cash settlement options and other annuities with no cash settlement options must be valued on an issue year basis. In this section, an issue year basis of valuation refers to a valuation basis under which the interest rate used to determine the minimum valuation standard for the entire duration of the annuity or guaranteed interest contract is the calendar year valuation interest rate for the year of issue or year of purchase of the annuity or guaranteed interest contract, and the change in fund basis of valuation refers to a valuation basis under which the interest rate used to determine the minimum valuation standard applicable to each change in the fund held under the annuity or guaranteed interest contract is the calendar year valuation interest rate for the year of the change in the fund.

IV. The reference interest rate referred to in paragraph II shall be defined as follows:

(a) For life insurance, the lesser of the average over a period of 36 months and the average over a period of 12 months, ending on June 30 of the calendar year preceding the year of issue, of the monthly average of the composite yield on seasoned corporate bonds as published by Moody's Investors Service, Inc.

(b) For single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, the average over a period of 12 months, ending on June 30 of the calendar year of issue or year of purchase, of the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc.

(c) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a year of issue basis, except as stated in subparagraph (b), with guarantee duration in excess of 10 years, the lesser of the average over a period of 36 months and the average over a period of 12 months, ending on June 30 of the calendar year of issue or purchase, of the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc.

(d) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a year of issue basis, except as stated in subparagraph (b), with guarantee duration of 10 years or less, the average over a period of 12 months, ending on June 30 of the calendar year of issue or purchase, of the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc.

(e) For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the average over a period of 12 months, ending on June 30 of the calendar year of issue or purchase, of the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc.

(f) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a change in fund basis, except as stated in subparagraph (b), the average over a period of 12 months, ending on June 30 of the calendar year of the change in the fund, of the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc.

V. Alternative Method for Determining Reference Interest Rates. In the event that the monthly average of the composite yield on seasoned corporate bonds is no longer published by Moody's Investors Service, Inc., or in the event that the National Association of Insurance Commissioners determines that the monthly average of the composite yield on seasoned corporate bonds, as published by Moody's Investors Service, Inc., is no longer appropriate for the determination of the reference interest rate, then an alternative method for determination of the reference interest rate, adopted by the National Association of Insurance Commissioners and approved by rule adopted by the commissioner may be substituted.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:8 Reserve Valuation Method;  Life Insurance and Endowment Benefits. 

I. Except as otherwise provided in RSA 410:9 and 410:12, reserves according to the commissioner's reserve valuation method, for the life insurance and endowment benefits of policies providing for a uniform amount of insurance and requiring the payment of uniform premiums shall be the excess, if any, of the present value, at the date of valuation, of the future guaranteed benefits provided for by those policies, over the then present value of any future modified net premiums therefor. The modified net premiums for a policy shall be such uniform percentage of the respective contract premiums for such benefits such that the present value, at the date of issue of the policy, of all modified net premiums shall be equal to the sum of the then present value of the benefits provided for by the policy and the excess of subparagraph (a) over subparagraph (b), as follows:

(a) A net level annual premium equal to the present value, at the date of issue, of the benefits provided for after the first policy year, divided by the present value, at the date of issue, of an annuity of one percent per annum payable on the first and each subsequent anniversary of the policy on which a premium falls due. However, the net level annual premium shall not exceed the net level annual premium on the 19-year premium whole life plan for insurance of the same amount at an age one year higher than the age at issue of the policy.

(b) A net one-year term premium for the benefits provided for in the first policy year.

II. For a life insurance policy issued on or after January 1, 1985, for which the contract premium in the first policy year exceeds that of the second year and for which no comparable additional benefit is provided in the first year for the excess and which provides an endowment benefit or a cash surrender value or a combination in an amount greater than the excess premium, the reserve according to the commissioner's reserve valuation method as of any policy anniversary occurring on or before the assumed ending date defined in this section as the first policy anniversary on which the sum of any endowment benefit and any cash surrender value then available is greater than the excess premium shall, except as otherwise provided in RSA 410:12, be the greater of the reserve as of the policy anniversary calculated as described in paragraph I and the reserve as of the policy anniversary calculated as described in paragraph I, but with (a) the value defined in subparagraph (a) of paragraph I being reduced by 15 percent of the amount of such excess first year premium, (b) all present values of benefits and premiums being determined without reference to premiums or benefits provided for by the policy after the assumed ending date, (c) the policy being assumed to mature on that date as an endowment, and (d) the cash surrender value provided on that date being considered as an endowment benefit. In making the above comparison the mortality and interest bases stated in RSA 410:6 and 410:7 shall be used.

III. Reserves according to the commissioner's reserve valuation method shall be calculated by a method consistent with the principles of the preceding paragraphs of this section for:

(a) Life insurance policies providing for a varying amount of insurance or requiring the payment of varying premiums;

(b) Group annuity and pure endowment contracts purchased under a retirement plan or plan of deferred compensation, established or maintained by an employer (including a partnership or sole proprietorship) or by an employee organization, or by both, other than a plan providing individual retirement accounts or individual retirement annuities under section 408 of the Internal Revenue Code, as now or hereafter amended;

(c) Disability and accidental death benefits in all policies and contracts; and

(d) All other benefits, except life insurance and endowment benefits in life insurance policies and benefits provided by all other annuity and pure endowment contracts.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    410:9 Reserve Valuation Method;  Annuity and Pure Endowment Benefits. 

I. This section shall apply to all annuity and pure endowment contracts other than group annuity and pure endowment contracts purchased under a retirement plan or plan of deferred compensation, established or maintained by an employer (including a partnership or sole proprietorship) or by an employee organization, or by both, other than a plan providing individual retirement accounts or individual retirement annuities under section 408 of the Internal Revenue Code, as now or hereafter amended.

II. Reserves according to the commissioner's annuity reserve method for benefits under annuity or pure endowment contracts, excluding any disability and accidental death benefits in the contracts, shall be the greatest of the respective excesses of the present values, at the date of valuation, of the future guaranteed benefits, including guaranteed nonforfeiture benefits, provided for by the contracts at the end of each respective contract year, over the present value, at the date of valuation, of any future valuation considerations derived from future gross considerations, required by the terms of the contract, that become payable prior to the end of the respective contract year. The future guaranteed benefits shall be determined by using the mortality table, if any, and the interest rate, or rates, specified in the contracts for determining guaranteed benefits. The valuation considerations are the portions of the respective gross considerations applied under the terms of the contracts to determine nonforfeiture values.


Source. 2013, 221:1, eff. Jan. 1, 2014.

    411-A:1 Purpose and Construction of Chapter. 

I. The purpose of this chapter is to protect the interest of insurers and the public, by providing standards for the investment of the assets of life insurance companies, which standards seek an appropriate balance of the following objectives: safety of principal, maximum appreciation and yield, stability of value, sufficient liquidity and reasonable diversification.

II. This chapter shall be liberally construed to achieve the objectives of paragraph I.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:10 Preferred or Guaranteed Stock. 

An insurer may invest in preferred or guaranteed stocks or shares of any solvent institution existing under the laws of the United States or of Canada, or of any state or province thereof.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:11 Common Stocks;  Limited Partnerships. 

An insurer may invest in common stocks of any solvent institution organized and existing under the laws of the United States or Canada, or of any state or province thereof, if such institution has had net earnings available for dividends on such stock in at least 5 of the 7 fiscal years next preceding acquisition by the insurer. As used in this section the term "common stock" includes transferable certificates of participation in business trusts. An insurer may invest in or otherwise acquire and hold a limited partnership interest in any limited partnership formed pursuant to the laws of any state or the United States. No limited partnership interest shall be acquired under this section if the cost thereof would exceed 2 percent of the assets of such insurer nor if such cost, plus the book value on the date of such acquisition of all limited partnership interests then held by such insurer and acquired under this section, would exceed 10 percent of such assets.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:12 Insurance Stocks. 

I. An insurer may, within the limitations set forth in RSA 401-B:2, invest in the stocks of any solvent insurance company formed under the laws of this or another state, provided that such stocks meet the applicable requirements of RSA 411-A:10 or 411-A:11.

II. With the commissioner's advance written consent an insurer may acquire and hold the controlling interest in the outstanding voting stock of a stock insurer formed under the laws of this or another state. The commissioner shall not give his consent if he finds that such acquisition would not be in the best interests of the insurers involved, or of their respective policyholders or stockholders, or that it would lessen competition in the insurance business.

III. An insurer may invest not more than 5 percent of its assets in the stock of any company owning or holding the stock of any life insurance company or companies.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:13 Stock of Subsidiaries. 

I. An insurer may, within the limitations set forth in RSA 401-B:2, invest in the stock of its subsidiary insurance corporation formed or acquired by it; or in the stock of its subsidiary business corporation or corporations formed and engaged solely in any one or more of the following businesses:

(a) Any business necessary and incidental to the convenient operation of the insurer's insurance business, or to the administration of any of its lawful affairs, or to the service or benefit of its policyholders;

(b) Any business providing actuarial, computer, data processing, accounting, claims, appraisal, collection, or similar services;

(c) Real estate management and development;

(d) Premium financing;

(e) Financing agents of the insurer;

(f) Acting as investment adviser or principal underwriter of an investment company or companies, registered as such under the Investment Company Act of 1940;

(g) Financial and investment counseling services;

(h) Administration of self-insurance plans;

(i) Administration of self-insured pension and similar plans, or the self-insured portions of such plans;

(j) Acting as administrative agent for a government instrumentality which is performing an insurance function;

(k) Securities broker-dealer;

(l) Escrow services;

(m) Trust services with respect to funds payable or paid by it under its insurance contracts.

II. For the purposes of this section a "subsidiary" is a corporation of which the insurer owns sufficient stock to give it effective control.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:14 Mutual Funds. 

An insurer may invest in the securities of any open-end or closed-end management type investment company or investment trust registered with the Federal Securities and Exchange Commission under the Investment Company Act of 1940 (15 U.S.C. section 80a-1 et seq.) as from time to time amended, if such investment company or trust has assets of not less than $25,000,000 as at date of investment by the insurer.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:15 Trustees' or Receivers' Obligations. 

An insurer may invest in certificates, notes or other obligations issued by trustees or receivers of any institution created or existing under the laws of the United States or of any state, district or territory thereof, which, or the assets of which, are being administered under the direction of any court having jurisdiction, if such obligation is adequately secured as to principal and interest.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:16 Acceptances, Bills of Exchange. 

An insurer may invest in those bank and bankers' acceptances and other bills of exchange which are eligible for purchase in the open market by federal reserve banks.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:17 Equipment Trust Certificates. 

An insurer may invest in equipment trust obligations or certificates which are adequately secured, or in other adequately secured instruments evidencing an interest in transportation equipment wholly or in part within the United States or Canada and a right to receive determined portions of rental, purchase or other fixed obligatory payments for the use or purchase of such transportation equipment.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:18 Bank Deposits. 

An insurer may have any of its cash funds on deposit in checking or savings accounts, under certificates of deposit, or in any other form in solvent banks or trust companies.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:19 Savings and Share Accounts. 

An insurer may invest in share or savings accounts of savings and loan or building and loan associations to the extent that the investment is insured by the Federal Savings and Loan Insurance Corporation or the Federal Deposit Insurance Corporation.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:2 Scope of Chapter. 

Except as provided in RSA 411-A:36, this chapter applies to domestic life insurance companies only.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:20 Hydrocarbon Production Payments. 

An insurer may invest in production payments, or interests therein evidenced by trust certificates or other instruments, payable from oil, gas or other hydrocarbons in producing properties located in the United States or the adjacent continental shelf if an obligation secured by and payable from such production payment or interest therein would qualify for investment under RSA 411-A:9 as an obligation which is adequately secured and has investment qualities and characteristics wherein the speculative elements are not predominant. For purposes of this section "production payments" shall be deemed to mean right to oil, gas or other hydrocarbons in place or as produced which entitle the owner thereof to a specified fraction or percentage of production until a specified sum of money has been received.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:21 Real Estate Mortgages. 

I. An insurer may invest in bonds or notes secured by mortgages or deeds of trust representing first liens upon unencumbered improved real property located in the United States or Canada, including leasehold estates having an unexpired term of not less than 21 years, inclusive of the term or terms which may be provided by enforceable options of renewal, subject to the following conditions:

(a) The amount loaned or the aggregate amount of bonds issued upon the security of a mortgage or deed of trust shall not at the time of the investment exceed 75 percent of the fair market value of the real estate, as such value has been determined by a qualified appraiser. An appraiser shall be presumed to be qualified if he or she is a member in good standing of the American Institute of Appraisers or any other similar professional organization.

(b) In applying the limitation under subparagraph (a), there may be excluded from the amount invested that portion of the investment which is guaranteed by the secretary of veterans' affairs pursuant to the Servicemen's Readjustment Act of 1944 (38 U.S.C. section 1801 et seq.), as amended, or insured by the United States secretary of housing and urban development or other United States or Canadian government agency.

(c) Insurance not less comprehensive than fire and extended coverage must be carried on the improvements on the real estate, in an amount not less than 75 percent of the insurable value of the improvements or the unpaid balance of the investment, whichever is the lesser amount, and the policy or policies evidencing such insurance shall be endorsed to show the interest of the lender.

(d) No mortgage loan upon a leasehold made or acquired by an insurer pursuant to this section shall permit amortization over a period exceeding 
4/5 of the lease term remaining at the time of the loan.

II. For the purpose of this section real estate shall not be deemed to be encumbered by reason of the existence of taxes or assessments which are not delinquent, instruments creating or reserving mineral, oil or timber rights, rights-of-way, joint driveways, sewer rights, rights in walls, or by reason of building restrictions or other restrictive covenants, or when such real estate is subject to lease in whole or in part whereby rents or profits are reserved to the owner.

III. In addition to the foregoing and supplemental to RSA 411-A:30 an insurer may, to an aggregate amount not in excess of 5 percent of the assets of such insurer, make and hold loans upon real property, including leasehold estates therein, in any state of the United States, or in the District of Columbia or Puerto Rico, or in any province of the Dominion of Canada, notwithstanding the fact that such loans and the mortgages securing the same do not comply with the provisions of this section.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:22 Purchase Money Mortgages. 

An insurer may invest in purchase money mortgages or like securities, received by it upon the sale or exchange of real property theretofore owned by it, not subject to the limitations of RSA 411-A:21.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:23 Real Estate. 

I. Except as provided in RSA 411-A:25, an insurer may invest in real estate only if used for the purposes or acquired in the manner, and within the limits, as follows:

(a) The building in which it has its principal office, the land upon which the building stands, and such other real estate as may be requisite for the insurer's convenient accommodation in the transaction of its business. The amount so invested shall not aggregate more than 10 percent of the insurer's assets.

(b) Real estate acquired in satisfaction of loans, mortgages, liens, judgments, decrees or debts previously owing to the insurer in the due course of its business.

(c) Real estate acquired in part payment of the consideration on the sale of other real estate owned by it, if such transaction shall have effected a net reduction in the insurer's investments in real estate.

(d) Real estate acquired by gift or devise, or through merger, consolidation or bulk reinsurance of another insurer under this chapter.

(e) The seller's interest in real estate subject to an agreement of purchase or sale, but the sum invested in any such interest shall not exceed 
2/3 of the fair market value of such parcel.

(f) Additional real estate and equipment incident thereto, if necessary or convenient for the purpose of enhancing the sale or other value of real estate previously acquired or held under this section. Such real estate and equipment, together with the real estate for the enhancement of which it was acquired, shall be included, for the purpose of applicable investment limits, and shall be subject to disposal under RSA 411-A:32 at the same time and under the same conditions as apply to such enhanced real estate.

(g) Improved real estate, or any interest therein, acquired or held by purchase, lease or otherwise, acquired as an investment for production of income, or acquired to be improved or developed for such investment purposes pursuant to an existing program therefor. The insurer may hold, mortgage, improve, develop, maintain, manage, lease, sell, convey and otherwise dispose of real estate acquired by it under this provision.

(h) Real estate acquired pursuant to an insurer's employee relocation program as permitted by RSA 402:28.

II. For the purposes of RSA 411-A:21 and this section, "improved" real estate means:

(a) Farmland used for tillage, crop or pasture;

(b) Real estate on which permanent improvements, or improvements under construction or in process of construction, suitable for residence, residential, recreational, institutional, commercial or industrial use, are situated; and

(c) Real estate to be developed for the use or uses set forth in the previous paragraph, on which improvements, or improvements under construction or in process of construction, such as streets, sidewalks, sewers and utilities which will become an integral part of such development, are situated or abut.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:24 Housing Developments. 

To the extent and upon such conditions as may be authorized by the commissioner, an insurer may invest in stock and evidences of indebtedness of any housing company or redevelopment company organized under the private housing finance law of this or any other state, or of any corporation organized for the purpose of owning and operating any housing project under laws expressly designed to promote the provision of housing for persons of low and moderate income, or in the securities of any corporation organized under the laws of this or any other state for the purpose of owning, acquiring or holding real property or any interest therein as an investment for the production of income or to be developed or improved for such investment purpose, if all of the stock other than directors' qualifying shares of such housing company, redevelopment company or corporation has been or is to be originally issued to one or more insurers, whether domestic or foreign. Investments made pursuant to this section shall not be subject to the requirements of RSA 411-A:11.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:25 Leased Property. 

An insurer may invest in personal or real property owned either by the insurer or by a trustee, while under lease to a lessee.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:26 Data Processing Systems. 

An insurer may purchase and hold electronic computers and mechanical machines and equipment constituting a data processing and accounting system, provided that the cost thereof shall be amortized in not more than 10 years, and provided further that the unamortized cost thereof shall not at any time exceed one percent of the insurer's admitted assets without the approval of the commissioner.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:27 Policy Loans. 

An insurer may lend to a policyholder, upon pledge of the policy as collateral security, any sum not exceeding the cash surrender value of the policy; or may lend against pledge or assignment of any of its supplementary contracts or other contracts or obligations, so long as the loan is adequately secured by such pledge or assignment.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:28 Collateral Loans. 

An insurer may lend its funds upon the pledge of securities eligible for investment under this chapter. No such loan shall exceed the market value of such collateral pledged.


Source. 1978, 11:1. 2009, 186:11, eff. Jan. 1, 2010.

    411-A:29 Foreign Investments and Foreign Currency Exposure. 

I. Subject to the limitations of RSA 411-A:6, an insurer may acquire foreign investments, or engage in investment practices with persons of or in foreign jurisdictions, of substantially the same types as those that an insurer is permitted to acquire under this chapter, if, as a result and after giving effect to the investment:

(a) The aggregate amount of foreign investments then held by the insurer under this subsection does not exceed 20 percent of its admitted assets; and

(b) The aggregate amount of foreign investments then held by the insurer under this subparagraph in a single foreign jurisdiction does not exceed 10 percent of its admitted assets as to a foreign jurisdiction that has a sovereign debt rating of SVO 1 from the Securities Valuation Office of the National Association of Insurance Commissioners or 3 percent of its admitted assets as to any other foreign jurisdiction.

II. Subject to the limitations of RSA 411-A:6, an insurer may acquire investments, or engage in investment practices denominated in foreign currencies, whether or not they are foreign investments acquired under paragraph I, or additional foreign currency exposure as a result of the termination or expiration of a hedging transaction with respect to investments denominated in a foreign currency, if:

(a) The aggregate amount of investments then held by the insurer under this subparagraph denominated in foreign currencies does not exceed 10 percent of its admitted assets; and

(b) The aggregate amount of investments then held by the insurer under this subparagraph denominated in the foreign currency of a single foreign jurisdiction does not exceed 10 percent of its admitted assets as to a foreign jurisdiction that has a sovereign debt rating of SVO 1 from the Securities Valuation Office of the National Association of Insurance Commissioners or 3 percent of its admitted assets as to any other foreign jurisdiction.

III. In addition to investments permitted under paragraphs I and II, an insurer that is authorized to do business in a foreign jurisdiction, and that has outstanding insurance, annuity, or reinsurance contracts on lives or risks resident or located in that foreign jurisdiction and denominated in foreign currency of that jurisdiction, may acquire foreign investments respecting that foreign jurisdiction, and may acquire investments denominated in the currency of that jurisdiction, subject to the limitations of RSA 411-A:6. However, investments made under this paragraph in obligations of foreign governments, their political subdivisions, and government sponsored enterprises shall not be subject to the limitations of RSA 411-A:6 if those investments carry an SVO rating of 1 or 2 from the Securities Valuation Office of the National Association of Insurance Commissioners. The aggregate amount of investments acquired by the insurer under this paragraph shall not exceed the greater of:

(a) The amount the insurer is required by the law of the foreign jurisdiction to invest in the foreign jurisdiction; or

(b) One hundred fifteen percent of the amount of its reserves, net of reinsurance, and other obligations under the contracts on lives or risks resident or located in the foreign jurisdiction.

IV. In addition to investments permitted under paragraphs I and II, an insurer that is not authorized to do business in a foreign jurisdiction, but which has outstanding insurance, annuity, or reinsurance contracts on lives or risks resident or located in that foreign jurisdiction and denominated in foreign currency of that jurisdiction, may acquire foreign investments respecting that foreign jurisdiction, and may acquire investments denominated in the currency of that jurisdiction subject to the limitations of RSA 411-A:6. However, investments made under this paragraph in obligations of foreign governments, their political subdivisions, and government sponsored enterprises shall not be subject to the limitations of RSA 411-A:6 if those investments carry an SVO rating of 1 or 2 from the Securities Valuation Office of the National Association of Insurance Commissioners. The aggregate amount of investments acquired by the insurer under this paragraph shall not exceed 105 percent of the amount of its reserves, net of reinsurance, and other obligations under the contracts on lives or risks resident or located in the foreign jurisdiction.

V. Investments acquired under this section shall be aggregated with investments of the same types made under all other sections of this chapter, and in a similar manner, for purposes of determining compliance with the limitations, if any, contained in the other sections. Investments in obligations of foreign governments, their political subdivisions, and government sponsored enterprises of these persons, except for those exempted under paragraphs III and IV, shall be subject to the limitations of RSA 411-A:6.


Source. 1978, 11:1. 2009, 186:12, eff. Jan. 1, 2010. 2016, 254:3, eff. Aug. 9, 2016.

    411-A:3 Eligible Investments. 

I. Insurers shall invest in or lend their funds on the security of, and shall hold as invested assets, only eligible investments as prescribed in this chapter.

II. Any investment made or acquired by an insurer prior to July 1, 1978, which investment was permitted by statute at the time it was made, and which investment the insurer was legally entitled to possess on June 30, 1978, shall be deemed to be an eligible investment.

III. Eligibility of any investment made or acquired on or after July 1, 1978, shall be determined in accordance with the provisions of this chapter and shall be determined as of the date of its making or acquisition.

IV. Any investment limitation based upon the amount of the insurer's assets or particular funds shall relate to such assets or funds as shown by the insurer's annual statement as of the December 31 next preceding the date of acquisition of the investment by the insurer, or as shown by a current financial statement resulting from merger of another insurer, bulk reinsurance, or change in capitalization.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:30 Miscellaneous Investments. 

I. An insurer may make loans or investments not otherwise expressly permitted under this chapter and may make loans or investments in amounts in excess of limits set forth in this chapter, in an aggregate amount not over 10 percent of the insurer's assets, if such loan or investment qualifies as a sound investment. No such loan or investment shall be represented by loans or investments expressly prohibited by statute or by regulation.

II. The insurer shall keep a record of all loans and investments made under this section.


Source. 1978, 11:1. 2009, 186:13, eff. Jan. 1, 2010.

    411-A:31 Conversion and Incidental Rights. 

Nothing in this chapter shall be deemed to prohibit an insurer from making an investment otherwise authorized under this chapter, because the investment is convertible into other securities in which the insurer is not permitted to invest under this chapter, or because the insurer receives in connection with such investment stock warrants, whether or not detachable, stock options, stock, property interests or other assets of any kind. Anything so received by the insurer and in which the insurer is otherwise not authorized to invest shall be carried on its books at no value.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:32 Time Limit for Disposal of Real Estate. 

I. Except as stated in paragraph II, or unless the insurer elects to hold the real estate as an investment under RSA 411-A:23, I(g):

(a) An insurer shall dispose of real estate acquired under RSA 411-A:23, I(a) within 5 years after it has ceased to be necessary for the convenient accommodation of the insurer in the transaction of its business.

(b) An insurer shall dispose of real estate acquired under RSA 411-A:23, I(b) through (e) within 5 years after the date of acquisition, unless used or to be used for the insurer's accommodation under RSA 411-A:23, I(a).

II. Upon satisfactory proof that the interests of the insurer will suffer materially by the forced sale thereof, the commissioner may by order grant a reasonable extension of the period, as specified in such order within which the insurer shall dispose of any particular parcel of such real estate. In the alternative, the insurer may continue to hold real estate beyond the limits provided in this section and include such real estate in the category of miscellaneous investments, pursuant to RSA 411-A:30.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:33 Time Limit for Disposal of Other Ineligible Property and Securities. 

Any personal property or securities lawfully acquired by an insurer, which it could not otherwise have invested in or loaned its funds upon at the time of such acquisition, shall be disposed of within 5 years from date of acquisition, unless within such period the security has attained the standard of eligibility; except, that any security or personal property acquired under any agreement of bulk reinsurance, merger or consolidation may be retained for a longer period if so provided in the plan for such reinsurance, merger or consolidation as approved by the commissioner. The commissioner may by order grant, from time to time, reasonable extensions of the period, as specified in any such order, within which an insurer shall dispose of any such property or security. Nothing in this section shall be deemed to prohibit an insurer from holding property beyond the time limits provided, if such property is listed as a miscellaneous investment.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:34 Failure to Dispose of Real Estate or Securities;  Effect;  Penalty. 

I. Any real estate, personal property, or securities lawfully acquired and held by an insurer after expiration of the period for disposal thereof or any extension of such period granted by the commissioner as provided in RSA 411-A:32 and 411-A:33 shall not be allowed as an asset of the insurer, unless such real estate, personal property or securities are maintained by the insurer as miscellaneous investments.

II. The insurer shall forthwith dispose of any ineligible investment unlawfully acquired by it. If the insurer fails to dispose of the investment within a reasonable time, the commissioner may, upon hearing, suspend or revoke said insurer's certificate of authority or license for a period not to exceed 3 years, impose an administrative fine in lieu of such suspension or revocation, or take such other administrative action against the offending company as the commissioner, in his discretion, may determine.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:35 Prohibited Investment and Investments Underwriting. 

I. In addition to investments excluded pursuant to other provisions of this chapter, an insurer shall not invest in or lend its funds upon the security of:

(a) Issued shares of its own capital stock, except:

(1) For the purpose of mutualization; or

(2) For retirement; or

(3) Pursuant to a written plan for such investment or loan which plan shall be subject to the approval of the commissioner.

(b) Securities issued by any corporation or enterprise the controlling interest of which is, or will after such acquisition by the insurer be, held directly or indirectly by the insurer or any combination of the insurer and the insurer's directors, officers, subsidiaries, or controlling stockholders, and the spouses and children of any of the foregoing individuals. For purposes of this section, "controlling interest" shall be deemed to mean ownership of more than 50 percent of a corporation's stock. Investments in controlled insurance corporations or subsidiaries under RSA 411-A:12 and 411-A:13 are not subject to this provision.

(c) Any note or other evidence of indebtedness of any director, officer or controlling stockholder of the insurer or of the spouse or child of any of the foregoing except as to policy loans authorized under RSA 411-A:27 and except as to mortgage loans authorized under RSA 402:28.

II. No insurer shall underwrite or participate in the underwriting of an offering of securities or property of any other person. This provision shall not be deemed to prohibit:

(a) The acquisition and ownership by the insurer of its subsidiary corporation acting as investment adviser or principal underwriter of a management company or investment company registered with the Securities and Exchange Commission under the Investment Company Act of 1940,
 as amended.

(b) The registration by the insurer, under the Securities Act of 1933
 or other applicable law, of restricted or other securities acquired and owned by it in regular course of business.

III. No insurer shall enter into any agreement to withhold from sale any of its securities or property, and the disposition of its assets shall at all times be within the control of the insurer.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:36-a Valuation of Securities. 

Securities held in accordance with the provisions of this chapter shall be valued in accordance with the published valuation standards of the Securities Valuation Office of the National Association of Insurance Commissioners.


Source. 1992, 288:21, eff. Jan. 1, 1993.

    411-A:36 Investments of Foreign and Alien Life Insurance Companies. 

The investment portfolio of foreign or alien life insurance companies shall be as permitted by the laws of their domicile if of a quality substantially equal to that required under this chapter for similar funds of like domestic insurers.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:37 Rules and Regulations. 

The commissioner may issue such rules, regulations and orders as may be necessary to carry out the purpose and provisions of this chapter.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:4 General Qualifications. 

I. Unless specifically authorized by a provision of this chapter, no security investment shall be eligible for acquisition, unless it is interest bearing or interest accruing or entitled to dividends or is otherwise income earning, is not then in default in any respect, and the insurer is entitled to receive for its exclusive account and benefit the interest or income accruing thereon. A debt security will be considered to be income earning where, although bearing no fixed or contingent interest, it is issued at a discount and contains a specific maturity date on which redemption is to be made at a stated value. Stocks will be considered income earning although dividends are currently not being paid. Nothing in this section shall prohibit the acquisition by an insurer of warrants, options or similar rights to acquire securities if the acquisition of such securities would then be permitted by the provisions of this chapter (other than RSA 411-A:30); or if such warrants, options or similar rights are acquired in connection with an investment otherwise permitted by this chapter.

II. Nothing in this chapter shall prohibit the acquisition by an insurer of other or additional securities or property if received as a dividend or as a lawful distribution of assets, or upon a debt or judgment, or under a lawful and bona fide agreement of bulk reinsurance, merger or consolidation, or if acquired by it through the exercise of warrants, options or similar rights to acquire securities received by it in accordance with this chapter. Nothing in this chapter shall prevent any insurer from entering into an agreement for the purpose of protecting the interests of the insurer in securities lawfully held by it, or for the purpose of reorganization of a corporation which issued securities so held, and from depositing such securities with a committee or depositaries appointed under such agreement, nor from accepting stock, bonds or other securities or other property which may be distributed pursuant to any such agreement, or to any plan of reorganization or arrangement; and no provision of this chapter shall prevent any insurer from acquiring or holding any property acquired in satisfaction of any debt previously contracted, or that shall be obtained by sale or foreclosure of any security held by it. Any security or property so acquired which is not otherwise an eligible investment under this chapter shall be disposed of pursuant to RSA 411-A:32 or 411-A:33.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:5 Authorization;  Record of Investments. 

An insurer shall not make any investment of loan, other than policy loans or annuity contract loans, unless the same is authorized or approved by the insurer's board of directors; provided however, that nothing in this chapter shall prohibit an insurer's board of directors from delegating its authority to make and acquire investments and loans. The insurer shall maintain a full record of each investment.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:6 Diversification. 

I. An insurer shall not at any one time have any combination of investments in or loans upon the security of obligations, property or securities of any one municipal corporation, institution, person or corporation (other than its lawful subsidiary) aggregating over 10 percent of the insurer's assets. This shall not apply as to general obligations of, or obligations guaranteed by, the United States, its agencies or government sponsored enterprises, or of any state, or of Canada or any province thereof, or include policy loans made under RSA 411-A:27.

II. An insurer shall not invest in or hold at any one time more than 10 percent of the outstanding voting stock of any corporation, except as to voting rights of preferred stock during default of dividends. This does not apply as to stock of a subsidiary of the insurer acquired under RSA 411-A:13 or to controlling stock of an insurer acquired under RSA 411-A:12, II.

III. An insurer shall invest and have invested at any one time in aggregate amount not more than 10 percent of admitted assets in all stocks, investment in which is permitted under RSA 411-A:11, 411-A:12 and 411-A:14, and not more than 20 percent of its assets in stocks referred to in RSA 411-A:10. For the purposes of this paragraph stocks shall be valued at cost. This provision shall not apply to stock of controlled or subsidiary corporations or money market mutual funds.

IV. An insurer shall not at any one time have more than 50 percent of its assets invested in obligations secured by mortgages of real property, exclusive of that portion of such obligations guaranteed or insured by an agency or government sponsored enterprise of the United States government. For the purposes of this paragraph, mortgages shall be valued at book value.


Source. 1978, 11:1. 2009, 186:8, eff. Jan. 1, 2010.

    411-A:7 Public Obligations. 

An insurer may invest in bonds or other evidences of indebtedness, not in default as to principal or interest, which are valid and legally authorized obligations issued, assumed or guaranteed by the United States or by any state thereof, or by Canada or any of the provinces thereof, or by any county, city, town, village, municipality or district therein or by any political subdivision thereof or by a public instrumentality of one or more of the foregoing, if, by statutory or other legal requirements applicable thereto, such obligations are payable, as to both principal and interest, from taxes levied or required to be levied upon all taxable property or all taxable income within the jurisdiction of such governmental unit, or from adequate special revenues pledged or otherwise appropriated or by law required to be provided for the purpose of such payment.


Source. 1978, 11:1, eff. July 1, 1978.

    411-A:8 Obligations and Stock of Certain Federal and International Agencies. 

An insurer may invest in obligations and stock which are stated, issued, assumed or guaranteed by the following agencies of the government of the United States:

I. Farm Loan Bank.

II. Commodity Credit Corporation.

III. Federal intermediate credit banks.

IV. Federal land banks.

V. Central Bank for Cooperatives.

VI. Federal home loan banks, and stock thereof.

VII. Federal National Mortgage Association, and stock thereof.

VIII. Government National Mortgage Association.

IX. International Bank for Reconstruction and Development.

X. Inter-American Development Bank.

XI. Asian Development Bank.

XI-a. African Development Bank.

XII. Federal Home Loan Mortgage Corporation.

XIII. Any other similar agency of, or participated in by, the government of the United States and of similar financial quality.


Source. 1978, 11:1. 1990, 21:2. 2009, 186:9, eff. Jan. 1, 2010.

    411-A:9 Corporate Obligations. 

An insurer may invest in bonds, debentures, notes, mortgage-backed securities, asset-backed securities, and other evidences of indebtedness issued, assumed or guaranteed by any solvent institution created or existing under the laws of the United States or Canada or of any state, district, province or territory thereof, which are not in default as to principal or interest.


Source. 1978, 11:1. 2009, 186:10, eff. Jan. 1, 2010.

    411:1 Capital Stock. 

Any corporation organized under the laws of this state and engaged wholly or in part in the life insurance business as a stock company shall have a capital stock of not less than $600,000 paid in, which shall be invested as provided in RSA 411-A. One-half of such capital shall be deposited with the insurance commissioner.


Source. 1913, 42:1. PL 278:1. RL 328:1. RSA 411:1. 1969, 283:9. 1978, 11:4, eff. July 1, 1978.

    411:10 Repealed by 1987, 246:5, II, eff. May 18, 1987. 

    411:11 Certificate. 

Upon receipt of a deposit in trust from any such company, as required or allowed by the laws of this state, the commissioner shall issue upon the request of such company a certificate which shall set forth the corporate name of the company, its principal office, that a deposit for the protection of all its policyholders has been duly made, the amount of securities so deposited and that it is authorized to transact the business of life insurance.


Source. 1913, 42:5. 1917, 20:3. PL 278:11. RL 328:11. RSA 411:11. 1963, 70:4. 1987, 246:2, eff. May 18, 1987.

    411:12 Noncompliance. 

Upon the failure of any company organized or doing business under this chapter to make the deposit required under RSA 411:8 the commissioner shall notify such company to issue no new policies until there shall have been compliance with said requirement.


Source. 1913, 42:6. PL 278:12. RL 328:12. RSA 411:12. 1987, 246:6, eff. May 18, 1987.

    411:13 Change of Securities, Etc. 

Any such company making a deposit in trust shall have the right at any time to change their securities on deposit by substituting for those withdrawn a like amount in other securities of the character described in RSA 411-A.


Source. 1913, 42:9. PL 278:13. RL 328:13. RSA 411:13. 1987, 246:3, eff. May 18, 1987.

    411:14 Collection of Interest. 

The commissioner shall permit companies, having on deposit with him stocks or bonds as security, to collect the dividends or interest accruing on such deposits, delivering to their authorized agents, respectively, the coupons or other evidences of interest as the same become due; but upon default by any company to deposit additional security as called for by the commissioner, or pending any proceedings to close up or enjoin it, the commissioner shall collect the dividends and interest as they become due and add the same to the securities in his hands belonging to such company.


Source. 1913, 42:13. PL 278:14. RL 328:14.

    411:15 to 411:19 Repealed by 1978, 11:7, eff. July 1, 1978. 

    411:2 Certificate of Authority. 

Upon said deposit and satisfactory evidence to the commissioner that the capital stock of at least $200,000 has been paid in and invested as herein prescribed, he shall issue to said stock company a certificate authorizing it to do business as such.


Source. 1913, 42:1. PL 278:2. RL 328:2.

    411:20 to 411:27 Repealed by 1969, 272:3, eff. June 23, 1969. 

    411:28 Acting Without Certificate. 

Any such company, doing or attempting to do life insurance business without a certificate as provided for in this chapter, shall forfeit $ 100 for every day it continues to write new business in this state without such certificate.


Source. 1913, 42:14. PL 278:29. RL 328:27.

    411:29 Suits for Penalties. 

Suits to recover any of the penalties provided for in this chapter shall be instituted in the name of the state on relation of the attorney general, under the direction and by the authority of the commissioner. Said penalties shall be paid to the state.


Source. 1913, 42:15. PL 278:30. RL 328:28.

    411:3 Mutual Companies. 

No such certificate shall be issued to such a corporation organized on the mutual plan until at least 500 persons have subscribed in the aggregate for at least $500,000 of insurance upon their lives and shall each have paid in one full annual premium in cash upon the insurance applied for, nor until it shall have deposited with the commissioner at least $200,000 in the securities required by law.


Source. 1913, 42:2. 1917, 20:1. PL 278:3. RL 328:3. RSA 411:3. 1969, 283:10, eff. June 25, 1969.

    411:30 Transfer of Risks, Etc. 

No such corporation shall transfer its risks, or any part thereof, to, or reinsure its risks, or any part thereof, except reinsurance effected in the ordinary course of business, in any insurance corporation, association or society which is not at the time of such transfer or reinsurance authorized to do business in this state.


Source. 1913, 42:19. 1919, 19:1. PL 278:31. RL 328:29.

    411:31 Change of Payee, Etc. 

The insured in any such corporation shall have the right at any time, with the consent of such corporation, to make a change in his payee or beneficiary without requiring the consent of such payee or beneficiary; provided, that such policy has not been assigned as security for debt or other legal consideration.


Source. 1913, 42:20. PL 278:32. RL 328:30.

    411:32 Negotiation of Insurance. 

No insurance shall be negotiated in this state by or on behalf of any such company except by agents or brokers who shall be qualified, appointed and licensed in accordance with the law.


Source. 1913, 42:22. 1917, 20:4. PL 278:33. RL 328:31.

    411:33 Application of Chapter. 

Nothing in this chapter shall affect life insurance companies, associations or societies or accident insurance companies doing business on the assessment plan.


Source. 1913, 42:21. PL 278:34. RL 328:32.

    411:4 Annual Statement. 

The president or vice-president, and secretary or actuary, or a majority of the trustees or directors, of every life insurance company organized under the laws of this state, shall annually, on January 1, or within 60 days thereafter, prepare under oath and deposit in the office of the insurance commissioner, a statement of the condition of such company on December 31 of the preceding year, showing:

I. Name and where located, the names of the officers, the amount of capital stock, and amount of capital stock paid in.

II. The value of real estate owned by such company, the amount of cash on hand, the amount of cash deposited in banks or trust companies, giving names of depositaries, the amount of unreported and deferred premiums, the amount of stocks and bonds, giving names and amounts, with the par and market value of each kind, the amount of loans secured by first mortgage on real estate, the amount of all other loans, and how secured, with the rate of interest, the amount of premium notes on policies in force, the amount of notes given for unpaid stock, and how secured, the amount of interest due and unpaid, and all other assets.

III. The amount of losses due and unpaid, the amount of losses adjusted but not due, the amount of losses unadjusted, the amount of claims for losses resisted, the amount of money borrowed and the amount required to safely reinsure all outstanding risks according to the American Experience Table of Mortality, and 3
1/2 percent interest per annum, or the actuaries' combined experience table with the same rate of interest.

IV. The amount of cash premiums and premium notes received, the amount of interest received from all sources during the year, and the amount received from all other sources.

V. The amount paid for losses, the amount of dividends paid to policyholders and to stockholders, the amount of commissions and salaries paid to agents, the amount paid to officers for salaries, the amount paid for taxes, and the amount of all other payments and expenditures.

VI. The greatest amount insured on any one life, the amount deposited in other states and territories as security for policyholders therein, stating the amount in each state or territory, the amount of premiums received in this state during the year, the amount paid for losses in this state during the year, the whole number of policies issued during the year, with the amount of insurance effected thereby, and total amount of insurance at risk.


Source. 1913, 42:3. PL 278:4. RL 328:4.

    411:5 Additional Inquiries. 

The commissioner is authorized to amend the form of annual statement, and to propose such additional inquiries as he may think necessary to elicit a full exhibit of the standing of such companies.


Source. 1913, 42:3. PL 278:5. RL 328:5.

    411:6 Policy Reserves. 

As soon as practicable after the filing of said annual statement the commissioner shall determine the reserves for all policies of each such company in force on December 31 immediately preceding, in accordance with the provisions of RSA 410.


Source. 1913, 424:4. PL 278:6. RL 328:6. RSA 411:6. 1963, 70:1, eff. July 9, 1963.

    411:7 Making Valuation. 

For the purpose of making such valuation the commissioner may employ a competent actuary, who shall be paid by the company for which the services are rendered; but nothing herein shall prevent any company from making said valuation herein contemplated, which may be received by the commissioner upon such proof as he may determine.


Source. 1913, 42:4. PL 278:7. RL 328:7.

    411:8 Security Deposit. 

The commissioner shall require a domestic insurance company to make a deposit in trust in an amount necessary, in the discretion of the commissioner for the protection of the company's policyholders, provided that the required deposit shall not exceed the greater of $1,000,000 or the amount of deposits required under RSA 402:73.


Source. 1913, 42:4. PL 278:8. 1933, 80:1. RL 328:8. RSA 411:8. 1963, 70:2. 1978, 11:5. 1987, 246:1, eff. May 18, 1987.

    411:9 Repealed by 1987, 246:5, I, eff. May 18, 1987. 

    412-A:1 Policies to be Filed With Commissioner. 

Every insurance company which issues insurance on hulls of aircraft, including their accessories and equipment, and liability resulting from the ownership, use or maintenance of aircraft shall file with the insurance commissioner for informational and auditing purposes a copy of the form of the policy containing the insurance contract covering such losses and all printed endorsements that may be attached thereto. As part of the audit process, the commissioner may disapprove any form if it contains a provision that does not comply with the requirements of law, is not in the public interest, is contrary to public policy, is inequitable, misleading, deceptive, or encourages misrepresentation of such policy.


Source. 2003, 150:2, eff. Jan. 1, 2004. 2018, 68:3, eff. July 24, 2018.

    412-A:2 Liability for Aircraft Accident. 

No policy of insurance issued or delivered in this state covering any loss, expense, or liability arising out of the ownership, maintenance, or use of an aircraft shall exclude or deny coverage because the aircraft is operated in violation of federal or civil air regulations, or any state law or local ordinance. This section does not prohibit the use of specific exclusions or conditions in any such policy which relate to any of the following:

I. Certification of an aircraft in a stated category by the federal aviation administration;

II. Certification of a pilot in a stated category by the federal aviation administration;

III. Establishing requirements for pilot experience;

IV. Establishing limitations on the use of the aircraft.


Source. 2003, 150:2, eff. Jan. 1, 2004.

    412-A:3 Penalties. 

Any insurer willfully violating any of the provisions of this chapter may be fined not more than $500. The commissioner may suspend or revoke the license of any insurer or organization for any violation of this chapter or the failure to comply with an order of the commissioner, issued under this chapter.


Source. 2003, 150:2, eff. Jan. 1, 2004.

    412-A:4 Hearing and Appeal. 

Any insurer or organization aggrieved by any order or decision of the commissioner is entitled to a rehearing and appeal under RSA 541.


Source. 2003, 150:2, eff. Jan. 1, 2004.

    412:1 Purpose. 

The purpose of this chapter is:

I. To protect policyholders and the public against the adverse effects of excessive, inadequate or unfairly discriminatory rates.

II. To promote price competition among insurers so as to provide rates that are responsive to competitive market conditions.

III. To cause the provision of price and other information to enable consumers to purchase insurance suitable for their needs and to foster competitive insurance markets.

IV. To improve availability, fairness, and reliability of insurance.

V. To provide regulatory procedures for the maintenance of appropriate data reporting systems as necessary to allow the commissioner to monitor degree of competition in the marketplace.

VI. To authorize essential cooperative action among insurers in the ratemaking process and to regulate such activity to prevent practices that tend to substantially lessen competition or create a monopoly.

VII. To encourage the most efficient and economical marketing practices.

VIII. To prohibit price fixing agreements and other anti-competitive behavior by insurers.

IX. To ensure that policy forms, endorsements, applications, or other contract language comply with provisions of the insurance laws and do not contain provisions which are inequitable, misleading, deceptive, or encourage misrepresentation.

X. To protect policyholders and the public against the adverse effects of any policy provision that is not in the public interest or is contrary to public policy.


Source. 2003, 150:1. 2008, 212:3, eff. June 16, 2008.

    412:10 Repealed by 2004, 156:8, II, eff. July 23, 2004. 

    412:11 Cancellation Because of Age;  Prohibited. 

No insurance company authorized to transact business in this state, which insures against loss by reason of the liability to pay damages to others for damage to property or bodily injury including death, arising from the operation, maintenance, or use of motor vehicles within this state, shall cancel, reduce liability limits, refuse to renew or increase the premium of any such motor vehicle policy for the sole reason that the person to whom such policy has been issued has reached a certain age.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:12 Physical Examinations. 

When an insurer requires any person to submit to a physical examination as a prerequisite to issuance or delivery of any motor vehicle liability policy, the insurer shall assume and pay the cost of the physical examination.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:13 Competitive Market. 

A competitive market is presumed to exist unless the commissioner, after hearing, determines that a reasonable degree of competition does not exist in the market and the commissioner issues a ruling to that effect. Such ruling shall expire no later than 2 years after issue unless the commissioner renews the ruling after hearings and a finding as to the continued lack of a reasonable degree of competition. In determining whether a reasonable degree of competition exists, the commissioner shall consider relevant tests of workable competition pertaining to market structure, market performance and market conduct and the practical opportunities available to consumers in the market to acquire pricing and other consumer information and to compare and obtain insurance from competing insurers as further described in RSA 412:14.


Source. 2003, 150:1, eff. Jan. 1, 2004. 2019, 101:1, eff. Aug. 20, 2019.

    412:14 Monitoring Competition. 

I. In determining whether or not a competitive market exists pursuant to RSA 412:13, the commissioner shall monitor the degree of competition in this state. In doing so, the commissioner shall utilize existing relevant information, analytical systems and other sources; cause or participate in the development of new relevant information, analytical systems and other sources; or rely on some combination thereof. Such activities may be conducted internally within the insurance department, in cooperation with other state insurance departments, through outside contractors or in any other appropriate manner.

II. All of the following may be considered by the commissioner:

(a) The extent to which the largest insurer groups control the insurance marketplace.

(b) Whether the total number of companies writing the form of insurance in this state is sufficient to provide multiple options to the public.

(c) The extent to which insurer entries and exits, considered over several years, suggest the presence or lack of entry or exit barriers or both.

(d) The degree to which the insurance products offered to consumers are homogenous in nature and, thus, comparable.

(e) The availability of insurance coverage in all geographic areas. A review of changes in residual market shares, if applicable, may be used as an indication of availability.

(f) The overall rate level which is not excessive, inadequate, or unfairly discriminatory.

(g) The trend in price level for each type of insurance.

(h) The profitability of each form of insurance over a period of several years.

(i) The level of knowledge of market participants and the extent to which comparative pricing information has been made readily available to consumers.

(j) The extent to which the market for each type of insurance is growing.

(k) The presence of conditions indicating reverse competition.

(l) Any other factors customarily reviewed and considered relevant.

III. For the purpose of carrying out the provisions of this section, the commissioner may, at any time, request information or data from insurers authorized to conduct business in this state that the commissioner believes relevant to monitoring and maintaining a competitive market.


Source. 2003, 150:1. 2005, 248:11. 2006, 196:7, eff. July 30, 2006.

    412:15 Rate Standards. 

Rates shall be made in accordance with the following provisions:

I. Rates shall not be excessive, inadequate, or unfairly discriminatory.

(a) A rate in a competitive market shall not be disapproved for being excessive.

(b) A rate in a noncompetitive market is excessive if it is likely to produce a profit that is unreasonably high for the insurance provided or if expenses are unreasonably high in relation to services rendered.

(c) A rate is inadequate if:

(1) The rate is unreasonably low for the insurance provided and the continued use of the rate endangers the solvency of the insurer using it; or unless

(2) The rate is unreasonably low for the insurance provided and the use of the rate by the insurer has, or if continued will have, the effect of substantially lessening competition or the tendency to create monopoly in any market.

(d) Unfair discrimination exists if, after allowing for practical limitations, price differentials fail to reflect equitably the differences in expected losses and expenses. A rate is not unfairly discriminatory if it is averaged broadly among persons insured under a group, franchise or blanket policy or a mass marketed plan. In this paragraph, a 
mass marketed plan
 means a method of selling property-liability insurance wherein:

(1) The insurance is offered to employees of particular employers or to members of particular associations or organizations or to persons grouped in other ways, except groupings formed principally for the purpose of obtaining such insurance; and

(2) The employer, association or other organization, if any, has agreed to, or otherwise affiliated itself with, the sale of such insurance to its employees or members.

II. In determining whether rates comply with the excessiveness standard in a noncompetitive market under subparagraph I(b), the inadequacy standards under subparagraph I(c) and the unfair discrimination standard under subparagraph I(d), the following criteria shall apply:

(a) Due consideration shall be given to past and prospective loss experience within and outside this state; to the conflagration and catastrophe hazards; to a reasonable margin for profit and contingencies; to dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers; to past and prospective expenses both countrywide and those specifically applicable to this state; and to provisions for special assessments and to all other relevant factors within and outside the state.

(b) Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans that establish standards for measuring variations in hazards or expense provisions, or both. Such standards may measure any differences among risks that can be demonstrated to have a probable effect upon losses or expenses. No risk classification, however, may be based upon race, creed, national origin or the religion of the insured.

(c) The expense provisions included in the rates to be used by an insurer shall reflect the operating methods of the insurer and its anticipated expenses.

(d) The rates may contain provision for contingencies and an allowance permitting a reasonable profit. In determining the reasonableness of the profit, consideration shall be given to all investment income attributable to the line of insurance.

III. (a) The use of any information from credit reports, credit histories, and credit scoring models for underwriting and rating purposes for homeowners insurance and private passenger automobile insurance shall be based upon objective, documented, and measurable standards and shall be used in a manner which provides for appropriate consumer protections, including adequate and clear consumer notice, procedures to promptly correct and adjust underwriting or rating decisions based on incorrect credit information, and confidentiality protections.

(b) The insurance commissioner shall, pursuant to RSA 541-A, adopt such rules as may be necessary to regulate the obligations of insurers with respect to the use of such information in the underwriting and rating of homeowners insurance and private passenger automobile insurance. Information that explains and justifies underwriting rules, credit scoring models or rating plans that rely upon credit reports, credit histories, or credit scoring mechanisms shall be included in the rate filing required pursuant to RSA 412:16.

IV. For commercial risks, except for workers' compensation which is governed by RSA 412:34, the commissioner may permit insurers to use appropriate systems of schedule rating filed by any insurer or rating bureau approved by the commissioner, subject to rules adopted under RSA 541-A, to assure the uniform and impartial application of such rating. Insurers shall retain supporting documentation for such ratings. Such ratings shall be:

(a) Based on an insured's management, safety, and loss control policies and record;

(b) Based on the policy administration expenses; and

(c) No greater than plus or minus 40 percent of the insurer's base rates.

V. In order to further uniform administration of rate regulatory laws, the commissioner and every insurer, advisory organization and statistical agent may exchange information and experience data with insurance supervisory officials, insurers and advisory organizations in other states and may consult with them with respect to the application of rating systems and the collection of statistical data.

VI. Insurers may charge service fees for unanticipated costs, such as the costs associated with returned checks or late payments. Such fees shall not be in excess of the reasonable administrative cost associated with the service at issue. Installment fees may not be charged for the first payment of each policy term because they are never unanticipated.

VII. For personal lines policies, the general rule is that premium is earned pro-rata over the length of the policy. However, insurers may file other than pro-rata earning patterns if the risk is distributed unevenly over the policy period. If the personal lines policy is canceled with or without cause by either party, all unearned premium at the time of the cancellation shall be returned to the insured.


Source. 2003, 150:1. 2006, 196:8. 2008, 212:5, eff. June 16, 2008. 2016, 115:2, eff. July 19, 2016. 2017, 55:5, 6, eff. Aug. 1, 2017. 2019, 103:1, eff. Aug. 20, 2019. 2021, 50:6, eff. July 24, 2021.

    412:16 Rate Filings. 

I. This section shall not apply to:

(a) Financial guaranty.

(b) Employment practices liability.

(c) Commercial inland marine.

(d) Directors and officers liability.

(e) Boiler and machinery.

(f) Commercial credit insurance products.

(g) Surety bonds.

(h) Mortgage guaranty.

(i) Fiduciary liability.

II. Every insurer shall file with the commissioner every manual, predictive model or telematics model or other model that pertains to the formulation of rates and/or premiums, minimum premium, class rate, rating schedule or rating plan and every other rating rule, and every modification of any of the foregoing which it proposes to use. Personal lines filings shall include underwriting rules used by insurers or a group of affiliated insurers to the extent necessary to determine the applicable rate and/or policy premium for an individual insured or applicant. An insurer may file its rates by either filing its final rates or by filing a multiplier and, if applicable, an expense constant adjustment to be applied to prospective loss costs that have been filed by an advisory organization on behalf of the insurer as permitted by RSA 412:23. Every such filing shall state the effective date, and shall indicate the character and extent of the coverage contemplated. Information contained in the underwriting rules that does not pertain to the formulation of rates and/or premiums shall be identified by the filer as proprietary and shall be kept confidential by the department and shall not be subject to the provisions of RSA 91-A.

III. Every insurer shall file or incorporate by reference to material that has been filed with or approved by the commissioner, at the same time as the filing of the rate, all supplementary rating and supporting information to be used in support of or in conjunction with a rate. The information furnished in support of a filing may include or consist of a reference to:

(a) The experience or judgment of the insurer or information filed by the advisory organization on behalf of the insurer as permitted by RSA 412:23;

(b) Its interpretation of any statistical data it relies upon;

(c) The experience of other insurers or advisory organizations; or

(d) Any other relevant factors.

IV. When a filing is not accompanied by the information upon which the insurer supports such filing, the commissioner may require such insurer to furnish the required information upon which it supports such filing. Until the requested information is provided, the filing shall not be considered complete and may be subject to possible disapproval pursuant to the provisions of RSA 412:19, II.

V. After reviewing an insurer's filing if the commissioner finds that the data upon which the filing is based is fully credible under acceptable actuarial standards and practices, the commissioner may require that the insurer's rates be based upon the insurer's own loss, special assessment and expense information. If the insurer's loss or allocated loss adjustment expenses information is not actuarially credible, as determined by the commissioner, the insurer may use or supplement its experience with information filed with the commissioner by an advisory organization or statistical agent.

VI. Insurers utilizing the services of an advisory organization or statistical agent shall provide with their rate filing, at the request of the commissioner, a description of the rationale for such use, including its own information and method of utilization of the advisory organization's or statistical agent's information.

VII. In a competitive market, every insurer, except as specified in this chapter, shall file with the commissioner the information specified in this section that it will use in this state.

(a) For all personal risk policies, the rates and supplementary rating information shall be filed with the commissioner at least 30 days before the effective date.

(b) For all commercial risk policies, except policies issued to a large commercial policyholder, and except as provided in this chapter, the rates and supplementary rating information that will be used in this state shall be filed for informational purposes only within 30 days of the effective date.

(c) For policies of insurance issued to large commercial policyholders, defined in RSA 412:3, XI, the filing requirements of this section shall not apply. Information relating to classifications, rules, and rates applicable to any policy issued to a large commercial policyholder pursuant to this paragraph shall be kept available by the insurer for inspection by the commissioner, upon request.

(1) All policies issued pursuant to the provisions of this section shall contain a conspicuous disclaimer printed in at least 10-point, bold-faced type that states that the policy applied for, including the rates, rating plans, resulting premiums, and the policy forms, are not subject to the rate and form requirements of this state and other provisions of the insurance law that apply to other commercial products and may contain significant differences from a policy that is subject to all provisions of the insurance law. Such notice shall set forth possible differences in policy conditions, forms, and endorsements, as compared to a policy that is subject to all of the provisions of the insurance law. The commissioner may prescribe the format and provisions of such notice. The disclosure notice will also include a policyholder's acknowledgment statement, to be signed and dated prior to the effective date of the coverage, and shall remain on file with the insurer.

(2) In procuring insurance, a large commercial policyholder shall certify that it meets the eligibility requirements set out in RSA 412:3, XI and specify the requirements that the policyholder has met. This certification is to be completed annually and remain on file with the insurer.

(3) A surplus lines broker seeking to obtain or provide insurance for a large commercial policyholder is not authorized to purchase insurance from any eligible unauthorized insurer without making a diligent search of authorized insurers as required by RSA 405:24.

(d) In a competitive market, if the commissioner finds, after a hearing that an insurer's rates require closer supervision because of the insurer's financial condition or unfairly discriminatory rating practices, the insurer shall file with the commissioner at least 30 days before the effective date, all such rates and supplementary rating information and supporting information as prescribed by the commissioner. Upon application by the filer, the commissioner may authorize an earlier effective date.

VIII. In a noncompetitive market, subject to the exceptions specified in RSA 412:16, IX and X, and RSA 412:28, each filing shall be on file for a waiting period of 30 days before it becomes effective, which period may be extended by the commissioner for an additional period not to exceed 60 days if written notice is given within such waiting period to the insurer or advisory organization which made the filing that additional time is needed for the consideration of the filing. Upon written application by the insurer, the commissioner may authorize a filing that has been reviewed to become effective before the expiration of the waiting period or any extension thereof. A filing shall be deemed to meet the requirements of this chapter unless disapproved by the commissioner within the waiting period or any extension thereof. Failure of the insurer or advisory organization to provide the requested information within the waiting period or the extension thereof shall be deemed a request to withdraw the filing from further consideration. Failure of the commissioner to act within the waiting period or the extension thereof shall result in the filing being deemed to meet the requirements of this chapter. Neither the insurer nor the commissioner may waive the timeliness requirements of the provisions in this section.

IX. The commissioner may, by written order, suspend or modify the requirement of filing as to any kind of insurance, subdivision or combination thereof, or as to classes of risks, for which the rates cannot practicably be filed before they are used. The commissioner may make such examination as deemed advisable to ascertain whether any rates affected by such order meet the standards set forth in RSA 412:15.

X. Upon the written application of the insured, stating his or her reasons therefor, filed with and approved by the commissioner, a rate in excess of or below that provided by a filing otherwise applicable may be used on any specific risk.

XI. A filing and any supporting information not considered proprietary pursuant to paragraph II shall be open to public inspection on or after the effective date.

XII. No insurer shall make or issue a contract or policy except in accordance with the filings that are in effect for the insurer as provided in this chapter.

XIII. A rate for a residual market in which insurers are mandated by law to participate shall not become effective until approved by the commissioner.


Source. 2003, 150:1. 2004, 156:4. 2008, 212:6, eff. June 16, 2008. 2016, 115:3-5, eff. July 19, 2016. 2017, 55:7, 8, eff. Aug. 1, 2017. 2019, 10:3, eff. July 9, 2019; 101:2, eff. Aug. 20, 2019. 2022, 42:6, eff. July 2, 2022.

    412:17-a Volunteer Drivers. 

An insurer may not refuse to issue a policy of automobile insurance, as defined in RSA 417-A, to an applicant solely because the applicant is a volunteer driver. An insurer may not impose a surcharge or otherwise increase the rate for a policy of automobile insurance solely on the basis that the named insured, a member of the insured's household, or a person who customarily operates the insured's vehicle is a volunteer driver. For purposes of this section, "
volunteer driver
" means a person who provides services, including transporting individuals or goods, without compensation above expenses to a charitable organization as defined in RSA 7:21. This section does not prohibit an insurer from refusing to renew, imposing a surcharge, or otherwise raising the rate for a policy of automobile insurance based upon factors other than the volunteer status of the insured driver.


Source. 2007, 351:1, eff. Jan. 1, 2008.

    412:17 Cancellation Because of Age;  Prohibited. 

No insurance company authorized to transact business in this state, which insures against loss by reason of the liability to pay damages to others for damage to property or bodily injury including death, arising from the operation, maintenance, or use of motor vehicles within this state, shall cancel, reduce liability limits, refuse to renew, or increase the premium of any such motor vehicle policy for the sole reason that the person to whom such policy has been issued has reached a certain age. The provisions of this section shall not apply to an increase or decrease of the premiums for such policies for any particular age group if a statewide classification system approved by the insurance commissioner is adopted for such drivers.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:18 Repealed by 2021, 147:3, I, eff. Sept. 21, 2021. 

    412:19 Disapproval of Filings. 

I. For filings made in a noncompetitive market and residual market filings, if within the waiting period or any extension thereof as provided in RSA 412:16, VIII, the commissioner finds that a filing does not meet the requirements of this chapter, written notice of disapproval shall be sent to the insurer or advisory organization which made the filing, specifying therein in what respects the filing fails to meet the requirements of this chapter and stating that such filing shall not become effective. If the commissioner disapproves a filing, the insurer or advisory organization may request a hearing on the disapproval within 30 days and the commissioner shall schedule that hearing within 30 days of the receipt of the request. The insurer or advisory organization bears the burden of proving compliance with the standards established by this chapter.

II. If at any time after a rate has been approved and for filings made in a competitive market, the commissioner finds that the rate no longer meets the requirements of this chapter, the commissioner may order the discontinuance of use of the rate. The order of discontinuance may be issued after a hearing with at least 10 days' prior notice to all insurers affected by the order. The order must be in writing and state the grounds for the order. It shall also state when, within a reasonable time thereafter, the filing will be deemed no longer effective. The order shall not affect any contract or policy made or issued prior to the expiration of the period set forth in the order. However, a policyholder shall have the privilege to cancel the policy containing the disapproved rate without penalty. The commissioner's order may include a provision for a premium adjustment for contracts or policies made or issued after the effective date of the order.

III. Any insured aggrieved with respect to any filing which is in effect may make written application to the commissioner for a hearing thereon. The application shall specify the grounds to be relied upon by the applicant. If the commissioner shall find that the application is made in good faith, that the applicant would be so aggrieved if his or her grounds are established, and that such grounds otherwise justify holding such a hearing, a hearing shall be held within 30 days after receipt of such application upon not less than 10 days' written notice to the applicant and to every insurer and advisory organization which made such filing.

IV. If, after such hearing, the commissioner finds that the filing does not meet the requirements of this chapter, an order shall be issued specifying in what respects such filing fails to meet the requirements of this chapter, and stating when, within a reasonable period thereafter, such filing shall no longer be deemed to be in effect. Copies of the order shall be sent to the applicant and to every such insurer and advisory organization. The order shall not affect any contract or policy made or issued prior to the expiration of the period set forth in the order.

V. Whenever an insurer has no legally effective rates as a result of the commissioner's disapproval of rates or other act, the commissioner shall on request of the insurer specify interim rates for the insurer that are high enough to protect the interests of all parties and may order that a specified portion of the premiums be placed in an escrow account approved by the commissioner. When the new rates become legally effective, the commissioner shall order the escrowed funds or any overcharge in the interim rates be distributed appropriately.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:2 Scope of Chapter. 

I. This chapter applies to all classes of property and casualty insurance that are now or may hereafter be written in any combination on risks or operations located in this state under the provisions of RSA 401:1, I, II, V, VI, VII, and VIII and any miscellaneous insurance under RSA 401:1-a that is designated by the commissioner to be regulated under this chapter.

II. This chapter shall not apply to:

(a) Reinsurance, other than statutorily authorized joint reinsurance mechanisms.

(b) Accident and health insurance.

(c) Life insurance and annuities.

(d) Insurance on vessels or craft, their cargoes, marine builders' risks, marine protection and indemnity, or other risks commonly insured under ocean marine, as determined by the commissioner.

(e) Title insurance, except as otherwise provided in RSA 416-A:17 and RSA 416-A:17-a.

(f) Insurance on hulls of aircraft, including their accessories and equipment, and liability resulting from the ownership, use or maintenance of aircraft.


Source. 2003, 150:1. 2004, 156:1, eff. July 23, 2004. 2017, 55:1, eff. Aug. 1, 2017.

    412:20 Licensing Advisory Organizations and Statistical Agents. 

I. No advisory organization or statistical agent shall provide any service relating to statistical collection or the rates of any insurance subject to this chapter, and no insurer shall utilize the services of such organization for such purposes unless the organization has obtained a license under paragraph III.

II. No advisory organization or statistical agent shall refuse to supply any services for which it is licensed in this state to any insurer authorized to do business in this state and offering to pay the fair and usual compensation for the services.

III. (a) An advisory organization or statistical agent applying for a license shall include with its application:

(1) A copy of its constitution, charter, articles of organization, agreement, association or incorporation, and a copy of its bylaws, plan of operation and any other rules or regulation governing the conduct of its business.

(2) A list of its members and subscribers.

(3) The name and address of one or more residents of this state upon whom notices, process affecting it, or orders of the commissioner may be served.

(4) A statement showing its technical qualifications for acting in the capacity for which it seeks a license.

(5) A biography of the ownership and management of the organization.

(6) Any other relevant information and documents that the commissioner may require.

(b) Every organization that has applied for a license shall notify the commissioner of every material change in the facts or in the documents on which its application was based. Any amendment to a document filed under this section shall be filed at least 30 days before it becomes effective.

(c) If the commissioner finds that the application and the natural persons through whom it acts are competent, trustworthy, and technically qualified to provide the services proposed, and that all requirements of the law are met; he or she shall issue a license specifying the authorized activity of the applicant. The commissioner shall not issue a license if the proposed activity would tend to create a monopoly or to substantially lessen the competition in any market.

(d) Licenses issued pursuant to this section shall remain in effect for one year unless the license is suspended or revoked. The commissioner may at any time, after hearing, revoke or suspend the license or issue a written order requiring the discontinuance of an act or practice of an advisory organization or statistical agent that is involved with such act or practice that is unfair or unreasonable or does not otherwise comply with the requirements and standards of this chapter.

(e) Advisory organizations wishing to operate as statistical agents or organizations who hold a current license as a rating organization within this state may be so authorized under their license as an advisory organization. A separate license is not required.

(f) The fee for said application and license shall be as specified in RSA 400-A:29, VI.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:21 Insurers and Advisory Organizations:  Prohibited Activity. 

I. No insurer or advisory organization shall:

(a) Attempt to monopolize, or combine or conspire with any other person to monopolize an insurance market.

(b) Engage in a boycott, on a concerted basis, of an insurance market.

II. No insurer shall agree with any other insurer or with an advisory organization to mandate adherence to or to mandate use of any rate, prospective loss cost, rating plan, rating schedule, rating rule, policy or bond form, rate classification, rate territory, underwriting rule, survey, inspection or similar material, except as needed to facilitate the reporting of statistics to advisory organizations, statistical agents or the commissioner.

III. The fact that 2 or more insurers, whether or not members or subscribers of an advisory organization, use consistently or intermittently the same rates, prospective loss cost, rating plans, rating schedules, rating rules, policy or bond forms, rate classifications, rate territories, underwriting rules, surveys or inspections or similar materials is not sufficient in itself to support a finding that an agreement exists.

IV. Two or more insurers having a common ownership or operating in this state under common management or control may act in concert between or among themselves with respect to any matters pertaining to those activities authorized in this chapter as if they constituted a single insurer.

V. No insurer or advisory organization shall make any arrangement with any other insurer, advisory organization, or other person which has the purpose or effect of unreasonably restraining trade or unreasonably lessening competition in the business of insurance.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:22 Advisory Organizations and Statistical Agents;  Prohibited Activity. 

In addition to the other prohibitions contained in this chapter, except as specifically permitted under RSA 412:23 and RSA 412:24, no advisory organization or statistical agent shall compile or distribute recommendations relating to rates that include expenses, other than loss adjustment expenses, or profit.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:23 Advisory Organizations;  Permitted Activity. 

An advisory organization in addition to other activities not prohibited, is authorized, on behalf of its members and subscribers, to:

I. Develop statistical plans including territorial and class definitions.

II. Collect statistical data from members, subscribers or any other source.

III. Prepare, file and distribute prospective loss costs which may include provisions for special assessments.

IV. Prepare, file and distribute factors, calculations or formulas pertaining to classification, territory, increased limits and other variables.

V. Prepare, file and distribute manuals of rating rules, rating schedules and other supplementary rating information that do not include final rates, expense provisions, profit provisions or minimum premiums.

VI. Distribute information that is required or directed to be filed with the commissioner.

VII. Conduct research and on-site inspections in order to prepare classifications of public fire defenses.

VIII. Consult with public officials regarding public fire protection as it would affect members, subscribers and others.

IX. Conduct research in order to discover, identify and classify information relating to causes or prevention of losses.

X. Conduct research relating to the impact of statutory changes upon prospective loss costs and special assessments.

XI. Prepare, file and distribute policy forms and endorsements and consult with members, subscribers and others relative to their use and application.

XII. Conduct research and on-site inspections for the purpose of providing risk information relating to individual structures.

XIII. Conduct on-site inspection to determine rating classification for individual insureds.

XIV. Collect, compile and publish past and current prices of individual insurers, provided such information is also made available to the general public at a reasonable cost.

XV. Collect and compile exposure and loss experience for the purpose of individual risk experience ratings.

XVI. File final rates, at the direction of the commissioner, for residual market mechanisms.

XVII. Furnish any other services, as approved or directed by the commissioner, related to those enumerated in this section.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:24 Statistical Agents;  Permitted Activity. 

In addition to other activities not prohibited, any statistical agent is authorized, on behalf of its members and subscribers, to:

I. Develop statistical plans including territorial and class definitions.

II. Collect statistical data from members, subscribers or any other source.

III. Distribute information that is required or directed to be filed with the commissioner.

IV. Collect, compile and distribute past and current prices of individual insurers and publish such information.

V. Collect and compile exposure and loss experience for the purpose of individual risk experience ratings.

VI. Furnish any other services, as approved or directed by the commissioner, related to those enumerated in this section.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:25 Advisory Organizations;  Filing Requirements. 

Every advisory organization shall file with the commissioner before the effective date every statistical plan, all prospective loss costs, provisions for special assessments and all supplementary rating information and every change or amendment or modification of any of the foregoing proposed for use in this state. Such filings shall be subject to the provisions of RSA 400-A:29, VI(d) and (e), RSA 412:16, and RSA 412:19 and other provisions of this chapter relating to filings made by insurers.


Source. 2003, 150:1, eff. Jan. 1, 2004. 2017, 133:2, eff. Aug. 15, 2017.

    412:26 Joint Underwriting;  Joint Reinsurance Pool;  Assigned Risk and Residual Market Activities. 

I. Notwithstanding RSA 412:21, II and III, insurers participating in joint underwriting, joint reinsurance pools, assigned risk or residual market mechanisms may in connection with such activity act in cooperation with each other in the making of rates, rating systems, policy forms, underwriting rules, surveys, inspections and investigations, the furnishing of loss and expense statistics or other information, or carrying on research. Agreements may be made among insurers with respect to the equitable apportionment among them of insurance that may be afforded applicants who are in good faith entitled to, but who are unable to procure such insurance through ordinary methods.

II. Every joint underwriting association, joint reinsurance pool, assigned risk or residual market shall file with the commissioner for approval every statistical plan, all prospective loss costs, provisions for special assessments and all supplementary rating information and every change or amendment or modification of any of the foregoing proposed for use in this state. Such filings shall not take effect until the commissioner shall approve the same as just and reasonable and adequate for the risks to which they respectively apply and shall otherwise be subject to the provisions of RSA 412:16 and RSA 412:19 and other provisions of this chapter relating to filings made by insurers.

III. Except to the extent modified by this section, insurers, joint underwriting, joint reinsurance pool, and residual market mechanism activities are subject to the other provisions of this chapter.

IV. If, after hearing, the commissioner finds that any activity or practice of an insurer participating in joint underwriting or a pool is unfair, is unreasonable, will tend to lessen competition in any market or is otherwise inconsistent with the provisions or purposes of this chapter, the commissioner may issue a written order and require the discontinuance of such activity or practice.

V. Every pool shall file with the commissioner a copy of its constitution; its articles of incorporation, agreement or association; its bylaws, rules and regulations governing its activities; its members; the name and address of a resident of this state upon whom notices or orders of the commissioner or process may be served; and any changes in amendments or changes in the foregoing.

VI. (a) Any residual market mechanism, plan, or agreement to implement such a mechanism, and any changes or amendments thereto, shall be submitted in writing to the commissioner for consideration and approval, together with such information as may be reasonably required. The commissioner shall approve only such agreements as are found to contemplate:

(1) The use of rates which meet the standards prescribed by this chapter; and

(2) Activities and practices that are not unfair, unreasonable, or otherwise inconsistent with the provisions of this chapter.

(b) At any time after such agreements are in effect, the commissioner may review the practices and activities of the adherents to such agreements and if, after a hearing, the commissioner finds that any such practice or activity is unfair or unreasonable, or is otherwise inconsistent with the provisions of this chapter, the commissioner may issue a written order to the parties and either require the discontinuance of such acts or revoke approval of any such agreement.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:27 Information to be Furnished Insureds;  Hearings and Appeals of Insureds. 

I. Every advisory organization and every insurer shall, within a reasonable time after receiving written request therefor and upon payment of such reasonable charge as it may make, furnish to any insured affected by a rate made by the insurer, or to the authorized representative of the insured, all pertinent information as to such rate. If the advisory organization or insurer fails to grant or reject such request within 30 days after it is made, the applicant or insurer may request a hearing from the department pursuant to RSA 400-A:17.

II. If, after a hearing held under this section, it is determined that the rates charged by an insurer are in excess of the otherwise appropriate rate, such overcharge shall be refunded to the insured.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:28 Filing and Approval of Rates and Rating Plans. 

I. Every insurer, that insures employers against liability for compensation under the workers' compensation law, RSA 281-A, shall file with the insurance commissioner individually or in collaboration with others, in such form as the commissioner may prescribe every manual, minimum premium, class rate, rating schedule, or rating plan and every other rating rule, and every modification of any of the foregoing that it proposes to use; provided, that none of the above shall take effect until the commissioner shall have approved the same as adequate, not excessive, and not unfairly discriminatory.

II. An insurer shall file its rates by filing a multiplier, and, if applicable, other modifications to the prospective loss costs and rating plan filed by the National Council on Compensation Insurance or other authorized advisory organization on behalf of the insurer as permitted by RSA 412:23.

III. At the same time as a filing made pursuant to paragraphs I and II, every insurer shall file, or incorporate by reference any material that has been filed with and approved by the commissioner, all supplementary statistical and supporting information to be used as justification for this filing.

IV. The commissioner may evaluate systems of administered pricing versus competitive rating and the costs and benefits of applying such systems to regulating the classification of risks and premium rates for workers' compensation insurance in New Hampshire. The commissioner may provide an evaluation to the workers' compensation advisory council established by RSA 281-A:62.

V. A filing and any supporting information not considered proprietary pursuant to RSA 412:16, II shall be open to public inspection upon approval.


Source. 2003, 150:1. 2005, 248:12, eff. Sept. 12, 2005. 2019, 50:1, eff. Aug. 4, 2019.

    412:29 Withdrawal of Approval. 

The commissioner may withdraw approval of any premium, rate, rating manual, or schedule filed by any insurer according to RSA 412:28, if, in the commissioner's judgment, such rate filing no longer results in premiums that are adequate, not excessive, or not unfairly discriminatory.


Source. 2003, 150:1. 2005, 248:12, eff. Sept. 12, 2005.

    412:3 Definitions. 

In this chapter:

I. [Repealed.]

II. "
Advisory organization
" means any entity, including its affiliates or subsidiaries, which either has 2 or more member insurers or is controlled either directly or indirectly by 2 or more insurers, and which assists insurers in ratemaking-related activities such as those enumerated in RSA 412:4 and RSA 412:20. Two or more insurers having a common ownership or operating in this state under common management or control constitute a single insurer for purposes of this definition.

III. "
Classifications system
" or "
classification
" means the process of grouping risks with similar risk characteristics so that differences in costs may be recognized.

IV. "
Commercial risk
" means any kind of risk that is not a personal risk.

V. "
Commissioner
" means the insurance commissioner.

VI. "
Competitive market
" means a market that has not been found to be noncompetitive pursuant to RSA 412:13.

VII. "
Developed losses
" means losses, including loss adjustment expense, adjusted using standard actuarial techniques, to eliminate the effect of differences between current payment or reserve estimates and those which are anticipated to provide actual ultimate loss, including loss adjustment expense payments.

VIII. "
Expenses
" mean that portion of a rate attributable to acquisition, field supervision, collection expenses, general expenses, taxes, licenses and fees.

IX. "
Experience rating
" means a rating procedure utilizing past insurance experience of the individual policyholder to forecast future losses by measuring the policyholder's loss experience against the loss experience of policyholders in the same classification to produce a prospective premium credit, debit or unity modification.

X. "
Joint underwriting
" means an arrangement established to provide insurance coverage for a risk pursuant to which 2 or more insurers jointly contract with the insured at a price and under policy terms agreed upon between the insurers.

XI. "
Large commercial policyholder
" means an insurance contract holder that is a corporation, partnership, trust, sole proprietorship, or other business or public entity that uses an employed or retained risk manager to procure insurance and that has certified that it meets:

(a) At least one of the following 4 criteria:

(1) A net worth of $10,000,000 as certified by a certified public accountant or public accountant authorized to do business in this state.

(2) Net revenue or sales of $5,000,000 as certified by a certified public account or public accountant authorized to do business in this state.

(3) A total of more than 25 employees per individual company or more than 50 employees per holding company.

(4) Aggregate property and casualty insurance premiums, excluding workers' compensation, medical malpractice, life, health, and disability insurance premiums of $25,000 or more.

(b) "
Large commercial policyholder
" also includes a nonprofit or public entity with an annual budget or assets of $25,000,000 or more that employs or retains a risk manager to procure insurance and meets the premium criteria listed in subparagraph (a)(4), and a municipality with a population of 20,000 or more that meets the premium criteria listed in subparagraph (a)(4).

(c) In this section, "
risk manager
" means a chartered property and casualty underwriter, certified insurance counselor, an associate in risk management, certified risk manager or a licensed insurance consultant.

XII. "
Loss adjustment expense
" means the expenses incurred by the insurer in the course of settling claims.

XIII. "
Market
" means the interaction between buyers and sellers consisting of a product component and a geographic component. A product component consists of identical or readily substitutable products including but not limited to consideration of coverage, policy terms, rate classifications and underwriting. A geographic component is a geographical area in which buyers seek access to the insurance product through sales outlets and other distribution mechanisms. Determination of a geographic component shall consider existing distribution patterns.

XIV. "
Noncompetitive market
" means a market for which there is a ruling in effect pursuant to RSA 412:13 that a reasonable degree of competition does not exist.

XV. "
Personal risk
" means homeowners, including dwelling insurance for owner-occupied one to 4 family buildings, tenants, private passenger non-fleet automobiles on a personal automobile policy, mobile homes and other property and casualty insurance for personal, family or household needs. This includes any property and casualty insurance that is otherwise intended for non-commercial coverage.

XVI. "
Pool
" means a voluntary arrangement, established on an on-going basis, pursuant to which 2 or more insurers participate in the sharing of risks on a predetermined basis. The pool may operate through an association, syndicate, or other pooling agreement.

XVII. "
Prospective loss costs
" means that portion of a rate that does not include provisions for expenses, other than loss adjustment expenses, or profit, and are based on historical aggregate losses and loss adjustment expenses adjusted through development to their ultimate value and projected through trending to a future point in time.

XVIII. "
Rate
" means that cost of insurance per exposure unit whether expressed as a single number or as a prospective loss cost with an adjustment to account for the treatment of expenses, profit, special assessments, and individual insurer variation in loss experience, prior to any application of individual risk variations based on loss or expense considerations, and does not include minimum premium.

XIX. "
Residual market mechanism
" means an arrangement, either voluntary or mandated by law, involving participation by insurers in the equitable apportionment among them of insurance which may be afforded applicants who are unable to obtain insurance through ordinary methods.

XX. "
Special assessments
" means guaranty fund assessments, assessments for residual market mechanisms, vocational rehabilitation fund assessments, and other similar assessments.

XXI. "
Statistical agent
" means an entity that has been licensed by the commissioner to collect statistics from insurers and provide reports developed from these statistics to the commissioner for the purpose of fulfilling the statistical reporting obligations of those insurers under this chapter.

XXII. "
Supplementary rating information
" means any manual or plan of rates, or prospective loss costs, classification, rating schedule, minimum premium, policy fee, rating rule, underwriting rule and any other similar information needed to determine the applicable rate in effect or to be in effect.

XXIII. "
Supporting information
" means:

(a) The experience and judgment of the filer and the experience or data of other insurers or advisory organizations relied upon by the filer;

(b) The interpretation of any other data relied upon by the filer;

(c) Description of methods used in making the rates; and

(d) Any other information required by the commissioner to be filed.

XXIV. "
Trending
" means any procedure for projecting losses to the average date of loss, or premiums or exposures to the average date of writing, for the period during which the policies are to be effective.


Source. 2003, 150:1. 2004, 156:6, 8, I, eff. July 23, 2004. 2016, 115:1, eff. July 19, 2016. 2018, 68:1, eff. July 24, 2018.

    412:30 Special Notice Required. 

Any insured receiving a premium quote from an insurer, based on an approved rating plan, as described in RSA 412:28, that is higher than the premium that would be derived from the rates and rating plan approved for the assigned risk plan, shall be made aware by the insurer, in writing, that coverage may be obtained at a lower premium in the assigned risk plan.


Source. 2003, 150:1. 2005, 248:13, eff. Sept. 12, 2005.

    412:31 Workers' Compensation Insurance Rate. 

All insurance carriers authorized to write workers' compensation insurance shall make available, at the written request of the employer, a workers' compensation insurance rate containing a deductible provision which shall bind the employer to pay, at a minimum, 100 percent of the first $500 of benefits due to an employee, whether these benefits be medical benefits or indemnity benefits. The commissioner shall approve rates that include larger medical and indemnity deductibles on benefits greater than $500. The commissioner shall prescribe the maximum medical and indemnity deductibles. Employers who choose to acquire workers' compensation insurance with a deductible provision, as to the amount of the deductible, are considered insurers and shall have the same responsibilities under the applicable sections of RSA 281-A.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:32 Extraterritorial Auditing Procedure. 

I. In this section:

(a) "
Business headquarters
" or "
headquarters
" means the state in which the business resides, as evidenced by filing of federal income taxes.

(b) "
Extraterritorial
" means the movement of employees and exposures across state lines.

(c) "
Terminal
" or "
base of operations
" means a permanent location owned, leased or used by a trucker at which loading, unloading and other related nonclerical work functions, such as maintenance and transfers, are performed and from which the driver/employee physically reports to work on a regular basis.

(d) "
Trucker
" means a person or entity engaged in the business of transporting property by motor vehicle for hire.

(e) "
State of residence
" means the state in which the trucker resides as evidenced by the location used for filing of federal income taxes.

II. All insurers authorized to write workers' compensation coverage in this state, including premium auditors and underwriters, shall use the following extraterritorial rules in the determination of premium for risks with extraterritorial employments, as well as in calculating estimated and final premium to be charged employers.

III. For employers with employees, specifically salesmen, sales engineers, servicemen, supervisors, executives and administrative employees, who move from state to state in the performance of their jobs the following shall apply:

(a) The payroll for an employee who resides in the same state as the headquarters from which the employee travels shall be assigned to such employee's headquarters state.

(b) The payroll for an employee who resides in a state different from that in which the employee's headquarters is located, but nevertheless travels from such headquarters, shall be assigned to the headquarters state.

(c) The payroll for an employee who resides in a state in which no headquarters is located, and who conducts business from home for an out-of-state employer, shall be assigned to the employee's state of domicile or residence.

IV. For employers involved in interstate trucking operations the following shall apply:

(a) The payroll for employees shall be assigned to the state in which the base terminal or base of operations from which they load, unload, store, or transfer freight on a regular basis is located.

(b) The payroll for employees who do not operate from a terminal or base of operations shall be assigned in the following manner:

(1) Employee records reflecting significant single state operations shall be assigned to that state.

(2) Employee records reflecting multi-state operations shall be assigned to the employee's state of residence or domicile.

V. For employers involved in construction, erection, installation and similar contracting operations the following shall apply:

(a) The payroll for employees assigned to a job of 2 days or less duration in a state, other than that of the business headquarters, shall be assigned to the state where the headquarters is located.

(b) The payroll for employees assigned to a job of 3 days or longer duration in a state, other than that of the business headquarters, shall be assigned to the state where the job is located.

(c) The payroll for employees assigned to general oversight of an out-of-state job, and not responsible for direct daily supervision, shall be assigned to the state where the headquarters is located.

(d) The payroll for employees hired for a specific job project shall be assigned to the state in which the job is located.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:33 Premium and Loss Information. 

All insurance companies writing workers' compensation coverage for risks located in the state of New Hampshire shall provide to each policyholder, on at least an annual basis, premium and loss information relative to the risk's workers' compensation experience. Such information shall include loss and claim specific information itemizing: name of claimant, claim number, date of loss, amounts paid and amounts in reserve with a notation indicating whether the claim is open or closed.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:34 Schedule Rating. 

The commissioner may permit insurers to use appropriate systems of schedule rating filed by any insurer or rating bureau approved by the commissioner, subject to rules adopted under RSA 541-A, to assure the uniform and impartial application of such rating. Such ratings shall be:

I. Based on an employer's safety policies and record, including its policies with regard to injured workers' return to work;

II. No greater than plus or minus 25 percent of the insurer's base rates;

III. Voluntary on the part of both the insurer and the employer; and

IV. Applicable to an annual premium greater than $1,000.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:35 Auditable Basis Policies. 

I. All workers' compensation policies issued in this state shall be issued on an auditable basis. A final premium shall be charged based upon actual exposure existing during the term of the policy coverage.

II. Audits shall be conducted by either physical inspection of an insured's records and operations, or by telephone or mail request by the insurer to the insured.

III. Audits shall be completed promptly, no more than 120 days after the expiration or cancellation of the policy, provided that there is no bona fide dispute. Any insurer that violates the provisions of this paragraph shall be subject to the penalty provisions of RSA 412:40.

IV. (a) In cases where there is a bona fide dispute, the insurer shall notify the insured in writing that there is a bona fide dispute and this notice shall toll the 120-day time period until the dispute is resolved. Upon resolution of the dispute, the insurer shall proceed to complete the audit within the time remaining in the 120-day time period. A bona fide dispute includes the insured's failure to cooperate with the audit, provided the insurer has notified the insured of:

(1) The acts or omissions that constitute the insured's failure to cooperate; and

(2) The consequences of the insured's failure to cooperate, including delay in the completion of the audit.

(b) The consequence of the insured's failure to cooperate with this paragraph within 30 days of the notice shall be the assessment of a penalty equaling 3 times the estimated premium and setting the estimated premium as the final premium. Upon receipt of the penalty and final premium, the insured shall have an additional 10 days to request that the penalty be waived and to have the final premium be recalculated based upon actual exposure by completing the audit that is required by paragraph III. No timely request by an insured for a waiver and recalculation shall be denied by the insurer. The request shall be granted upon completion of the audit.

V. Gross unearned premium shall be returned pursuant to RSA 402:81.


Source. 2003, 150:1. 2008, 211:1. 2014, 31:9, eff. July 26, 2014. 2020, 37:119, eff. Sept. 27, 2020.

    412:36 Part of Contract. 

The adjusted rate arrived at by any reduction or increase from the basic rate filed with and approved by the commissioner, in the application of such system of schedule or merit rating, shall be clearly set forth in the insurance contract or in the endorsement attached thereto.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:37-a Certificates of Insurance. 

Every certificate of insurance issued or presented in this state pursuant to a workers' compensation insurance policy shall contain the following information:

I. All states for which such statutory coverage is provided;

II. Names of all executive officers or members who are excluded, if any, pursuant to RSA 281-A:18-a, or a notation that no executive officers or members are excluded; and

III. Names of all sole proprietors or partners who have elected to be covered under the policy or a notation that no sole proprietors or partners are covered.


Source. 2008, 378:4, eff. Jan. 1, 2009.

    412:37-b Advisory Organizations;  Required Activity. 

The commissioner shall consult with workers' compensation advisory organizations, workers' compensation carriers, and third party administrators or self-insureds regarding the most effective options for including workers' compensation medical claims data in the New Hampshire comprehensive health information system, as defined under RSA 420-G:11-a. The commissioner shall make a report with recommendations on options for including workers' compensation medical claims data in the New Hampshire comprehensive health information system on or before December 1, 2015 to the speaker of the house of representatives, the president of the senate, the governor, and the chairpersons of the house and senate committees having jurisdiction over health and human services.


Source. 2015, 210:2, eff. Sept. 4, 2015.

    412:37 Repealed by 2004, 156:8, III, eff. July 23, 2004. 

    412:38 Examinations. 

I. The commissioner may, as often as he or she deems it expedient, make or cause to be made an examination of each advisory organization or statistical agent referred to in RSA 412:20 and of each group, association or other organization referred to in RSA 412:26, provided that each statistical agent and advisory organization licensed in this state shall be examined at least once every 5 years. The reasonable costs of any such examination shall be paid by the advisory organization, statistical agent or group, association or other organization examined. The officers, manager, agents and employees of such advisory organization, statistical agent, or group, association or other organization may be examined at any time under oath and shall exhibit all books, records, account, documents or agreements governing its method of operation. In lieu of any such examination, the commissioner may accept the report of an examination made by the insurance supervisory official of another state, pursuant to the laws of that state.

II. As often as the commissioner deems necessary, the commissioner or a delegate may examine all policies, daily reports, binders, renewal certificates, endorsements, and other evidences of insurance or of the cancellation thereof, for the purpose of ascertaining that lawful rates are being charged. In connection therewith the commissioner may require the company or any officer or agent to produce all books and papers relating to the formulation or change of such rates in the possession of the company or agent and shall have power to examine under oath any officer or agent of said company on matters pertinent to the formulation or changing of such rates. The expense of an examination undertaken pursuant to authority hereby conferred shall be borne by the company examined.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:39 False or Misleading Information. 

No person or organization shall willfully withhold information that will affect the rates or premiums chargeable under this chapter from, or knowingly give false or misleading information to the commissioner, any statistical agent, any advisory organization or any insurer. A person or organization violating this section shall be subject to the penalties provided in RSA 412:40.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:4 Consumer Information. 

I. The commissioner may utilize, develop, or cause to be developed consumer information which shall be provided on a readily available basis to purchasers of homeowners, private passenger nonfleet automobile, or property insurance for personal, family, or household needs.

II. The commissioner may utilize, develop, or cause to be developed consumer information which shall be provided on a readily available basis to purchasers of insurance for commercial risks and personal risks not otherwise specified herein.

III. Such consumer information may be developed internally within the insurance department, in cooperation with other state insurance departments, through outside contractors or in any other appropriate manner. Insurers, advisory organizations, statistical agents, and other persons or organizations involved in conducting the business of insurance in this state, to which this section applies, shall reasonably cooperate upon request in the development and utilization of consumer information.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:40 Penalties. 

I. The commissioner, may upon a finding that any person or organization has violated any provisions of this chapter, impose a penalty of not less than $500 or more than $10,000 for each violation, but if the violation is found to be willful, a penalty of not less than $1,000 or more than $25,000 may be imposed for each violation. Separate penalties may be in addition to any other penalty provided by law.

II. For purposes of this chapter, any insurer using a rate for which the insurer has failed to file the rate, supplementary rate information, underwriting rules or guidelines, or supporting information as required by this chapter, shall have committed a separate violation for each day such failure continues.

III. The commissioner may suspend or revoke the license of any advisory organization, statistical agent or insurer that fails to comply with an order of the commissioner within the time limited by such order, or any extension thereof which the commissioner may grant.

IV. The commissioner may determine when a suspension of license shall become effective and it shall remain in effect for the period fixed by the commissioner, unless the commissioner modifies or rescinds such suspension, or until the order upon which such suspension is based is modified, rescinded or reversed.

V. No penalty shall be imposed and no license shall be suspended or revoked except upon a written order of the commissioner stating his or her findings, made after hearing.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:41 Hearing and Appeal. 

Any insurer or organization aggrieved by any order or decision of the commissioner shall be entitled to a hearing and appeal in accordance with the provisions of RSA 541-A.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:42 Exemptions. 

The commissioner may by his or her own initiative or upon request of any person, by rule exempt any market from any or all of the provisions of this chapter, if and to the extent that the exemption is necessary to achieve the purposes of this chapter.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:43 Rulemaking Authority. 

I. The commissioner may make reasonable rules as necessary to effect the purposes of this chapter.

II. The commissioner shall adopt rules, under RSA 541-A, relative to defining "resident" for the purposes of this chapter and RSA 417-A. Such definition shall include any criteria necessary for determining residency in this state, including the residency of persons on active duty in the military service of the United States, retired persons, and other persons temporarily out of this state.

III. [Repealed.]


Source. 2003, 150:1. 2011, 137:2. 2012, 100:9, eff. July 28, 2012.

    412:44 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 provision or application; and, to this end, the provisions of this chapter are severable.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:5 Approval of Form. 

I. Every insurer and advisory organization shall file policy forms, endorsements, and other contract language covered by this chapter and RSA 264, for a waiting period of 30 days before it becomes effective, which period may be extended by the commissioner for an additional period not to exceed 30 days if written notice or electronic notice is given within the initial 30-day waiting period to the insurer or advisory organization which made the filing that additional time is needed for the consideration of the filing. Upon written application by the insurer or advisory organization, the commissioner may authorize a filing which has been reviewed to become effective before the expiration of the waiting period or extension thereof. The commissioner may disapprove such form if it contains a provision that does not comply with the requirements of law, is not in the public interest, is contrary to public policy, is inequitable, misleading, deceptive, or encourages misrepresentation of such policy. An approved filing and any supporting information that is not exempt from disclosure by law or rule shall be open to public inspection on or after the date that the filing is approved or the effective date, whichever is later. A filing shall be deemed to meet the requirements of this chapter unless disapproved by the commissioner within the waiting period or extension thereof. Every policy issued by an insurer on an unapproved form shall constitute a separate violation under RSA 412:40.

I-a. Except as otherwise provided in this section:

(a) Forms for the following types of commercial insurance shall be exempt from the 30-day waiting period requirement of paragraph I and shall instead be filed for informational and auditing purposes only and shall be filed within 30 days of the effective date:

(1) Fidelity.

(2) Kidnap and ransom.

(3) Political risk and expropriation.

(4) Excess and umbrella liability.

(5) Directors' and officers' liability.

(6) Fiduciary liability.

(7) Employment practices liability.

(8) Errors and omissions and professional liability other than medical malpractice.

(9) Media liability.

(10) Product liability, product recall, and completed operations.

(11) Highly protected commercial property.

(12) Commercial flood insurance other than the National Flood Insurance Program.

(13) Any other commercial lines of insurance coverage or risk that the commissioner shall, pursuant to regulation, exempt from policy form filing requirements in order to promote enhanced competition or to more effectively use the resources of the department.

(b) All other standards in paragraph I shall apply to forms that are filed for information and audit purposes under this paragraph.

(c) Subparagraph (a) shall not apply to the insurance listed under subparagraphs (a)(1)-(11) when:

(1) The commissioner has determined that a reasonable degree of competition does not exist for that type of insurance, and a ruling has been issued to that effect in accordance with RSA 412:13; or

(2) The policy form for that type of insurance is issued by a risk sharing plan established under RSA 404-C.

II. No liability policy issued or delivered in this state that insures against personal risk shall contain any exclusion which would preclude coverage for intra-family or inter-spousal claims.

III. No liability policy issued or delivered in this state shall contain coverage for payment of a fine or penalty for a criminal offense provided, however, the policy may provide coverage for defense costs and restitution to injured parties.

IV. An insurer may authorize an advisory organization to file policy forms, endorsements and other contract language on its behalf.

V. Every insurer and advisory organization shall provide reasonable means whereby any person aggrieved by the application of an insurer's rating system, claims practices, sales practices or underwriting procedures may be heard, in person or by an authorized representative, upon the person's written request to review the manner in which such procedures were applied in connection with insurance afforded or tendered to the person.

VI. This section shall not apply to the following insurance products: mortgage guaranty, surety bonds, commercial inland marine, financial guaranty, and boiler and machinery.


Source. 2003, 150:1. 2006, 9:2. 2008, 212:4. 2009, 215:4. 2014, 31:7. 2015, 70:1, eff. Aug. 1, 2015. 2017, 55:2, 3, eff. Aug. 1, 2017. 2018, 68:2, eff. July 24, 2018. 2019, 10:1, 2, eff. July 9, 2019.

    412:6-a Changes in Coverage. 

I. In the event that a company or filing or advisory organization eliminates or reduces coverages, conditions, or definitions in its policies issued under this section other than at the request of a policyholder, the company shall attach to the policy at renewal a printed notice in each such policy explaining clearly what coverages, conditions, or definitions have been eliminated or reduced. If explanations of such reduced or eliminated coverages are not contained in the printed notice attached to its policies at renewal, then such coverages, conditions, or definitions shall remain in full force and effect without such reductions or eliminations.

II. Except as provided in paragraph III, no insurance policy renewal shall add any stand-alone, premium bearing coverage unless such coverage is added at the request of the policyholder or is due to a requirement imposed by law.

III. If the policyholder has not requested that new premium bearing coverage be added to a policy upon renewal, but such coverage is added because the company is replacing coverage or a policy that the company no longer offers, the company shall provide a printed notice explaining clearly what coverage has been added and how to obtain information concerning premium impact.

IV. The requirements of this section shall apply to such policies renewed or endorsed with the same company, or a group of companies affiliated by ownership or contractual relationship encompassing joint operations or processes as filed and approved by the commissioner.


Source. 2004, 156:2. 2006, 196:6. 2009, 215:7, eff. Sept. 13, 2009. 2018, 132:3, eff. July 29, 2018.

    412:6-b Certificates of Insurance. 

I. In this section:

(a) "
Certificate
" or "
certificate of insurance
" means any document or instrument, no matter how titled or described, which is issued by an insurer or insurance producer as evidence of property or casualty insurance coverage. "Certificate" or "certificate of insurance" shall not include a policy of insurance or insurance binder.

(b) "
Certificate holder
" means any person, other than a policyholder, who possesses a certificate of insurance and is identified as the certificate holder on the certificate.

(c) "
Insurance producer
" means an insurance producer licensed under RSA 402-J.

(d) "
Insurer
" means an entity established to conduct the kinds of insurance business as provided in RSA 401 and licensed in accordance with the provisions of RSA 402 or RSA 405.

(e) "
Person
" means any individual, partnership, corporation, association, or other legal entity, including any government or governmental subdivision or agency.

(f) "
Policyholder
" means a person who has contracted with a property or casualty insurer for insurance coverage.

II. (a) No person shall issue a certificate of insurance that:

(1) Does not comply with the requirements of subparagraph (b).

(2) Is misleading, deceptive, or encourages misrepresentation.

(3) Violates any law.

(b) The following are requirements for the content, purpose, issuance, and use of certificates of insurance:

(1) Each certificate shall contain the following statement, or language substantially similar, in sufficient font and size and located on the certificate to be readily identifiable:

"This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend, or alter the coverage, terms, exclusions, and conditions afforded by the policy or policies referenced herein."

(2) No person shall demand or require the issuance of a certificate of insurance from an insurer, insurance producer, or policyholder that contains any false or misleading information concerning any policy of insurance to which the certificate makes reference.

(3) No person shall knowingly prepare or issue a certificate of insurance that contains any false or misleading information.

(4) No person shall prepare or issue a certificate of insurance that purports to affirmatively or negatively alter, amend, or extend the coverage provided by any policy of insurance referenced in the certificate; provided that with respect to subparagraph (3) and this subparagraph a certificate may show an umbrella/excess liability limit less than the actual policy limit if the certificate is issued with respect to a particular agreement or contract and such lower limit meets the requirements of the agreement.

(5) The requirements of this section shall apply to certificates of insurance issued as evidence of insurance policies and coverage on property, operations, or any risk located in this state, regardless of where the certificate holder, policyholder, insurer, or insurance producer is located.

(6) No certificate of insurance shall contain references to contracts, including construction or service contracts, other than the referenced contract of insurance, unless such reference is in relation to coverage or other requirements of the insurance contract.

(7) A certificate holder shall only have a contractual right to notice of cancellation, nonrenewal, or any similar notice concerning a policy of insurance if the person is identified and designated within the policy or any endorsement to that policy as an additional insured and that policy or endorsement requires notice to be provided.

(c) The commissioner may publish sample certificates of insurance which provide templates as to form and content, which, in his or her opinion, meet the requirements of subparagraph (b) and are acceptable for use by insurers and insurance producers. In addition to templates developed by the commissioner, insurance industry trade organizations, and supporting entities, may submit templates for consideration and inclusion in the set of sample certificates so published.

(d) An insurer or insurance producer may prepare or issue an addendum to a certificate that clarifies and explains the coverage provided by any policy of insurance referenced in the certificate and otherwise complies with the requirements of this section.

(e) An insurance producer may charge a reasonable fee for providing a certificate. A fee shall be reasonable if it accurately reflects the actual effort and cost to the producer required to prepare and issue the certificate.

(f) With the permission of the policy holder, an insurance producer may provide any bank or lending institution with a copy of the certificate of insurance, policy of insurance, or insurance binder relating to the subject property. If the insurance producer provides a copy of the insurance, policy of insurance, or insurance binder, an insurance producer may complete supplemental questionnaires for a bank or lending institution, provided that the insurance producer shall not be required to analyze or warrant any provisions of the insurance policy.


Source. 2011, 137:1. 2012, 100:6-8, eff. July 28, 2012. 2018, 24:1, eff. July 14, 2018.

    412:6 Prepayment of Judgment Prohibited. 

No corporation or other insurer shall issue or deliver any policy of insurance against loss or expense by reason of claims made upon the insured for damages on account of bodily injuries suffered by an employee of the insured, or by any other person, or on account of damage to or the destruction of property, or wrongful acts and economic damages, which shall contain any provision making, or purporting to make, the pre-payment of any judgment that may be recovered against the insured upon any claim covered by the policy a condition precedent to any right of action against the insurer upon said policy; but every such policy shall contain an agreement in clear and explicit terms binding the insurer, to the extent of the liability assumed by the policy, to pay and satisfy any such judgment, and to protect the insured against the levy of any execution issued upon the same.


Source. 2003, 150:1, eff. Jan. 1, 2004.

    412:7 Policies;  Forms. 

For policies of insurance issued to large commercial policyholders defined in RSA 412:3, XI, the filing requirements for forms or policy contracts shall not apply, except that:

I. All policies issued pursuant to the provisions of this chapter shall contain a conspicuous disclaimer printed in at least 10-point, bold-faced type that states that the policy applied for, including the rates, rating plans, resulting premiums, and the policy forms, are not subject to the rate and form requirements of this state and other provisions of the insurance law that apply to other commercial products and may contain significant differences from a policy that is subject to all provisions of the insurance law. Such notice shall set forth possible differences in policy conditions, forms, and endorsements, as compared to a policy that is subject to all of the provisions of the insurance law. The commissioner may prescribe the format and provisions of such notice. The disclosure notice shall also include a policyholder's acknowledgment statement, to be signed and dated prior to the effective date of the coverage, and shall remain on file with the insurer.

II. In procuring insurance, a large commercial policyholder shall certify that it meets the eligibility requirements set out in RSA 412:3, XI and specify the requirements that the policyholder has met. This certification is to be completed annually and remain on file with the insurer.

III. A surplus lines broker seeking to obtain or provide insurance for a large commercial policyholder is not authorized to purchase insurance from any eligible unauthorized insurer without making a diligent search of authorized insurers as required by RSA 405:24.


Source. 2003, 150:1. 2004, 156:3, eff. July 23, 2004.

    412:8 Requirements of Coverage. 

I. No insurer shall issue any motor vehicle liability policy, with respect to any motor vehicle registered or principally garaged in this state, that does not provide at least the minimum coverage set forth in RSA 264.

II. No liability policy issued with respect to any motor vehicle registered or principally garaged in this state that insures against personal risk shall contain any exclusion which would preclude coverage for intra-family or inter-spousal claims.

III. When an automobile insurance policy contains coverage for physical damage by reason of collision, any deductible amount of such coverage shall not apply if the damage is caused by an uninsured motor vehicle, including a motor vehicle which is uninsured within the definition of RSA 259:117, and the operator of the uninsured vehicle has been positively identified and is solely at fault.


Source. 2003, 150:1. 2009, 215:5. 2014, 31:8, eff. July 26, 2014. 2017, 55:4, eff. Aug. 1, 2017.

    412:9 Prohibition on Nonresident Automobile Insurance. 

Policies of automobile insurance, as defined in RSA 417-A, shall only be issued and renewed to residents of the state of New Hampshire, except that such policies shall also be permitted to be sold to any person if the vehicle insured is exclusively garaged in New Hampshire. Notwithstanding any other provision of law to the contrary, no individual shall be provided coverage under a policy of automobile insurance, as defined in RSA 417-A, if such applicant or applicants have been determined by the insurer to have intentionally misrepresented their residency status or exclusive garaging status at the time of initial application or renewal. Payment shall be made by the insurer with respect to accidents for all valid bodily injury and property damage liability claims and all valid uninsured motorist claims by individuals other than the applicant or applicants who made the intentional misrepresentation. However, the insurer shall be legally entitled to reimbursement by the policyholder for all such paid claims.


Source. 2003, 150:1, eff. Jan. 1, 2004. 2021, 147:1, eff. Sept. 21, 2021.

    415-A:1 Definitions. 

In this chapter:

I. "
Accident and health insurance
" means insurance written under RSA 415, RSA 21-I:99-21-I:111, RSA 282-B, and coverages written under RSA 415-E, RSA 420-A, RSA 420-B, and RSA 420-C. For purposes of this chapter, multiple-employer welfare arrangements, nonprofit health service corporations, health maintenance organizations, and preferred provider agreements subject to RSA 420-C shall be deemed to be engaged in the business of insurance.

I-a. "
Claim denial
" means any of the following: a denial, reduction, or termination of, or a failure to provide or make payment (in whole or in part) for, a benefit, including any such denial, reduction, termination, or failure to provide or make payment that is based on a determination of a participant's or beneficiary's eligibility to participate in a plan, and including, with respect to group health plans, a denial, reduction, or termination of, or a failure to provide or make payment (in whole or in part) for, a benefit resulting from the application of any utilization review, as well as a failure to cover an item or service for which benefits are otherwise provided because it is determined to be experimental or investigational or not medically necessary or appropriate.

I-b. "
Claim involving urgent care
" means any claim for medical care or treatment with respect to which the application of the time periods for making non-urgent care determinations:

(a) Could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function; or

(b) In the opinion of a physician with knowledge of the claimant's medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care or treatment that is the subject of the claim.

I-c. "
Claimant's representative
" shall mean an individual authorized by a claimant in writing to pursue a claim or appeal on the claimant's behalf.

I-d. "
Date of enrollment
" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

I-e. "
Employee benefit plan
" means employee welfare benefit plans described in section 3 of the Employee Retirement Income Security Act of 1974, 29 U.S.C., section 1002 and not exempted under section 4(b) of this Act, 29 U.S.C. section 1003, other than those plans, or portions of them, that provide disability benefits.

II. "
Form
" means policies, contracts, riders, endorsements, and applications as provided in RSA 415, RSA 21-I:99-21-I:111, RSA 282-B, RSA 415-E, RSA 420-A, RSA 420-B, and RSA 420-C.

III. "Policy" means the entire contract between the insurer and the insured, including the policy, riders, certificates, endorsements and the application, if attached, and also includes subscriber contracts issued by nonprofit hospital and medical service associations.

IV. "
Post-service claim
" means any claim for a health benefit to which the terms of the plan do not condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining the medical care. "
Post-service claim
" shall not include a request for reimbursement made by a provider pursuant to the terms of an agreement between the provider and the health carrier.

V. "
Pre-service claim
" means any claim for a benefit under a health plan with respect to which the terms of the plan condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining medical care. "
Pre-service claim
" shall not include a request for reimbursement made by a provider pursuant to the terms of an agreement between the provider and the health carrier.


Source. 1975, 494:1. 1995, 112:14. 1997, 190:9. 2001, 207:1, 2. 2003, 175:1, 2. 2007, 289:8, eff. Jan. 1, 2008. 2016, 111:4, eff. May 20, 2016. 2022, 42:9, 10, eff. July 2, 2022.

    415-A:2-a Insurance Contracts;  Welfare Recipients. 

No accident or health insurance policy issued or renewed after August 28, 1981 shall contain any provision denying or limiting insurance benefits because services are rendered to an insured or a dependent who is eligible for or who receives medical assistance under RSA 167 or RSA 161.


Source. 1981, 502:3, eff. Aug. 28, 1981.

    415-A:2-b Use of Term Physician in Provider Contracts. 

No contract shall use the term physician for the purpose of allowing a health care insurer to avoid contracting with other health care professionals for health care services. A physician shall mean a person licensed to practice medicine under RSA 329. Nothing in this section shall be construed to require a health care insurer to contract with a health care provider.


Source. 1998, 377:1, eff. Aug. 25, 1998.

    415-A:2 Standards for Policy Provisions. 

I. The commissioner shall adopt rules to establish specific standards, including standards of full and fair disclosure, that set forth the manner, content and required disclosure for the sale of all policies of accident and health insurance which shall be in addition to, and in accordance with, applicable laws of this state, including RSA 415, which may cover but shall not be limited to:

(a) Terms of renewability.

(b) Initial and subsequent conditions of eligibility.

(c) Nonduplication of coverage provisions.

(d) Coverage of dependents.

(e) Preexisting conditions.

(f) Termination of insurance.

(g) Probationary periods.

(h) Limitations.

(i) Exceptions.

(j) Reductions.

(k) Elimination periods.

(l) Requirements for replacement.

(m) Recurrent conditions.

(n) The definition of terms including but not limited to the following: hospital, accident, sickness, injury, physician, accidental means, total disability, partial disability, nervous disorder, guaranteed renewable and noncancellable.

II. The commissioner may adopt rules prohibiting provisions which may be misleading or unreasonably confusing in connection with either the purchase of insurance or the settlement of claims; prohibiting provisions which may be contrary to the health care needs of the public or coverage which is so limited in scope as to be of no significant economic value to the holders thereof; and prohibiting provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair and unfairly discriminatory to the policyholder, certificate holder or subscriber, any other person insured under the policy, or the beneficiary.


Source. 1975, 494:1, eff. Aug. 28, 1975.

    415-A:3 Minimum Standards for Benefits. 

I. The commissioner may adopt rules to establish minimum standards for benefits under each of the following categories of coverage:

(a) Basic hospital expense coverage.

(b) Basic medical-surgical expense coverage.

(c) Basic hospital/medical-surgical expense coverage.

(d) Hospital confinement indemnity coverage.

(e) Major medical expense coverage.

(f) Basic medical expense coverage.

(g) Disability income protection coverage.

(h) Accident only coverage.

(i) Specified disease coverage.

(j) Specified accident coverage.

(k) Limited benefit health coverage.

(l) Student major medical expense coverage.

(m) Paid family medical leave coverage.

II. Nothing in this section shall preclude the issuance of any policy or contract which combines 2 or more of the categories of coverage enumerated in subparagraphs I(a) through (m).

III. No policy shall be delivered or issued for delivery in this state which does not meet the prescribed minimum standards for the categories of coverage listed in subparagraphs I(a) through (m) which are contained within the policy unless the commissioner finds such policy will be in the public interest and such policy meets the requirements set forth in RSA 415. The commissioner may disapprove specific policy forms pursuant to RSA 415:2 and 3.

IV. The commissioner shall prescribe the method of identification of policies and contracts based upon coverages provided and may issue rules prescribing reasonable standardization and simplification of coverage to facilitate understanding and comparisons.


Source. 1975, 494:1. 2002, 207:5, 6. 2010, 188:3, 4, eff. Aug. 20, 2010. 2022, 42:11, eff. July 2, 2022.

    415-A:4-a Minimum Standards for Claim Review;  Accident and Health Insurance. 

Any carrier that offers group health plans and employee benefit plans shall establish and maintain written procedures by which a claimant may obtain a determination of claims and by which a claimant may appeal a claim denial.

I. The procedures for determination of a claim shall meet the following minimum standards:

(a) The plan shall maintain a toll-free telephone number to ensure that a representative of the plan shall be accessible by telephone to insureds, patients, and claimant's representatives as required to meet the response times specified herein.

(b) Clinical review criteria considered or utilized in making claim benefit determinations shall be:

(1) Developed with input from appropriate practitioners with professional knowledge or clinical expertise in the area being reviewed;

(2) Updated at least biennially and as new treatments, applications, and technologies emerge;

(3) Developed in accordance with the standards of national accreditation entities;

(4) Based on current, nationally accepted standards of medical practice; and

(5) If practicable, evidence-based.

(c) The notification of a claim denial shall be communicated in writing or by electronic means and shall include:

(1) The specific reason or reasons for the determination and shall refer to the specific provision of the policy or plan on which the determination is based;

(2) A statement of the claimant's or the representative of the claimant's right to access the internal grievance process and the process for obtaining external review;

(3) If the claim denial is based upon a determination that the claim is experimental or investigational or not medically necessary or appropriate:

(A) The name and credentials of the carrier or other licensed entity, the medical director, including board status and the state or states where the person is currently licensed. If the person making the claim denial is not the medical director but a designee, then the credentials, board status, and state or states of current license shall also be provided for that person; and

(B) An explanation of the clinical rationale for the determination. This explanation shall recite the terms of the plan or the policy or of any clinical review criteria or any internal rule, guideline, protocol, or other similar provision that was relied upon in making the claim denial and how these provisions apply to the claimant's specific medical circumstances;

(4) If an internal rule, guideline, protocol, or other similar provision was relied upon in making the benefit determination, a statement that such rule, guideline, protocol, or other similar provision was relied upon in making the claim denial;

(5) If clinical review criteria were relied upon in making the benefit determination, a statement that such clinical review criteria were relied upon in making the claim denial. The recitation of the terms of the clinical review criteria required under RSA 415-A:4-a(c)(3)(B) shall be accompanied by the following notice: "The clinical review criteria provided to you are used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract;"

(6) A description of the plan's grievance procedures and the time limits applicable to such procedures. In the case of a denial of a benefit concerning a claim involving urgent care or in the case of a denial of a claim related to continuation of an ongoing course of treatment for a person who has received emergency services, but who has not been discharged from a facility, a description of the expedited review applicable to such a claim shall be included in the determination. For all other claim benefit determinations, a description of the grievance process shall be specifically described in the determination.

II. Notification of a claim denial shall be made within the following time periods:

(a) The determination of a claim involving urgent care shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 72 hours after receipt of the claim, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the licensee shall notify the claimant or claimant's representative within 24 hours of receipt of the claim and shall advise the claimant or claimant's representative of the specific information necessary to determine the claim. The claimant or the claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the benefit determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(b) The determination of a claim involving urgent care and relating to the extension of an ongoing course of treatment and involving a question of medical necessity shall be made within 24 hours of receipt of the claim, provided that the claim is made at least 24 hours prior to the expiration of the prescribed period of time or course of treatment.

(c) The determination of all other claims for preservice benefits shall be made within a reasonable time period appropriate to the medical circumstances, but in no event more than 15 days after receipt of the claim. This period may be extended one time by the licensee for up to 15 days; provided, that the licensee both determines that such an extension is necessary due to matters beyond the control of the licensee and notifies the claimant or claimant's representative, prior to the expiration of the initial 15-day period, of the circumstances requiring the extension of time and the date by which the licensee expects to render a decision. If such an extension is necessary due to a failure of the claimant or claimant's representative to provide sufficient information to determine whether, or to what extent, benefits are covered as payable, the notice of extension shall specifically describe the required additional information needed, and the claimant or claimant's representative shall be given at least 45 days from receipt of the notice within which to provide the specified information. Notification of the benefit determination following a request for additional information shall be made as soon as possible, but in no case later than 15 days after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(d) The determination of a post-service claim shall be made within 30 days of the date of filing. In the event the claimant fails to provide sufficient information to determine the claim, the carrier shall notify the claimant within 15 days as to what additional information is required to process the claim and the claimant shall be given at least 45 days to provide the required information. The 30-day period for claim determination shall be tolled until such time as the claimant submits the required information.

III. Any carrier or other licensed entity that offers group health plans and employee benefit plans shall file with the department a copy of its claim determination procedure, including all forms used, and a copy of the materials designed to inform its members or insureds of the requirements of the claim determination and grievance procedure and the responsibilities and rights of the members or insureds under the plan each year. The carrier shall also file an acknowledgment that all applicable state and federal laws to protect the confidentiality of individual medical records are followed.

IV. In any request for a benefit determination, the claimant may authorize a representative to pursue the claim or benefit determination by submitting a written statement to the licensed entity that acknowledges the representation.

V. No fees or costs shall be assessed against a claimant related to a request for claim benefit determination.


Source. 2001, 207:3. 2003, 175:3, 4; 276:4-7. 2005, 248:7. 2006, 304:2, eff. Aug. 18, 2006.

    415-A:4-b Appeal Procedure. 

Every carrier or other licensed entity which offers group health insurance or employee benefit plans shall file with the insurance department, by April 1 of each year, and shall maintain a written procedure by which a claimant, or a representative of the claimant, shall have a reasonable opportunity to appeal a claim denial to the carrier or other licensed entity, and under which there shall be a full and fair review of the claim denial. The written procedure filed with the insurance department shall include all forms used to process an appeal.

I. Full and fair review shall require that:

(a) The person or persons reviewing the grievance shall not be the same person or persons making the initial determination, shall not be subordinate to or the supervisor of the person making the initial determination, and shall act as a fiduciary;

(b) The person reviewing the grievance on a first or second level appeal shall have appropriate medical and professional expertise and credentials to competently render a determination on appeal;

(c) The claimant or claimant's representative shall have at least 180 days following receipt of a notification of an adverse claim determination to appeal;

(d) The claimant or claimant's representative shall have an opportunity to submit written comments, documents, records, and other information relating to the claim without regard to whether those documents or materials were considered in making the initial determination;

(e) The claimant or claimant's representative shall be provided upon request, and without charge, reasonable access to, and copies of all documents, records, and other information relevant to or considered in making the initial adverse claim determination; and

(f) The review shall be a de novo proceeding and shall consider all information, documents, or other material submitted in connection with the appeal without regard to whether the information was considered in making the claim denial.

II. In the appeal of a claim denial that is based in whole or in part on a medical judgment:

(a) The review shall be conducted by or in consultation with a health care professional who has appropriate training and experience in the field of medicine;

(b) The titles and qualifying credentials of the person conducting the review shall be included in the decision; and

(c) The identity and qualifications of any medical or vocational expert whose advice was considered, without regard to whether it was relied upon in making the initial claim denial, shall be made available to the claimant upon request.

III. In the appeal of a claim for urgent care, a claim involving a matter that would seriously jeopardize the life or health of a covered person or would jeopardize the covered person's ability to regain maximum function, or a claim concerning an admission, availability of care, or the continued stay or health care service for a person who has received emergency services, but who has not been discharged from a facility, an expedited appeal process shall be made available which shall provide for:

(a) The submission of information by the claimant to the carrier by telephone, facsimile, or other expeditious method; and

(b) The determination of the appeal shall be made not more than 72 hours after the submission of the completed request for appeal.

IV. Timing and Notification for Determination on Appeal.

(a) In the case of nonexpedited appeal of a pre-service claim or a post-service claim, the determination on appeal shall be made within a reasonable time appropriate to the medical circumstances, but in no event more than 30 days after receipt by the carrier or other licensed entity of the claimant's appeal.

(b) In the case of an expedited appeal related to an urgent care claim, a carrier or other licensed entity shall make a decision and notify the covered person as expeditiously as the covered person's medical condition requires, but in no event more than 72 hours after the appeal is filed. If the expedited review involves ongoing urgent care services, the service shall be continued without liability to the covered person until the covered person has been notified of the determination. A carrier or other licensed entity shall provide written confirmation of its decision concerning an expedited review within 2 business days of providing notification of that decision, if the initial notification was not in writing.

(c) The period of time within which a decision shall be rendered on appeal shall begin to run at the time the appeal is filed in accordance with the appeal procedures of the carrier or other licensed entity, without regard to whether all the information necessary to make a determination on appeal is contained in the filing. In the event the claimant fails to submit information necessary to decide the appeal, the period for making the determination on appeal shall be tolled from the date the claimant is notified in writing of what additional information is required until the date the claimant responds to the request. The carrier or other licensed entity shall provide notification of incompleteness as soon as possible; but in no event more than 24 hours after the filing of the appeal in appeals involving urgent care. In the event that the claimant fails, within a 45-day period from the date of notification, to provide sufficient information, the carrier may deny the appeal on the basis of incompleteness. The appeal may be reopened upon receipt of the required information.

V. Manner and Content of Notification of Determination on Appeal.

(a) The carrier or other licensed entity shall provide a claimant with a written determination of the appeal that shall include:

(1) The specific reason or reasons for the determination, including reference to the specific provision of the policy or plan on which the determination is based;

(2) If the determination is based upon a finding that the claim is experimental or investigational or not medically necessary or appropriate:

(A) The name and credentials of the person reviewing the grievance, including board status and the state or states where the person is currently licensed; and

(B) An explanation of the clinical rationale for the determination. This explanation shall recite the terms of the plan or the policy or of any clinical review criteria or any internal rule, guideline, protocol, or other similar provision that was relied upon in making the claim denial and how these provisions apply to the claimant's specific medical circumstance;

(3) A statement describing all other dispute resolution options available to the claimant, including, but not limited to other options for internal review and options for external review, and options for bringing a legal action;

(4) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits;

(5) If an internal rule, guideline, protocol, or other similar provision was relied upon in making the claim denial, a statement that such rule, guideline, protocol, or other similar provision was relied upon in making the claim denial; and

(6) A statement describing the claimant's right to contact the insurance commissioner's office for assistance which shall include a toll-free telephone number and address of the commissioner.

(b) A carrier or other licensed entity that offers group health plans or employee benefit plans shall file with the commissioner by April 1 of each year, a copy of its current grievance procedures, with all changes from the previous year annotated in the document, and a certificate of compliance , stating that the carrier or other licensed entity has established and maintained, for each of its health benefit plans, grievance procedures that fully comply with the provisions of this chapter. Material modifications to the procedure shall be filed with the commissioner prior to becoming effective.

(c) A carrier or other licensed entity that offers group health plans or employee benefit plans shall maintain written records documenting all grievances and appeals received during a calendar year, a general description of the reason for the appeal or grievance, the name of the claimant, the dates of the appeal or grievance and the date of resolution.

(d) A carrier or other licensed entity that offers group health plans or employee benefit plans shall provide to consumers:

(1) A description of the internal grievance procedure for claim determinations and other matters. The description shall be set forth in or attached to the policy, certificate, membership booklet, or other evidence of coverage provided to covered persons;

(2) A statement of a covered person's right to contact the commissioner's office for assistance at any time. The statement shall include the toll-free telephone number and address of the commissioner; and

(3) A statement that the carrier or other licensed entity will provide assistance in preparing an appeal of an adverse benefit determination, and a toll-free telephone number to contact the carrier or other licensed entity.

(e) In any case where a carrier or other licensed entity that offers group health plans or employee benefit plans provides 2 levels of appeal for the pre-service claim determinations, the first level shall be completed within 15 days and the second level completed within the 30-day time period beginning from the initial date of filing the appeal or grievance. With respect to a second level appeal involving a claim for continuation of services or urgent care, the carrier or other licensed entity shall make a decision and notify the claimant within 72 hours after the second level appeal is filed. For second level appeals involving a post-service claim, the carrier shall make a decision and notify the claimant within 60 days of the date the appeal was filed.

(f) Annual reports shall be made to the insurance commissioner regarding plan complaints, claim denials, and prior authorization statistics in such form and containing such information as the commissioner may prescribe by rule or otherwise.

VI. In an appeal of a claim denial or other matter, the claimant may authorize a representative to pursue a claim or an appeal by submitting a written statement to the carrier or other licensed entity that acknowledges the representation.

VII. No fees or costs shall be assessed against a claimant related to a request for a grievance or appeal.


Source. 2001, 207:3. 2003, 175:5, 6. 2006, 304:3. 2007, 289:9. 2012, 99:2, eff. July 28, 2012.

    415-A:4 Outline of Coverage. 

I. In order to provide for full and fair disclosure in the sale of all policies of accident and health insurance, no such policy shall be delivered or issued for delivery in this state unless:

(a) In the case of a direct response insurance product, the outline of coverage described in paragraph III accompanies the policy; and

(b) In all other cases, the outline of coverage described in paragraph III is delivered to the applicant at the time application is made and an acknowledgment of receipt or certificate of delivery of such outline is provided the insurer with the application.

II. In the event the policy is issued on a basis other than that applied for, the outline of coverage properly describing the policy must accompany the policy when it is delivered and clearly state that it is not the policy for which application was made.

III. The commissioner shall prescribe the format and content of the outline of coverage required by paragraph I. "Format" means style, arrangement and overall appearance, including such items as the size, color and prominence of type and the arrangement of text and captions. Such outline of coverage shall include a:

(a) Statement identifying the applicable categories of coverage provided by the policy or contract as prescribed in RSA 415-A:3.

(b) Description of the principal benefits and coverage provided in the policy or contract.

(c) Statement of the exceptions, reductions and limitations contained in the policy or contract.

(d) Statement of the renewal provisions including any reservation by the insurer or nonprofit hospital or medical service association of a right to change premiums.

(e) Statement that the outline is a summary of the policy or contract issued or applied for and that the policy or contract should be consulted to determine governing contractual provisions.

(f) Statement that a maternity benefits rider will be made available at the insured's request, if maternity care is not covered under the policy. Nothing in this subparagraph shall be construed to apply to supplemental health insurance and disability insurance policies.


Source. 1975, 494:1. 1993, 196:2, eff. Jan. 1, 1994.

    415-A:5-a Access to Enhanced 911 System. 

I. No accident or health insurance policy issued or renewed after July 7, 2000 shall contain any provision which establishes or promotes an emergency medical response or transportation system that encourages or directs access by an insured or enrollee in competition with or in substitution of the state enhanced 911 system or other state, county, or local government emergency medical services system.

II. Notwithstanding paragraph I, an insurer may use transportation outside the enhanced 911 or other government emergency medical services system for services that are not in response to an emergency medical condition, as defined in RSA 420-J:3, XV.

III. No accident or health insurance policy issued or renewed after July 7, 2000 shall contain any provision requiring an insured or enrollee to obtain prior authorization before accessing the enhanced 911 system or other state, county, or local government emergency medical services system for response and/or transportation for emergency services, as defined in RSA 420-J:3, XVI.

IV. No person who issues an accident or health insurance policy subject to this chapter shall use false or misleading language in its enrollment sales materials or in any other materials provided to insureds or enrollees to discourage or prohibit insureds or enrollees from accessing the enhanced 911 system for response and/or transportation for emergency services.


Source. 2000, 104:1, eff. July 7, 2000.

    415-A:5 Preexisting Conditions. 

I. If an insurer or a nonprofit hospital or medical service association elects to use a simplified application form for a policy other than a Medicare supplement policy, with or without a question as to the applicant's health at the time of application, but without any questions concerning the insured's health history or medical treatment history, the policy, 9 months after the date of enrollment, must cover any loss occurring from any preexisting condition not specifically excluded from coverage by terms of the policy and, except as so provided, the policy shall not include wording that would permit a defense based upon preexisting conditions.

II. [Repealed.]

III. Health carriers issuing policies subject to RSA 420-G shall not impose any preexisting condition exclusion that is inconsistent with that chapter.


Source. 1975, 494:1. 1981, 418:1. 1995, 112:23, II. 2004, 187:4. 2007, 289:10. 2011, 189:6, eff. Aug. 13, 2011. 2019, 220:12, eff. Sept. 10, 2019.

    415-A:6 Adoption of Rules. 

I. Rules promulgated pursuant to this chapter shall be subject to notice and hearing pursuant to RSA 541-A. When a rule adopted pursuant to this chapter so provides, a policy of insurance issued subsequent to the rule's effective date and any optionally renewable policy of insurance renewed subsequent to the rule's effective date which does not comply with the rule shall, not less than 60 days after the rule's effective date, be construed, and the insurer or corporation shall be liable, as if the policy did comply with the rule.

II. The commissioner shall adopt rules to establish specific standards for processing benefit claims under group disability plans that shall be consistent with and not more restrictive than the United States Department of Labor Benefit Claims Procedure Regulation, 29 CFR 2560.503, as existing and thereafter amended, that sets standards for group disability plans under the Employee Retirement Income Security Act of 1974.


Source. 1975, 494:1. 2003, 175:7, eff. Jan. 1, 2004.

[RSA 415-A:7 repealed by 2020, 15:2, effective July 1, 2024.]
    415-A:7 Establishing Excess Cost Sharing. 

I. In this section:

(a) "
Insurer
" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a policy of insurance, health service corporation, health maintenance organization, preferred provider agreement, or any other entity providing accident and health insurance.

(b) "
Rebate
" means:

(1) Negotiated price concessions including, but not limited to, base rebates and reasonable estimates of any price protection rebates and performance-based rebates that may accrue directly or indirectly to the insurer during the coverage year from a manufacturer, dispensing pharmacy, or other party to the transaction; and

(2) Reasonable estimates of any fees and other administrative costs that are passed through to the health carrier and serve to reduce the insurer's prescription drug liabilities for the coverage year.

II. All rebates remitted by or on behalf of a pharmaceutical manufacturer, developer or labeler, directly or indirectly, to an insurer, or to a pharmacy benefits manager under contract with an insurer, related to its prescription drug benefits shall be remitted in one or both of the following ways:

(a) Remitted directly to the covered person at the point of sale to reduce the out-of-pocket cost to the covered person associated with a particular prescription drug;

(b) Remitted to, and retained by, the insurer. Rebates remitted to the insurer shall be applied by the insurer in its plan design and in future plan years to offset the premium for covered persons.

III. Beginning November 1, 2020 and annually thereafter, an insurer shall file with the commissioner a report in the manner and form determined by the commissioner demonstrating the manner in which the insurer has complied with this section.

IV. Any insurer that violates any provision of this section may, at the discretion of the commissioner, be subject to subparagraph (a) or (b), or both:

(a) Its certificate of authority may be indefinitely suspended or revoked.

(b) A civil fine not to exceed $2,500 may be imposed for each violation. Repeated violations of the same provision shall constitute separate civil offenses.

V. In making the disclosures required under this section, an insurer shall not be required by the department to publish or otherwise reveal information regarding the amount of rebates it receives, including, but not limited to, information regarding the amount of rebates it receives on a product-, manufacturer-, or pharmacy-specific basis. Such information is protected as a trade secret, is not a public record subject to disclosure under RSA 91-A:1, and shall not be disclosed directly or indirectly. An insurer shall impose the confidentiality provision of this section on any vendor or third party that performs health care or administrative services on behalf of the insurer that may receive or have access to rebate information.


Source. 2020, 15:1, eff. Sept. 15, 2020.

    415-B:1 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Insurance premium finance company" means a person engaged in whole or in part in the business of entering into premium finance agreements.

III. "Licensee" means an insurance premium finance company holding a license issued under this chapter.

IV. "Person" means an individual, partnership, association, business corporation, nonprofit corporation, common law trust, joint-stock company, or any other group of individuals however organized.

V. "Premium finance agreement" means an agreement by which an insured or prospective insured promises to pay to an insurance premium finance company the amount advanced or to be advanced under the agreement to an insurer or to an insurance agent or broker in payment of premiums of an insurance contract, together with interest or discount and a service charge as authorized and limited by this chapter, and in which as security for the amount advanced the premium finance company receives an assignment of the gross unearned premiums of such insurance contract.

VI. "Default" means the failure of the named insured to discharge when due any of his obligations in connection with the payment of premiums on a policy, or any installment of such premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:10 Return Premiums. 

Whenever a financed insurance contract is cancelled, the insurer shall return whatever gross unearned premiums are due under the insurance contract to the premium finance company for the account of the insured or insureds as soon as reasonably possible, but in any event, within 30 days after the effective date of cancellation. On auditable policies, gross unearned premiums shall be returned within 30 days after the date of the completed audit of the insured. In the event that a crediting of return premiums to the account of the insured results in a surplus over the amount due from the insured, the premium finance company shall refund such excess to the insured provided that no such refund shall be required if it amounts to less than $1. This section shall not apply to retrospectively rated policies.


Source. 1981, 118:1. 1988, 221:3. 1993, 210:6, eff. Jan. 1, 1994.

    415-B:11 Exemption From Filing Requirements. 

No filing of the premium finance agreement shall be necessary to perfect the validity of such agreement as a secured transaction as against creditors, subsequent purchases, pledges, encumbrancers, successors, or assigns.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:12 Rulemaking Authority. 

The commissioner may adopt rules pursuant to RSA 541-A for the purposes of this chapter.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:13 Penalty. 

Any premium finance company, insurer, agent, or broker who willfully and knowingly violates any provision of this chapter shall be guilty of a misdemeanor.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:2 License Required. 

I. No person shall engage in the business of a premium finance company in this state without having first obtained a premium finance company license from the commissioner, except as provided in paragraph IV.

II. The annual license fee shall be $200. Licenses may be renewed from year to year as of July 1 of each year upon payment of the license fee to the commissioner. Additionally, a premium finance company established in this state shall file with the commissioner proof of minimum capital and surplus in an amount equal to or greater than $250,000, or shall file with the commissioner a surety bond or equivalent acceptable to the commissioner in the amount of $250,000.

III. The commissioner may, at any time, require the applicant to disclose fully the identity of all stockholders, partners, officers, and employees; and he may, in his discretion, refuse to issue or renew a license in the name of any person, firm, partnership, or corporation if he is not satisfied that any officer, employee, stockholder, or partner thereof, who may materially influence the applicant's conduct, meets the standards of RSA 415-B:3, II.

IV. This section shall not require any insurance company, agent, broker, association, exchange, building or savings and loan association, bank, thrift institution, trust company, small loan company, industrial loan company or credit union authorized to do business in this state financing premiums on policies to be additionally licensed under this chapter; provided, however, that all other provisions of this chapter shall apply to such persons.


Source. 1981, 118:1. 2001, 224:7, eff. Sept. 9, 2001.

    415-B:3 Issuance and Renewal of License. 

I. Upon the filing of an application and the payment of the license fee, the commissioner shall make an investigation of each applicant and shall issue a license if the applicant is qualified in accordance with this chapter. If the commissioner does not find the applicant qualified, he shall, within 30 days after he has received such application, at the request of the applicant, give the applicant a full hearing.

II. The commissioner shall issue or renew a license when he is satisfied that the person to be licensed:

(a) Is competent and trustworthy and intends to act in good faith in the capacity involved by the license applied for;

(b) Has a good business reputation and has had experience, training or education so as to be qualified in the business for which the license is applied for; and

(c) If a corporation, is a corporation incorporated under the laws of this state or a foreign corporation authorized to transact business in this state.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:4 Revocation or Suspension of License;  Appeal. 

I. The commissioner may revoke or suspend the license of any premium finance company when, after investigation, the commissioner finds that:

(a) The license issued to such company was obtained by fraud;

(b) There was any misrepresentation in the application for the license;

(c) The holder of such license has shown himself untrustworthy or incompetent to act as a premium finance company; or

(d) Such company has violated any of the provisions of this chapter.

II. In lieu of revoking or suspending the license for any of the causes stated in paragraph I, after hearing as provided in paragraph III, the commissioner may subject such company to a penalty of not more than $1,500 for each offense when, in his judgment, he finds that the public interest would not be harmed by the continued operation of such company. The amount of any such penalty shall be paid by the company to the commissioner.

III. Before the commissioner shall penalize, revoke, suspend, or refuse to renew the license of any premium finance company, the aggrieved person shall be entitled to a hearing in accordance with RSA 541.

IV. If the commissioner refuses to issue a license as a premium finance company to any person, or if he revokes, suspends or refuses to renew the license of any premium finance company, or imposes a penalty on such company, after a hearing as provided under paragraph III, the applicant or licensee may appeal from such refusal to issue a license or from such adjudication in accordance with RSA 541.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:5 Licensee's Books and Records. 

I. Every licensee shall maintain records of its premium finance transactions. Such records shall be open to examination and investigation by the commissioner at any time during regular business hours at any location at which such records are maintained.

II. Every licensee shall preserve its records of such premium finance transactions, including cards used in a card system, if any, for at least 2 years after making the final entry in respect to any premium finance agreement. The preservation of records in photographic or microfilm form shall constitute compliance with this requirement.

III. Within 120 days after the completion of the fiscal year, each licensee shall file a report with the commissioner giving such information as the commissioner may require concerning the business operations during the preceding fiscal year of each licensee. Such information shall include but not be limited to a financial statement prepared according to generally accepted accounting principles and certified by a certified public accountant.

IV. Any licensee neglecting to make an annual report required by paragraph III or failing to amend such report within 15 days after notice from the commissioner shall, unless such neglect or failure is due to justifiable cause and not willful neglect, pay the state $25 for each day during which such neglect or failure continues.

V. If the licensee's records are located out of this state, the licensee at the licensee's option shall make such records available within 72 hours to the commissioner at a convenient location within the state, or pay the reasonable and necessary expenses for the commissioner or his representative to examine them at a place where they are maintained. The commissioner may designate representatives, including comparable officials of the state in which they are maintained, to inspect them on his behalf.

VI. The commissioner shall have the power to issue subpoenas to compel the attendance of witnesses and the production of documents, papers, books, records, and other evidence before him in any matter pertaining to this chapter.


Source. 1981, 118:1. 1985, 343:2, eff. July 1, 1985.

    415-B:6 Form of Premium Finance Agreement. 

I. A premium finance agreement shall:

(a) Be dated and signed by or on behalf of the insured; and the printed portion of the agreement shall be in at least 8-point type;

(b) Contain the name and place of business of the insurance agent or broker negotiating the related insurance contract; the name and residence or the place of business of the insured as specified by him; the name and place of business of the premium finance company to which payments are to be made; a brief description of the insurance contracts involved and the amount of the premium; and

(c) Set forth the following items where applicable:

(1) The total amount of the premiums,

(2) The amount of the down payment,

(3) The principal balance (the difference between (1) and (2)),

(4) The amount of the interest or discount,

(5) The balance payable by the insured (sum of (3) and (4)), and

(6) The number of installments required, the amount of each installment expressed in dollars, and the due date or period of each installment.

II. The items set out in subparagraph I(c) need not be stated in the sequence or order in which they appear, and additional items may be included to explain the computations made in determining the amount to be paid by the insured.

III. A premium finance agreement may contain any provision not prohibited by this chapter or by order of the commissioner.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:7 Limitation on Interest and Other Charges. 

I. A premium finance company shall not charge, contract for, receive, or collect an interest or discount charge other than as permitted by this chapter.

II. The interest or discount shall be agreed upon by the parties and shall be computed on the balance of the premiums due (after subtracting the down payment made by the insured in accordance with the premium finance agreement) from the effective date of the insurance policy for which the premiums are being advanced, up to and including the date when the final installment of the premium finance agreement is payable.

III. Notwithstanding the provisions of any premium finance agreement, any insured may repay the obligation in full at any time. If the insured voluntarily prepays, he shall receive a refund credit, which shall represent at least as great a proportion of the interest or discount as the sum of the periodic balances after the month in which prepayment is made bears to the sum of all periodic balances under the schedule of installments in the agreement. Where the amount of the refund credit is less than $1, no refund need be made.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:8 Delinquency and Cancellation Charges. 

I. A premium finance agreement may provide for the payment by the insured of a delinquency charge on any installment which is in default for a period of 5 consecutive days or more, of $1 to a maximum of 5 percent of the delinquent installment. If the default results in the cancellation of any insurance contract listed in the agreement, the agreement may provide for the payment by the insured of a cancellation charge equal to the difference between any delinquency charge imposed with respect to the installment in default and $15.

II. A premium finance agreement may provide for payment of collection costs, attorney's fees equal to 20 percent of the outstanding indebtedness, and any other charges which arise because one party breaches the contract.

III. None of the charges referred to in this section shall be considered directly or indirectly in determining whether a violation of the usury laws has occurred under a premium finance agreement.


Source. 1981, 118:1, eff. July 3, 1981.

    415-B:9 Cancellation of Insurance Contract Upon Default. 

I. When a premium finance agreement contains a power of attorney enabling the premium finance company to cancel upon default any insurance contract or contracts listed in the agreement, the insurance contract or contracts shall not be cancelled by the premium finance company unless such cancellation is effected in accordance with this section.

II. After default, the premium finance company may cancel such insurance contract or contracts by mailing to the insurer a notice of cancellation, stating the effective date of cancellation. Such date shall be not less than 10 days from the date of mailing the notice. The insurance contract shall be cancelled as if such notice of cancellation had been submitted by the insured himself but without requiring the return of the insurance contract or contracts. The premium finance company shall also mail a copy of the notice of cancellation to the insured at his last known address as shown on the records of the premium finance company, and to the insurance agent or broker. Termination of workers' compensation policies shall be made pursuant to the provisions set forth in RSA 281-A:9.

III. All statutory, regulatory, and contractual restrictions providing that the insurance contract may not be cancelled unless notice is given to a governmental agency, mortgagee, or other third party shall apply where cancellation is effected under the provisions of this section. The insurer shall give the prescribed notice on behalf of itself or the insured to any governmental agency, mortgagee, or other third party on or before the second business day after the day it receives the notice of cancellation from the premium finance company. The insurer shall determine the effective date of cancellation taking into consideration the number of days' notice required to complete the cancellation.

IV. The notice of cancellation shall state the date, not less than 10 days after its mailing, on which such cancellation shall become effective.


Source. 1981, 118:1. 1993, 210:5, eff. Jan. 1, 1994.

    415-C:1 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Consumer
" means a natural person who, for personal or family use and not for commercial or research purposes:

(a) Buys or sells residential real property, or

(b) Buys other than for purposes of resale any tangible personal property that is distributed in commerce and that is normally used for personal, family, or household purposes.

III. "
Consumer guaranty contract
":

(a) Is an agreement in which one party, for consideration, promises to pay, indemnify, provide a specified or determinable amount or benefit, or to do some act of value for another party, based upon a determinable risk contingency or peril, but which is not insurance or does not warrant full application of the state's insurance statutes or rules.

(b) Includes the following agreements:

(1) Service contracts, also known as extended warranties or warranty service contracts, that apply to motor vehicles, homes, and consumer products.

(2) [Repealed.]

(3) [Repealed.]

(4) Contracts deemed by the commissioner by rule or order subject to this chapter.

(c) Does not include any of the following:

(1) Expressed or implied warranties.

(2) Maintenance agreements.

(3) Motor vehicle road service, tourist service and repairs under RSA 407-C.

(4) Warranties, service contracts, or maintenance agreements offered by public utilities on their transmission devices regulated by the public utilities commission.

(5) Warranties, service contracts, and maintenance agreements that are conditioned upon or otherwise associated with the sale or supply of heating fuel.

(6) Warranties, service contracts, and maintenance agreements sold or offered for sale to persons other than consumers. 

(7) Debt cancellation or debt suspension contracts between a creditor and a borrower for the cancellation or suspension of the debt.

(8) Prepaid legal contracts.

IV. "
Contract fee
" means the total purchase price or consideration paid for a consumer guaranty contract.

V. "
Contract holder
" means a person who buys a consumer guaranty contract or permitted transferee.

VI. "
Maintenance agreement
" means a contract of limited duration that provides for scheduled maintenance only.

VII. "
Manufacturer
" means a person who:

(a) Manufactures or produces the property and sells the property under the person's own name or label;

(b) Is a wholly owned subsidiary of the person who manufactures or produces the property;

(c) Is a corporation which owns 100 percent of the person who manufactures or produces the property;

(d) Manufactures or produces the property and the property is sold under the trade name or label of another person;

(e) Does not manufacture or produce the property but, by written contract, licenses the use of the person's trade name or label to another person that sells the property under the licensor's trade name or label; or

(f) For personal property, does not manufacture or produce the property, but the property is sold under the person's trade name label.

VIII. "
Obligor
" means a person who is legally obligated to a contract holder under the terms of the consumer guaranty contract. Obligor shall not include service suppliers acting for a registered obligor.

IX. "
Person
" means an individual, partnership, corporation, incorporated or unincorporated association, joint stock company, reciprocal, syndicate, or any similar entity or combination of entities acting in concert.

X. "
Premium
" means the consideration paid to an insurer for a reimbursement insurance policy.

XI. [Repealed.]

XII. "
Reimbursement insurance policy
" means a policy of insurance issued to an obligor and by which an insurer agrees to either provide reimbursement to the obligor under the terms of the insured consumer guaranty contracts issued or sold by the obligor or, in the event of the obligor's non-performance, to pay on behalf of the obligor all covered contractual obligations incurred by the obligor under the terms of the insured consumer guaranty contracts issued or sold by the obligor.

XIII. "
Sales representative
" means any person who is not an obligor, who sells, solicits, negotiates, or issues consumer guaranty contracts on behalf of an obligor.

XIV. (a) "
Service contract
" means a contract or agreement for a separately stated consideration, and a specified period of time or usage, covering any consumer good, including, but not limited to, any automobile, household system, or appliance, which promises to provide for the service, repair, replacement, or maintenance of the property necessitated by operational or structural failure due to: a defect in materials or workmanship; normal wear and tear; power surges; or accidental damage from handling. This definition shall apply regardless of the name or label of such contract and regardless of the nature of the service contract obligor. A service contract may provide for the payment of incidental indemnity when service repair or replacement is not feasible or economical or under limited circumstances, including, but not limited to, towing, rental, road hazard, emergency road service, lodging, meals, food loss, or other minor expenses that directly relate to the failure of the consumer good.

(b) "
Service contract
" includes a contract or agreement for a separately stated consideration, and a specified period of time or usage that provides for any of the following:

(1) Repair or replacement of tires and/or wheels on an automobile damaged as a result of coming into contact with road hazards including, but not limited to, potholes, rocks, wood debris, metal parts, glass, plastic, curbs, or composite scraps;

(2) Removal of dents, dings, or creases on an automobile that can be repaired using the process of paintless dent removal without affecting the existing paint finish and without replacing automobile body panels, sanding, bonding, or painting;

(3) Repair of chips or cracks in or the replacement of an automobile windshield as a result of damage caused by road hazards; or

(4) Replacement of an automobile key or key-fob if the key or key-fob becomes inoperable or is lost or stolen.

XV. "
Service contract holder
" means a person who is the purchaser or holder of a service contract.

XVI. "
Service supplier
" means a person, not employed by the obligor, who is owned by the obligor or contractually obligated to provide on behalf of the obligor services or obligations specified in the consumer guaranty contract to be provided to a contract holder.

XVII. "
Warranty
" means a warranty made solely by the manufacturer, importer, or seller of property or services without charge, that is not negotiated or separated from the sale of the product and is incidental to the sale of the product, that guarantees indemnity for defective parts, mechanical or electrical breakdown, labor or other remedial measures, such as repair or replacement of the property or repetition of services.


Source. 2004, 224:1. 2015, 207:1, 6, 8, eff. Sept. 4, 2015. 2022, 142:1, 3, I and II, eff. Aug. 6, 2022.

    415-C:10-a Action Against an Obligor, Designee or Representative of an Obligor. 

I. When an obligor, its designee, or any other representative of an obligor, including a seller or administrator, in any action or proceeding brought by the insurance commissioner has been found to be in violation of this chapter or has been ordered to cease and desist, and said finding or order has become final, any consumer claiming to be adversely affected by the act or practice giving rise to such finding or order, and to whom restitution has not been provided under RSA 415-C:10, IV or to whom the obligor, its designee or representative has not made voluntary restitution acceptable to the consumer within 30 days of the finding or order, may bring suit against said obligor to recover such damages or loss that have been suffered by him or her because of such action or practice.

II. For the sole purposes of providing the consumer with the procedural rights set forth under RSA 541 and RSA 541-A, failure of the commissioner to take action under RSA 415-C:10 within 120 days from the date of the receipt of a complaint from an alleged injured person shall constitute a finding that the alleged act or practice is not in violation of this chapter. This finding may be appealed in accordance with RSA 541. If upon appeal the decision of the commissioner is not upheld, the consumer may proceed under RSA 415-C:10-a, I. This provision shall not bar the commissioner from bringing an enforcement action for violation of this chapter more than 120 days after receipt of a complaint.


Source. 2008, 255:6, eff. Aug. 25, 2008.

    415-C:10 Penalties. 

The commissioner, after proper notice and opportunity for hearing, may take action to enforce the provisions of this chapter, or rules adopted pursuant to this chapter, and may:

I. Revoke or suspend the obligor's registration.

II. Order the obligor to cease and desist from further consumer guaranty contract operations.

III. Impose a penalty of not more than $1000 for each violation or $10,000 for each violation the commissioner finds to be willful.

IV. Order the obligor to make restitution.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:11 Rulemaking. 

The commissioner may adopt rules under RSA 541-A that are reasonable and necessary for the implementation and administration of this chapter, including rules relative to enforcement procedures and procedures governing registration requirements, verification of fiscal responsibility, and examinations by the department.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:12 Severability. 

If any provision of this chapter, or the application of the provision to any person or circumstances, shall be held invalid, the remainder of the chapter, and the application of the provision to persons or circumstances other than those as to which it is held invalid, shall not be affected.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:2 Exemptions. 

I. Manufacturer's service contracts on the manufacturer's products need only comply with RSA 415-C:5, 415-C:6, 415-C:7, 415-C:9, 415-C:10, and RSA 415-C:10-a.

II. Consumer guaranty contracts are not insurance and are exempt from this state's insurance laws, except for the provisions of RSA 400-A:16 through RSA 400-A:25 or as provided by this chapter.

III. For activities related to the marketing, selling, offering for sale, issuing, making, proposing to make, and administration of consumer guaranty contracts, an obligor or related consumer guaranty contract seller, administrator, or other related person shall be exempt from this state's insurance laws, except for the provisions of RSA 400-A:16 through 400-A:25 or as provided by this chapter.

IV. An obligor, administrator, seller, or other related person who provides consumer guaranty contracts and insurance contracts is subject to the state's laws as they apply to the obligor, administrator, seller, or other related person for each type of agreement.


Source. 2004, 224:1. 2009, 215:6, eff. July 15, 2009.

    415-C:3 Obligor Registration. 

I. No obligor shall offer, administer, sell, solicit, negotiate, or act under a consumer guaranty contract in this state unless:

(a) The obligor registers with the commissioner on a form prescribed by the commissioner and pays the registration fee required by RSA 400-A:29, VIII-a(a); or

(b) The obligor is authorized as an insurer in this state to issue specified lines of consumer guaranty contracts, in which case the insurer is exempt from paragraphs II and III of this section and RSA 415-C:4.

II. An obligor's registration shall include the following:

(a) A certified copy of the obligor's charter and bylaws.

(b) A certificate giving a full statement, under oath of the obligor's president and secretary, that the fiscal requirements stated in this chapter are met.

(c) Other information in relation to the obligor's condition as may be required by the commissioner.

III. Every obligor registration made pursuant to this chapter shall expire on the next June 14 following such registration unless renewed prior to that date. Renewal shall be made by paying an annual renewal fee pursuant to RSA 400-A:29, VIII-a(b) and supplementing the original form for any material change to the registration.

IV. An obligor's employee is exempt from the registration provisions stated in this section if the obligor is authorized to do business in this state.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:4 Fiscal Requirements. 

An obligor shall provide proof of financial responsibility to the insurance department by:

I. Posting a bond in the amount of at least $25,000 or 5 percent of all consumer guarantee contracts sold in New Hampshire, whichever is greater, up to a maximum of $250,000 and maintaining a reserve account in an amount no less than 40 percent of the gross consideration received for all contract fees from consumer guaranty contracts issued to New Hampshire residents less claims paid;

II. Insuring all consumer guaranty contracts under a reimbursement insurance policy issued by an insurer authorized to issue such insurance in this state; or

III. Demonstrating that the obligor, as either a stand alone company or together with the obligor's parent, maintains a net worth or stockholders' equity of $25,000,000 or more as evidenced by the obligor's annual audited financial statement or form 10K or 20F filed with the United States Securities and Exchange Commission. Proof of the above shall be deemed acceptable if not rejected in writing by the insurance commissioner within 60 days of submission.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:5 Recordkeeping Requirements. 

I. Books and records:

(a) An obligor shall keep accurate accounts, books, and records concerning transactions regulated under this chapter.

(b) An obligor's accounts, books, and records shall include:

(1) Copies of each type of consumer guaranty contract issued.

(2) The name and address of each contract holder to the extent that the contract holder has furnished the name and address.

(3) A list of the locations where consumer guaranty contracts are marketed, sold, offered for sale, issued, made, or proposed to be made.

(4) Claims files that shall contain at least the date and description of all claims or requests for services or expenditures related to the consumer guaranty contracts.

(c) Except as provided in paragraph II, an obligor shall retain all records required under subparagraph (b) pertaining to each consumer guaranty contract holder for at least 3 years after the specified period of coverage has expired.

(d) An obligor may keep all records required under this chapter on a computer disk or other similar technology. If the records are maintained in other than hard copy, the records shall be capable of duplication to legible hard copy at the request of the commissioner.

II. An obligor discontinuing business in this state shall maintain its records until it furnishes the commissioner satisfactory proof that it has discharged all obligations to contract holders in this state.

III. An obligor shall make all accounts, books, and records concerning transactions regulated under this chapter or other pertinent laws available to the commissioner upon request.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:6 Contract Disclosures. 

I. Consumer guaranty contracts shall not be issued, sold, or offered for sale in this state unless the obligor or a sales representative with express authority from the obligor has:

(a) Provided a receipt for, or other written evidence of, the purchase of the consumer guaranty contract to the contract holder; and

(b) Provided a copy of the consumer guaranty contract, including its terms and conditions, to the contract holder within a reasonable period of time from the date of purchase.

II. Consumer guaranty contracts marketed, sold, or offered for sale, issued, made, or proposed to be made in this state shall be dated and written in clear, understandable language and the entire contract shall be printed or typed in easy to read type.

III. Consumer guaranty contracts shall state:

(a) The total purchase price of the consumer guaranty contract. The purchase price is not required to be preprinted on the service contract and may be negotiated at the time of sale with the service contract holder.

(b) The specific products and services to be provided and any limitations, exceptions, or exclusions.

(c) The existence of any deductible amount, if applicable.

(d) Any terms, restrictions, or conditions governing the transferability, cancellation, and termination of the consumer guaranty contract by either the obligor or contract holder.

(e) All of the obligations and duties of the contract holder, such as the duty to meet certain conditions, protect against any further damage, and the requirement for certain service and maintenance.

(f) The procedure for obtaining prior approval, if prior approval is required.

(g) The procedure that the contract holder must take to make claims and receive service under the terms and conditions of the consumer guaranty contract, including a toll-free telephone number for service.

(h) The procedure that a contract holder may take to discuss with the obligor questions or complaints. This procedure shall include a statement substantially similar to the following: "In the event you do not receive satisfaction under this contract, you may contact the New Hampshire insurance department." The statement shall include the current address and phone number of the department.

IV. If any preexisting condition is excluded from coverage, the consumer guaranty contract must state the basis upon which the service or promised performance may be denied for such preexisting condition.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-C:7 Prohibited Acts and Terms. 

I. No obligor, its designee, or any other representative of an obligor, including a seller or administrator, shall in connection with the sale, or offer to sell, or any advertisement or in connection with any benefits, advantages, conditions, terms, or services available under a consumer guaranty contract:

(a) Make, publish, print, distribute, issue, circulate, advertise, or place before the public, any statement or representation that is false or misleading;

(b) Mislead by permitting or causing the omission of a material statement that under the circumstances should have been made in order to make the statements that were made not misleading.

(c) Require the purchase of a consumer guaranty contract or represent that the purchase is mandatory.

(d) Create or maintain a fraud.

(e) Use in its name the words insurance, casualty, guaranty, surety, mutual, or any other words descriptive of the insurance, casualty, guaranty or surety business; or a name deceptively similar to the name or description of any insurance or surety corporation, or any other obligor. This section shall not apply to a company that was using any of the prohibited language in its name prior to the effective date of this chapter. However, a company using the prohibited language in its name shall conspicuously disclose in its consumer guaranty contracts a statement substantially as follows: "This agreement is not an insurance contract."

(f) Fail to act promptly upon communications with respect to claims arising under a consumer guaranty contract.

(g) Fail to effectuate fair and equitable settlements or compromises of claims in which liability has become reasonably clear.

(h) Unfairly discriminate based solely on age, place or area of residence, race, color, creed, national origin, ancestry, marital or civil union status, lawful occupation including military service, sex, gender identity, sexual orientation, religion, or blindness or other disability.

(i) Fail to refund unearned contract fees with respect to any cancellation of a consumer guaranty contract with a duration of 12 months or more. Contract fees for contracts with a duration of 12 months or more are earned pro-rata over the length of the contract. Obligors shall not charge a cancellation administrative fee of more than 10 percent of the contract price or $75, whichever is less, for a contract of any duration. All cancellation administrative fees must be disclosed in the contract, regardless of the contract's duration.

II. An obligor shall not make, permit, or cause any practice that:

(a) Fails to perform the services promised under the contract in a timely, competent, or workmanlike manner; or

(b) Has the effect of creating or maintaining a fraud.

III. No consumer guaranty contract issued, sold, or covering property located in this state shall provide that:

(a) The consumer is not a party to the contract;

(b) The obligor has no liability to the consumer;

(c) The consumer does not have the right to bring an action to enforce the terms of the contract or otherwise challenge the denial of a claim which the consumer believes is wrongful. Consumer guaranty contracts may include provisions requiring the parties to submit to alternative dispute resolution, including a provision requiring binding arbitration that would expressly limit the right of the consumer to bring an action in a court of law, if such provision complies with and does not impede the rights of the consumer as provided under RSA 542. All arbitration provisions shall state that they are subject to RSA 542; or

(d) Any civil action or alternative dispute resolution procedure brought in connection with the consumer guaranty contract shall be brought in the courts of a jurisdiction other than New Hampshire.

IV. Nothing in this chapter shall be construed to impair or in any way affect any rule or law applicable to or governing consumer guaranty contracts.


Source. 2004, 224:1. 2008, 255:3. 2015, 207:3, eff. Sept. 4, 2015. 2019, 332:17, eff. Oct. 15, 2019. 2022, 142:2, eff. Aug. 6, 2022.

    415-C:8 Reimbursement Insurance Policies. 

I. Consumer guaranty contracts insured under a reimbursement insurance policy shall state:

(a) The name, address, and toll-free number of the reimbursement insurer; and

(b) The obligation of the reimbursement insurer to reimburse or, in the event of the obligor's non-performance, to pay on behalf of the obligor any sums the obligor is legally obligated to pay or shall provide the service which the obligor is legally obligated to undertake according to the obligor's contractual obligations under the consumer guaranty contracts issued or sold by the obligor. In the event the obligor does not provide for covered services within 60 days after the contract holder has submitted proof of loss to the obligor, the contract holder is entitled to apply directly to the reimbursement insurance company for satisfaction.

II. This chapter shall not prevent or limit the right of an insurer which issued a reimbursement insurance policy to seek indemnification or subrogation against an obligor if the issuer pays or is obligated to pay the contract holder sums that the obligor was obligated to pay pursuant to the provisions of the consumer guaranty contract or under a contractual agreement.

III. As applicable, an insurer that issued a reimbursement insurance policy shall not terminate the policy until a notice of termination in accordance with RSA 417-C has been mailed or delivered to the obligor. The termination of a reimbursement insurance policy shall not reduce the obligor's responsibility for consumer guaranty contracts issued by the obligor prior to the date of the termination.


Source. 2004, 224:1. 2015, 207:4, eff. Sept. 4, 2015.

    415-C:9 Examination. 

For the purpose of determining an obligor's financial stability and protecting consumer interests in the case of complaint, the commissioner shall have the power to examine under RSA 400-A:37 and to investigate the affairs of every obligor engaged in the business of consumer guaranty contracts in this state to determine compliance or noncompliance with this chapter. The expenses of examinations shall be paid to the state by the company or companies examined.


Source. 2004, 224:1, eff. Jan. 1, 2005.

    415-D:1 Purpose. 

The purpose of this chapter is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applications for long-term care insurance, as defined, from unfair or deceptive sales or enrollment practices, to establish standards for long-term care insurance, to facilitate public understanding and comparison of long-term care insurance policies, and to facilitate flexibility and innovation in the development of long-term care insurance coverage.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:10 Nonforfeiture Benefits. 

I. Except as provided in paragraph II, a long-term care insurance policy shall not be delivered or issued for delivery in this state unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate including a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. In the event the policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.

II. When a group long-term care insurance policy is issued, the offer required in paragraph I shall be made to the group policyholder. However, if the policy is issued as group long-term care insurance as defined in RSA 415-D:3, IV(d), other than to a continuing care retirement community or other similar entity, the offering shall be made to each proposed certificate holder.

III. The commissioner shall promulgate regulations specifying the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits, and the rules regarding contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse will be available and the substantial premium rate increase that triggers a contingent benefit upon lapse as described in paragraph I.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:11 Approval and Disapproval of Forms. 

No policy of group long-term care insurance affecting a resident of New Hampshire, whether such policy is delivered or issued for delivery in this state or any other state, and no certificate under such policy nor any application, rider, endorsement or amendment used in connection with the policy shall be delivered or issued for delivery in this state until a copy of the form of the policy and of the classification of risks and the premium rates have been filed with the insurance commissioner, nor until the expiration of 30 days after filing, unless the commissioner shall sooner give his written approval for delivery or issue.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:12 Authority to Adopt Rules. 

The commissioner shall issue reasonable rules to promote premium adequacy and to protect the policyholder in the event of substantial rate increases, and to establish minimum standards for marketing practices, agent compensation, agent testing, penalties and reporting practices for long-term care insurance.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:13 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 this chapter which can be given effect without the invalid provisions or applications, and to this end the provisions of this chapter are severable.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:2 Scope. 

The requirements of this chapter shall apply to policies and group insurance certificates delivered or issued for delivery in this state on or after January 1, 1990. This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with the substance of other applicable insurance laws insofar as such laws do not conflict with this chapter, except that laws and administrative rules designed and intended to apply to Medicare supplement insurance policies shall not be applied to long-term care insurance.


Source. 2003, 180:1, Aug. 23, 2003.

    415-D:3 Definitions. 

In this chapter:

I. "
Applicant
" means:

(a) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and

(b) In the case of a group long-term care insurance policy or certificate, the proposed certificate holder.

II. "
Certificate
" means any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this or any other state.

III. "
Commissioner
" means the insurance commissioner of this state.

IV. "
Group long-term care insurance
" means a long-term care insurance policy or certificate that is delivered or issued for delivery in this state and issued to:

(a) One or more employers or labor organizations, as to a trust or to the trustees of a fund established by one or more employers or labor organizations, or a combination thereof, for employees or former employees or a combination thereof or for members or former members or a combination thereof, of the labor organizations, or

(b) Any professional, trade or occupational association for its members or former or retired members, or combination thereof, if the association:

(1) Is composed of individuals all of whom are or were actively engaged in the same profession, trade, or occupation; and

(2) Has been maintained in good faith for purposes other than obtaining insurance; or

(c)(1) An association or a trust or the trustees of a fund established, created or maintained for the benefit of members of one or more associations. Prior to advertising, marketing or offering the policy within this state, the association or associations, or the insurer of the association or associations, shall file evidence with the commissioner that the association or associations have at the outset a minimum of 100 persons, have been organized and maintained in good faith for purposes other than that of obtaining insurance, have been in active existence for at least one year, and have a constitution and bylaws that provide that:

(A) The association or associations hold regular meetings not less than annually to further purposes of the members;

(B) Except for credit unions, the association or associations collect dues or solicit contributions from members; and

(C) The members have voting privileges and representation on the governing board and committees.

(2) Thirty days after the filing, the association or associations shall be deemed to satisfy the organization requirements, unless the commissioner makes a finding that the association or associations do not satisfy those organizational requirements.

(d) A group, other than as described in (c)(1) subject to a finding by the commissioner that:

(1) The issuance of the group policy is not contrary to the best interest of the public;

(2) The issuance of the group policy would result in economies of acquisition or administration; or

(3) The benefits are reasonable in relation to the premiums charged.

V. "
Long-term care insurance
" means any insurance policy, group insurance certificate or rider advertised, marketed, offered, or designed to provide coverage for not less than 12 consecutive months for each covered person on an expense-incurred, indemnity, prepaid, or other basis, for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services, provided in a setting other than an acute care unit of a hospital. The term includes group and individual annuities and life insurance policies, certificates, or riders that provide directly or supplement long-term care insurance. The term also includes a policy or rider that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity. The term shall also include qualified long-term care insurance contracts. Long-term care insurance may be issued by insurers; fraternal benefit societies; nonprofit health, hospital, and medical service corporations; prepaid health plans; health maintenance organizations, or any similar organization to the extent they are otherwise authorized to issue life or health insurance. Long-term care insurance shall not include any insurance policy that is offered primarily to provide basic Medicare supplement coverage, basic hospital expense coverage, basic medical-surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income or related asset-protection coverage, accident only coverage, or specified disease or specified accident coverage. With regard to life insurance, this term does not include life insurance policies that accelerate the death benefit specifically for one or more of the qualifying events of terminal illness, medical conditions requiring extraordinary medical intervention or permanent institutional confinement, and that provide the option of a lump-sum payment for those benefits and where neither the benefits nor the eligibility for the benefits is conditioned upon the receipt of long-term care. Notwithstanding any other provision of this chapter, any product advertised, marketed, or offered as long-term care insurance shall be subject to the provisions of this chapter.

VI. "
Loss ratio standards
" means the minimum anticipated loss ratio permitted for a long-term care insurance policy or certificate. The anticipated loss ratio is that which is expected to be incurred over the lifetime of the policy or, at the option of the insurer, 20 years, whichever is shorter. Such a loss ratio shall be based on a typical distribution of business anticipated to be sold in a period of 12 months and followed to its conclusion. The loss ratio shall be calculated as the ratio of the present value of all expected future benefits, excluding dividends, to the present value of all expected future premiums.

VII. "
Policy
" means any policy, contract, subscriber agreement, rider, amendment or endorsement delivered or issued for delivery in this state or any other state by an insurer; fraternal benefit society; nonprofit health, hospital, or medical service corporation; prepaid health plan; health maintenance organization or any similar organization.

VIII. "
Qualified long-term care insurance contract
" or "
federally tax-qualified long-term care insurance contract
" means:

(a) An individual or group insurance contract that meets the requirements of Section 7702B(b)
 of the Internal Revenue Code of 1986, as amended, as follows:

(1) The only insurance protection provided under the contract is coverage of qualified long-term care services. A contract shall not fail to satisfy the requirements of this subparagraph by reason of payments being made on a per diem or other periodic basis without regard to the expenses incurred during the period to which the payments relate;

(2) The contract does not pay or reimburse expenses incurred for services or items to the extent that the expenses are reimbursable under Title XVIII
 of the Social Security Act, as amended, or would be so reimbursable but for the application of a deductible or coinsurance amount. The requirements of this subparagraph do not apply to expenses that are reimbursable under Title XVIII of the Society Security Act only as a secondary payor. A contract shall not fail to satisfy the requirements of this subparagraph by reason of payments being made on a per diem or other periodic basis without regard to the expense incurred during the period to which the payments relate;

(3) The contract is guaranteed renewable, within the meaning of Section 7702B(b)(1)(C)
 of the Internal Revenue Code of 1986, as amended;

(4) The contract does not provide for a cash surrender value or other money that can be paid, assigned, pledged as collateral for a loan, or borrowed except as provided in subparagraph (e);

(5) All refunds of premiums, and all policyholder dividends or similar amounts, under the contract are to be applied as a reduction in future premiums or to increase future benefits, except that a refund on the event of death of the insured or a complete surrender or cancellation of the contract cannot exceed the aggregate premiums paid under the contract; and

(6) The contract meets the consumer protection provisions set forth in Section 7702B(g)
 of the Internal Revenue Code of 1986, as amended.

(b) The portion of a life insurance contract that provides long-term care insurance coverage by rider or as part of the contract and that satisfies the requirements of Sections 7702B(b) and (e)
 of the Internal Revenue Code of 1986, as amended.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:4 Extraterritorial Jurisdiction-Group Long-Term Care Insurance. 

No group long-term care insurance coverage may be offered to a resident of this state under a group policy issued in another state to a group described in RSA 415-D:3, IV(d), unless approved by this state.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:5 Disclosure and Performance Standards for Long-Term Care Insurance;  Rulemaking. 

The commissioner may adopt rules, under RSA 541-A, that include standards for:

I. Full and fair disclosure, that set forth the manner, content, and required disclosures for the sale of long-term care insurance policies and certificates, terms of renewability, initial and subsequent conditions of eligibility, non-duplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms.

II. No long-term care insurance policy may:

(a) Be cancelled, nonrenewed or otherwise terminated on the grounds of the age or deterioration of the mental or physical health of the insured individual or certificate holder.

(b) Contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new or other form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder.

(c) Provide coverage for skilled nursing care only or provide significantly more coverage for skilled care in a facility than coverage for lower levels of care.

(d) Be misleading or unreasonably confusing in connection with either the purchase of long-term care insurance or the settlement of claims.

(e) Be contrary to the health care needs of the public.

(f) Be so limited in scope as to be of no significant economic value to the holders of such policy.

(g) Be issued if not specifically authorized by statute.

(h) In the opinion of the commissioner, be unjust, unfair, and unfairly discriminatory to the policyholder, certificate holder, subscriber or any other person insured under the policy or certificate, or the beneficiary.

III. (a) No long-term care insurance policy or certificate shall use a definition of preexisting condition that is more restrictive than the following: "
Preexisting condition
" means a condition for which medical advice or treatment was recommended by, or received from a provider of health care services, within 6 months preceding the effective date of coverage of an insured person.

(b) No long-term care insurance policy or certificate may exclude coverage for a loss or confinement that is the result of a preexisting condition unless the loss or confinement begins within 6 months following the effective date of coverage of an insured person.

(c) The commissioner may extend the limitation periods set forth in subparagraphs (a) and (b) as to specific age group categories in specific policy forms upon findings that the extension is in the best interest of the public.

(d) The definition of "
preexisting condition
" does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and, on the basis of the answers on that application, from underwriting in accordance with that insurers established underwriting standards. Unless otherwise provided in the policy or certificate, a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in subparagraph (b) expires. No long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subparagraph (b).

IV. (a) No long-term care insurance policy may be delivered or issued for delivery in this state if such policy:

(1) Conditions eligibility for any benefits on a prior hospitalization requirement;

(2) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or

(3) Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care, or recuperative benefits on a prior institutionalization requirement.

(b) A long-term care insurance policy containing post-confinement, post-acute care, or recuperative benefits shall clearly label in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits" such limitations or conditions, including any required number of days of confinement.

(c) A long-term care insurance policy or rider that conditions eligibility of noninstitutional benefits on the prior receipt of institutional care shall not require a prior institutional stay of more than 30 days.

(d) No long-term care insurance policy or rider that provides benefits only following institutionalization shall condition such benefits upon admission to a facility for the same or related conditions within a period of less than 30 days after discharge from the institution.

(e) The commissioner may adopt rules establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in the rule.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:6 Cancellation of Insurance;  Conversion. 

I. An individual long-term care insurance policy shall not be cancelled, refused renewal, or otherwise terminated by the insurer, except where the required premium has not been paid by or on behalf of the insured; however, this shall not restrict or limit the insurer's right to rescind or revise a policy in the event of fraud or misrepresentation during the contestable period.

II. If a group policy is cancelled, refused renewal or terminated by either the insurer or the policyholder, each certificate holder shall be entitled to have issued to him or her an individual policy or replacement group certificate of insurance providing benefits equivalent to those enjoyed by the certificate holder under the group policy from which conversion is made. Such policy or certificate shall be issued by the insurer without evidence of insurability, provided the certificate holder makes application for the policy and pays the monthly premium within 30 days after receiving written notice of such cancellation, refusal to renew, or termination. No long-term care insurance policy or certificate shall contain a provision establishing a new waiting period in the event existing coverage is converted to or replaced by a new form or another form within the same company, except with respect to an increase in benefits voluntarily selected by the insured individual or group policyholder.

III. Unless the group policy from which conversion is made replaces previous group coverage, the premium for the converted policy shall be calculated on the basis of the insured's age at inception of coverage under the group policy from which conversion is made. If the group policy from which conversion is made replaces previous group coverage, the premium for the converted policy shall be calculated on the basis of the insured's age at inception of coverage under the group policy replaced.

IV. Notwithstanding any other provision of this section, any insured individual whose eligibility for group long-term care coverage is based upon that person's relationship to another person, shall be entitled to continuation of coverage under the group policy upon termination of the qualifying relationship by death or dissolution of marriage.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:7 Right to Return;  Free Look. 

Long-term care insurance applicants shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Long-term care insurance policies and certificates shall have the notice prominently printed on the first page or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. This paragraph shall also apply to denials of applications and any refund shall be made within 30 days of the return or denial.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:8 Outline of Coverage. 

An outline of coverage shall be delivered to a prospective applicant for long-term care insurance at the time of initial solicitation through means that prominently direct the attention of the recipient to the document and its purpose.

I. The commissioner shall prescribe a standard format, including style, arrangement and overall appearance, and the content of an outline of coverage.

II. In the case of agent solicitations, an agent shall deliver the outline of coverage prior to the presentation of an application or enrollment form.

III. In the case of direct response solicitations, the outline of coverage shall be presented in conjunction with any application or enrollment form.

IV. The outline of coverage shall include:

(a) A description of the principal benefits and coverage provided in the policy.

(b) A statement of the principal exclusions, reductions and limitations contained in the policy.

(c) A statement of the terms under which the policy or certificate, or both, may be continued in force or discontinued, including any reservation in the policy of a right to change premium. Continuation or conversion provisions of group coverage shall be specifically described.

(d) A statement that the outline of coverage is a summary only, not a contract of insurance, and that the policy or group master policy contains governing contractual provisions.

(e) A description of the terms under which the policy or certificate may be returned and premium refunded.

(f) A brief description of the relationship of cost of care and benefits.

(g) A statement that discloses to the policyholder or certificate holder whether the policy is intended to be a federally tax-qualified long-term care insurance contract under Section 7702B(b)
 of the Internal Revenue Code of 1986, as amended.

V. A certificate issued pursuant to a group long-term care insurance policy that is delivered or issued for delivery in this state shall include:

(a) A description of the principal benefits and coverage provided in the policy.

(b) A statement of the principal exclusions, reductions, and limitations contained in the policy.

(c) A statement that the group master policy determines governing contractual provisions.

VI. If an application for a long-term care insurance contract or certificate is approved, the issuer shall deliver the contract or certificate of insurance to the applicant no later than 30 days after the date of approval.

VII. At the time of policy delivery, a policy summary shall be delivered for an individual life insurance policy that provides long-term care benefits within the policy or by rider. In the case of direct response solicitations, the insurer shall deliver the policy summary upon the applicant's request, but regardless of request shall make delivery no later than at the time of policy delivery. In addition to complying with all applicable requirements, the summary shall also include:

(a) An explanation of how the long-term care benefit interacts with other components of the policy, including deductions from death benefits.

(b) An illustration of the amount of benefits, the length of benefit, and the guaranteed lifetime benefits if any, for each covered person.

(c) Any exclusions, reductions and limitations on benefits of long-term care.

(d) A statement that any long-term care inflation protection option is not available under this policy.

(e) If applicable to the policy type, the summary shall also include:

(1) A disclosure of the effects of exercising other rights under the policy.

(2) A disclosure of guarantees related to long-term care costs of insurance charges.

(3) Current and projected maximum lifetime benefits.

(f) The provisions of the policy summary listed above may be incorporated into a basic illustration required to be delivered in accordance with Ins 309
 or into the life insurance policy summary which is required to be delivered in accordance with Ins 301.

VIII. Any time a long-term care benefit, funded through a life insurance vehicle by the acceleration of the death benefit, is in benefit payment status, a monthly report shall be provided to the policyholder. The report shall include:

(a) Any long-term care benefits paid out during the month.

(b) An explanation of any changes in the policy such as death benefits or cash values, due to long-term care benefits being paid out.

(c) The amount of long-term care benefits existing or remaining.

IX. If a claim under a long-term care insurance contract is denied, the issuer shall, within 60 days of the date of a written request by the policyholder or certificate holder, or a representative thereof:

(a) Provide a written explanation of the reasons for the denial; and

(b) Make available all information directly related to the denial.

X. Any policy or rider advertised, marketed, or offered as long-term care or nursing home insurance shall comply with the provisions of this chapter.


Source. 2003, 180:1, eff. Aug. 23, 2003.

    415-D:9 Incontestability Period. 

I. For a policy or certificate that has been in force for less than 6 months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptance for coverage.

II. For a policy or certificate that has been in force for at least 6 months but less than 2-years, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.

III. After a policy or certificate has been in force for 2 years, it is not contestable upon the grounds of misrepresentation alone; such policy or certificate may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.

IV. No long-term care insurance policy or certificate may be field issued based on medical or health status. For purposes of this section, "
field issued
" means a policy or certificate issued by an agent or a third party administrator pursuant to the underwriting authority granted to the agent or third party administrator by an insurer.

V. If an insurer has paid benefits under the long-term care insurance policy or certificate, the benefit payments may not be recovered by the insurer in the event that the policy or certificate is rescinded.


[Paragraph VI effective until January 1, 2023; see also paragraph VI set out below.]



VI. In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by RSA 408:10. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.


[Paragraph VI effective January 1, 2023; see also paragraph VI set out above.]



VI. In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In this situation, the remaining death benefits under these policies shall be governed by RSA 408:13. In all other situations, this section shall apply to life insurance policies that accelerate benefits for long-term care.


Source. 2003, 180:1, eff. Aug. 23, 2003. 2022, 144:4, eff. Jan. 1, 2023.

    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 adoption in 2018 of 29 C.F.R. section 2510.3-5, including the guidance provided in the United States Department of Labor publication entitled "MEWAS, Multiple-Employer Welfare Arrangements under the Employee Retirement Income Security Act (ERISA): A Guide to Federal and State Regulation, Revised August 2013" and including published United States Department of Labor ERISA Advisory Opinion Letters.

III. "
Bona fide pathway II association
" means a group or association that meets the requirements of 29 C.F.R. section 2510.3-5(b).

IV. "
Commissioner
" means the insurance commissioner of the state of New Hampshire.

V. "
Eligible employee
" means a full-time or part-time employee who meets the requirements for eligibility for group coverage set forth in RSA 415:18, I(q).

VI. Employee welfare benefit plan" has the same meaning as in 29 U.S.C. section 1002(1).

VII. "
Fully insured health benefit plan
" means a policy, contract, certificate, or agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of health services, that is offered or issued to bona fide association by a health insurer licensed to do business in New Hampshire and that bears the risk under the plan.

VIII. "
Fund balance
" means the total assets in excess of total liabilities, except that assets pledged to secure debts not reflected on the books of the multiple-employer welfare arrangement shall not be included in the fund balance. Fund balance shall include other contributed capital, retained earnings, and surplus notes.

IX. "
Insolvency termination
" means the termination of an arrangement where the fund balance as of the termination date is inadequate.

X. "
Insurer
" means any insurer, nonprofit hospital or medical service corporation, health maintenance organization, or managed care organization, including but not limited to an insurer offering health coverage as defined in RSA 420-G:2, IX.

XI. "
Multiple-employer welfare arrangement (MEWA)
" or "
association
" means an employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the eligible employees of 2 or more employers, or to their beneficiaries, and shall include a MEWA as defined in the Employee Retirement Income Security Act of 1974, 29 U.S.C. section 1001 et seq. (ERISA). This shall include plans established by any political subdivision of the state or religious organization, but shall not include any plan or arrangement established or maintained under or pursuant to one or more agreements deemed collective bargaining agreements under section 3(40)(A)(i)
 of (ERISA). For the purposes of this chapter, 2 or more trades or businesses, whether or not incorporated, shall be deemed a single employer if such trades or businesses are under common ownership or within the same control group as defined under section 3(40)(B)
 of ERISA.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:399, eff. Dec. 1, 2021.

    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 such additional insurance as they consider necessary for protection against potential future claims. Any funds remaining in the arrangement after satisfaction of all obligations upon termination shall be paid to participating employers and/or covered employees as of the termination date in some equitable manner meeting with the approval of the commissioner, including, without ruling out other alternatives, equally on a per capita basis to each participating employer and/or employee who is covered under the arrangement as of the effective date of termination.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407, eff. Dec. 1, 2021.

    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 a member of the board of trustees or by an administrative executive appointed by the board, showing its condition on the last day of the preceding fiscal year. The report shall contain a financial statement of the arrangement, including its balance sheet and a statement of operations for the preceding year certified by an independent certified public accountant. The report shall also include an analysis of the adequacy of reserves and contributions or premiums charged, based on a review of past and projected claims and expenses.

II. In addition to information called for and furnished in connection with the annual report, if reasonable grounds exist, the commissioner may request information which summarizes paid and incurred expenses, and contributions or premiums received, and may request evidence satisfactory to the commissioner that the arrangement is actuarially sound. Such information and evidence shall be furnished to the commissioner by the arrangement as soon as reasonably possible after requested by the commissioner, but no later than 30 days after such request, unless the commissioner, for good cause, grants an extension.

III. At least once every 3 years, each such arrangement shall have a report prepared by an actuary who is a member of the Society of Actuaries of the American Academy of Actuaries as to the actuarial soundness of the arrangement. The report shall be made available to the commissioner upon request. The report shall consist of, but shall not be limited to, the following:

(a) Adequacy of contribution rate in meeting the level of benefits provided and changes, if any, needed in the contribution rates to achieve or preserve a level of funding deemed adequate to enable payment of the benefit amounts provided under the arrangement, which shall include a valuation of present assets, based on statement value, and prospective assets and liabilities of the plan and the extent of any unfunded accrued liabilities.

(b) A plan to amortize any unfunded liabilities and a description of actions taken to reduce unfunded liabilities.

(c) A description and explanation of actuarial assumptions.

(d) A schedule illustrating the amortization of any unfunded liabilities.

(e) A comparative review illustrating the level of funds available to the arrangement from rates, investment income, and other sources realized over the period covered by the report, indicating the assumptions used.

(f) A statement by the actuary that the report is complete and accurate and that in his opinion the techniques and assumptions used are reasonable and meet the requirements and intent of this chapter.

(g) Other factors or statements as may be reasonably required by the commissioner in order to determine the actuarial soundness of the plan.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407, eff. Dec. 1, 2021.

    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, 2021.

    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 or rules.

(b) Has refused to be examined or to produce its accounts, records and files for examination, or if any of its officers has refused to give information with respect to its affairs or to perform any other legal obligation as to such examination, when required by the commissioner.

(c) Has failed to pay any final judgment rendered against it in this state within 60 days after the judgment became final.

(d) No longer meets the requirements for the authority originally granted.

II. The commissioner may, in his discretion, deny, suspend, or revoke the approval of any arrangement if it finds that the arrangement:

(a) Has violated any lawful order or rule of the commissioner, provision of this chapter, RSA 420-J, or relevant provision of RSA 161-H.

(b) Has refused to be examined or to produce its accounts, records, and files for examination, or if any of its officers have refused to give information with respect to its affairs or to perform any other legal obligation as to such examination, when required by the commissioner.

III. The commissioner shall not grant or continue approval until such time as the arrangement replaces any trustee found by the commissioner, upon the presentation of sufficient evidence:

(a) To be incompetent;

(b) To be guilty of, or to have pled guilty or no contest to a felony, or a crime involving moral turpitude;

(c) To have had any type of insurance license revoked in this or any other state; or

(d) To have improperly manipulated assets, accounts, or specific excess insurance or to have otherwise acted in bad faith.

IV. To qualify for and retain approval to transact business, an arrangement shall make all contracts with administrators or service companies available for inspection by the department initially, and thereafter upon reasonable notice.

V. Failure to maintain compliance with applicable eligibility or filing requirements established by this section shall be grounds for suspension or revocation of approval of an arrangement, provided, however, that such arrangement shall have 60 days after notification by the commissioner to take such action necessary to correct the deficiency.


Source. 1991, 246:1. 1994, 214:6. 1997, 344:4, eff. July 1, 1997; 345:2, eff. Jan. 1, 1998. 2019, 346:407, eff. Dec. 1, 2021.

    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 other provisions in this chapter, the commissioner may issue a cease and desist order if he finds any person operating or maintaining a multiple-employer welfare arrangement without a currently effective certificate of approval.


Source. 1991, 246:1, eff. Jan. 1, 1992.

    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. 1, 1992. 2019, 346:408, eff. Dec. 1, 2021.

    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 a work location in New Hampshire, which is the primary workplace of at least one New Hampshire resident, including any self-employed New Hampshire resident who is qualified to enroll in the plan.

II. This chapter shall not apply to a multiple-employer welfare arrangement that is a bona fide pathway I association which offers or provides benefits which are fully insured by an authorized insurer or under the provisions of RSA 5-B.

III. RSA 415-E:4, RSA 415-E:8, RSA 415-E:9, III and RSA 415-E:11 shall not apply to a multiple-employer welfare arrangement which:

(a) Meets the general eligibility requirements of RSA 415-E:3, I;

(b) Is administered primarily from a principal place of business located within the state of New Hampshire;

(c) Has provided employee health benefits for a continuous period of 10 or more years;

(d) Maintains a termination liability fund wherein the fund balance plus the total liabilities of the multiple-employer welfare arrangement shall at no time, for a consecutive 90-day period, be less than 40 percent of the aggregate amount of premiums billed during the 6 prior months. For purposes of this subparagraph, that surety amount, if any, deposited with the commissioner pursuant to RSA 415-E:7, I, may be credited as a fund balance asset toward the termination liability fund amount required under this chapter; and

(e) Files with the commissioner, not later than 4 months following the end of each fiscal year, a report on the financial status of the termination liability fund, which report is filed under oath by a member of its board of trustees, or by an administrative executive duly appointed by the board, and further certified to by an independent certified public accountant with a place of business located within the state of New Hampshire.

IV. In the event a multiple-employer welfare arrangement does not satisfy the requirements of paragraph III, the arrangement shall within 60 days file with the commissioner an application for approval under RSA 415-E:4, and shall be subject to all provisions of this chapter until such time as the requirements of paragraph III are satisfied.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:400, eff. Dec. 1, 2021.

    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 conforms with this chapter and all of the provisions of Title XXXVII concerning this coverage.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 a fully insured basis if it is licensed as a qualified purchasing alliance under RSA 420-M and meets all of the pathway II requirements under this chapter.

III. No insurer shall issue a fully-insured health benefit plan to an association or MEWA with covered lives in New Hampshire unless the association or MEWA meets the requirements of either paragraphs I or II.

IV. A fully-insured association or MEWA that is a qualified association trust or that has been licensed by the department as a qualified purchasing alliance shall not be subject to the financial reporting and solvency requirements of this chapter that are applicable only to self-funded associations.

V. An insurer issuing a fully insured health benefit plan to an association or MEWA shall ensure that the terms of the plan conform with all applicable requirements of this chapter with respect to bona fide association coverage and that the coverage has received all required approvals from the department.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 42 U.S.C. section 18022(b)(1), subject to approval of the commissioner based on the New Hampshire benchmark plan;

(b) Cost sharing requirements of 42 U.S.C. section 18022(c)(1)-(c)(3);

(c) Lifetime and annual limits as prescribed in 29 C.F.R. section 2590.715-2711;

(d) A level of coverage equal to or greater than that designed to provide benefits that are actuarially equivalent to 60 percent of the full actuarial value of the benefits provided under the plan; and

(e) All other benefits required to comply with applicable federal laws and regulations and with any provision of title XXXVII that applies to large group health insurance coverage.

II. Every health benefit plan offered by any bona fide pathway II association, whether offering coverage on a self-funded basis or fully insured basis, and any insurer contracting with an offering association, shall comply with the following:

(a) Except as otherwise specifically provided herein, all requirements of RSA 420-G, including claims data and other reporting requirements;

(b) Requirements contained in RSA 420-J, and any rules adopted thereunder by the commissioner including, but not limited to, network adequacy, balance billing protections, and appeal and grievance processes;

(c) Payment of premium tax as provided in RSA 400-A:31-35 and administrative assessment under RSA 400-A:39;

(d) Requirements pertaining to examinations under RSA 400-A:37;

(e) Requirements pertaining to unfair insurance trade practices under RSA 417;

(f) Vaccine association assessment under RSA 126-Q; and

(g) Individual market assessment under RSA 404-G.

III. No health benefit plan or related policy, contract, certificate, or agreement offered or issued in this state to a bona fide pathway II association, whether offering coverage on a self-funded basis or fully insured basis, shall reserve discretion to the insurer or sponsoring association to interpret the terms of the contract or to provide standards of interpretation or review that are inconsistent with the laws of this state. Any such policy, contract, certificate, or agreement shall be void and unenforceable to the extent it conflicts with this section.

IV. A bona fide pathway II association, whether offering coverage on a self-funded basis or fully insured basis, shall not offer, and an insurer shall not deliver or issue for delivery to such association, a health benefit plan covering lives located in this state that contains an exclusion or limitation for pre-existing conditions or a waiting period on the coverage of pre-existing conditions.

V. For any bona fide pathway II association, whether offering coverage on a self-funded basis or fully insured basis, if coverage is issued to a sole proprietor, the association sponsoring the coverage shall be responsible for monitoring and ensuring that the sole proprietor meets the requirements to qualify as an employer under 29 C.F.R. section 2510.3-5(b) and meets the per month hourly work requirement contained in RSA 126-AA:2, III. Failure to ensure compliance with this provision shall be a violation of this chapter.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 health benefit plan, shall comply with all requirements of RSA 420-G, except that, for any such association with 250 or more New Hampshire covered lives, the association as a whole may be rated as a single risk pool separately from the small employer market.

II. Coverage for a fully insured bona fide pathway I association with 250 or more New Hampshire covered lives and any bona fide pathway II association with 250 or more New Hampshire covered lives may be rated as a single large group based on the association's group experience and in accordance with all standards applicable to large employer groups under RSA 420-G. The following additional requirements shall apply to such coverage:

(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, a change in the group's case characteristics.

(b) For fully insured bona fide pathway I associations, the association may vary rates among member small employers only in accordance with the provisions in RSA 420-G:10 applying to qualified association trusts.

(c) For any pathway II association, whether self funded or fully insured, the association may vary rates among member small employers, including participating self-employed New Hampshire members, as follows:

(1) Variation associated with age shall not exceed 5:1.

(2) Variation associated with tobacco use shall not exceed 1.5 to 1.

(3) No other variation shall be permitted.

(d) The same rating methodology shall apply to newly covered member employer groups and employee members renewing at each annual renewal date or anniversary date. The rating methodology shall not be construed to include health carrier incentives to individual subscribers or members to participate in wellness and fitness programs provided such incentives are approved by the insurance department.

(e) Nothing in this chapter shall be construed to allow a member small employer group within any association to be rated separately under large group rating standards.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 become eligible to participate in the group health plan sponsored by the group or association.

II. The group health plan sponsored by the group or association shall comply with 29 C.F.R. section 2590.702(b) with respect to nondiscrimination in rules for eligibility of benefits.

III. The group health plan sponsored by the group or association shall comply with 29 C.F.R. section 2590.702(c) with respect to nondiscrimination in premiums or contributions required by any participant or beneficiary for coverage under the plan.

IV. In applying the nondiscrimination provisions of paragraphs II and III, the group or association shall not treat the employees of different employer members of the group or association as distinct groups of similarly-situated individuals based on a health factor of one or more individuals.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 being permitted to return to the original market, nor shall an insurer or administrator be permitted to impose such a waiting period.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 II coverage on the existing small group markets and to perform the actuarial review necessary to support the small group risk adjustment program required under RSA 420-K. The plan of operation for the small group risk adjustment program required under RSA 420-K shall be approved and in place before any pathway II association coverage may be issued.

II. Upon the recommendation of the commission on the status of health coverage markets for individuals and small employers established under RSA 404-J, or upon the commissioner's own initiative, the commissioner may limit pathway II associations to the writing of existing business only and may adjust the risk score differential amount in RSA 420-K:4, I(d) as necessary to prevent the pathway II association market from having an adverse impact on the availability and choice of coverage in the small group market and as necessary to prevent average premiums for small groups from increasing at a rate that is significantly higher than the trend in claims costs.


Source. 2019, 346:402, eff. Dec. 1, 2021.

    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 has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance.

(c) Operated pursuant to a trust agreement by a board of trustees which shall have complete fiscal control over the arrangement and which shall be responsible for all operations of the arrangement. The trustees selected shall be owners, partners, officers, directors, or employees of one or more employers in the arrangement. A trustee may not be an owner, officer, or employee of the administrator or service company of the arrangement. The trustees shall have the authority to approve applications of association members for participation in the arrangement and to contract with an authorized administrator or service company to administer the day-to-day affairs of the arrangement.

(d) Neither offered nor advertised to the public generally.

(e) Operated in accordance with sound actuarial principles.

II. The arrangement shall issue to each covered employee a policy contract, certificate, summary plan description, or other evidence of the benefits and coverages provided. This evidence of the benefits and coverages provided shall contain in boldfaced print in a conspicuous location, the following statement: "The benefits and coverages described herein are provided through a trust fund established and funded by a group of employers." Arrangements in existence prior to January 1, 1992, that have previously issued benefit descriptions to employees may meet the disclosure requirements under this chapter by issuing to each employee such additional written material necessary to meet the requirements of this paragraph.

II-a. Each arrangement shall provide to each covered employee, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.

II-b. No arrangement shall extend preexisting condition exclusions beyond a period of 9 consecutive months after the date of enrollment of the person's health coverage.

III. Each arrangement shall maintain specific excess insurance with a retention level determined in accordance with sound actuarial principles and approved by the commissioner.

IV. Each arrangement shall establish and maintain appropriate loss reserves determined in accordance with sound actuarial principles and approved by the commissioner.

V. The commissioner shall not grant or continue approval until such time as the arrangement replaces any trustee found by the commissioner, upon the presentation of sufficient evidence:

(a) To be incompetent;

(b) To be guilty of, or to have pled guilty or no contest to a felony, or a crime involving moral turpitude;

(c) To have had any type of insurance license revoked in this or any other state;

(d) To have improperly manipulated assets, accounts, or specific excess insurance or to have otherwise acted in bad faith.

VI. To qualify for and retain approval to transact business, an arrangement shall make all contracts with administrators or service companies available for inspection by the department initially, and thereafter upon reasonable notice.

VII. Failure to maintain compliance with applicable eligibility or filing requirements established by this section shall be grounds for suspension or revocation of approval of an arrangement, provided, however, that such arrangement shall have 60 days after notification by the commissioner to take such action necessary to correct the deficiency.
415-E:3 General Eligibility;  Pathway I and Pathway II. 

To meet the requirements for approval and to maintain a multiple employer welfare arrangement, an association not exempted under RSA 415-E:2, II shall be approved either as a self-insured bona fide pathway I association or as a bona fide pathway II association as follows:

I. An association seeking approval as a self-insured bona fide pathway I association shall:

(a) Meet the definition in RSA 415-E:1, II of a bona fide pathway I association.

(b) Sponsor health coverage that is self-insured.

(c) Be nonprofit.

(d) Be 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 has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance.

(e) Be operated pursuant to a trust agreement by a board of trustees which shall have complete fiscal control over the arrangement and which shall be responsible for all operations of the arrangement. The trustees selected shall be owners, partners, officers, directors, or employees of one or more employers in the arrangement. A trustee may not be an owner, officer, or employee of the administrator or service company of the arrangement. The trustees shall have the authority to approve applications of association members for participation in the arrangement and to contract with an authorized administrator or service company to administer the day-to-day affairs of the arrangement.

(f) Be neither offered nor advertised to the public generally.

(g) Be operated in accordance with sound actuarial principles.

II. An association seeking approval as a bona fide pathway II association shall:

(a) Meet the definition in RSA 415-E:1, III of a bona fide pathway II association.

(b) Have a formal organizational structure with a governing body, bylaws, and other similar indications of formality, and complies with RSA 415-E:3, I-a(e) and with all other organizational requirements under this chapter and, if the association offers fully insured coverage, under RSA 420-M.

(c) Have its functions and activities controlled by its employer members, and the association's employer members that participate in the group health plan shall control the plan, both in form and in substance.

(d) Have a commonality of interest with its employer members, such that one or both of the following standards are met, in a manner that is not a subterfuge for discrimination as prohibited under RSA 415-E:1-e:

(1) The employers are in the same trade, industry, line of business, or profession; or

(2) Each employer has a principal place of business in the same region.

(e) Have at least one substantial business purpose unrelated to offering and providing health coverage or other employee benefits to its employer members and their employees.

(f) Have each employer member of the association participating in the group health plan who is a person acting directly as an employer of at least one employee who is a participant covered under the plan.

(g) Not make health coverage through the association's group health plan available other than to:

(1) An employee of a current employer member of the association; and

(2) A beneficiary of an individual eligible under subparagraph (1).

(h) Not be a health insurance issuer, or owned or controlled by a health insurance issuer, or by a subsidiary or affiliate of a health insurance issuer, other than to the extent such entities participate in the association in their capacity as employer members of the association.



Source. 1991, 246:1. 1993, 102:2. 2007, 289:11, eff. Jan. 1, 2008. 2019, 346:401, eff. Dec. 1, 2021.

    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. The names and addresses of the trustees of the arrangement.

III. A copy of the bylaws or trust agreement which governs the operation of the arrangement.

IV. A copy of the policy, contract, certificate, summary plan description, or other evidence of the benefits and coverages provided to covered employees.

V. A copy of the fidelity bond in an amount equal to not less than 10 percent of the funds handled annually and issued in the name of the arrangement covering its trustees, employees, administrator, or other individuals managing or handling the funds or assets of the arrangement. In no case may such bond be less than $1,000 or more than $500,000, except that the commissioner, after due notice to all interested parties and opportunity for hearing, and after consideration of the record, may prescribe an amount in excess of $500,000 subject to the 10 percent limitation.

VI. A copy of the arrangement's excess insurance agreement.

VII. Evidence satisfactory to the commissioner showing that the arrangement will be operated in accordance with sound actuarial principles. The commissioner shall not approve the arrangement unless the commissioner determines that the plan is designed to provide sufficient revenues to pay current and future liabilities, as determined in accordance with sound actuarial principles.

VIII. Such additional information as the commissioner may reasonably require.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:403, eff. Dec. 1, 2021.

    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, whichever is greater. For purposes of this paragraph, that surety amount, if any, deposited with the commissioner pursuant to RSA 415-E:7, I, may be credited as a fund balance asset toward the termination liability fund amount.

II. Each self-funded multiple-employer welfare arrangement shall file with the commissioner, not later than 4 months following the end of each fiscal year, a report on the financial status of the termination liability fund, which report is filed under oath by a member of its board of trustees, or by an administrative executive duly appointed by the board, and further certified to by an independent certified public accountant.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:404, eff. Dec. 1, 2021.

    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 with sound actuarial principles and approved by the commissioner.

III. The commissioner may, upon reasonable notice, conduct an examination of the loss reserves, financial condition, specific excess insurance, and working capital of a multiple-employer welfare arrangement the costs of which shall be borne by the arrangement. If the commissioner preliminarily finds that the reserves, specific excess insurance, or financial condition may be inadequate, or that the arrangement does not have a combined working capital in an amount establishing the financial strength and liquidity of the arrangement to pay claims promptly and showing evidence of the financial ability of the arrangement to meet its obligations to covered employees, the commissioner shall notify the arrangement of such inadequacy. Upon being so notified, the arrangement shall within 30 days file with the commissioner all information which, in the belief of the arrangement, proves the reasonableness and adequacy of the condition noted as being inadequate.

IV. If the commissioner determines, after reviewing the information filed, that an inadequate condition exists, the arrangement shall implement, within 30 days, a plan to correct the inadequacy and shall file proof of reasonable improvement or adequate condition with the commissioner within 6 months of the implementation of the plan. If the commissioner is satisfied that the plan submitted to improve the inadequate condition of the arrangement is sufficient, he shall so notify the arrangement. The arrangement shall report quarterly to the commissioner until the causes of the inadequate condition have been corrected.

V. The commissioner may suspend or revoke the approval of an arrangement if he finds that the arrangement has failed to correct or reasonably improve an inadequate condition within the time authorized by paragraph IV.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:405, eff. Dec. 1, 2021.

    415-E:7 Insolvency Protection. 

I. To assure the faithful performance of its obligations to its member employers and covered employees who are New Hampshire residents and their dependents, every arrangement shall, within 30 days after the close of the arrangement's fiscal year, deposit with the commissioner cash, securities, or any combination of these or other measures acceptable to the commissioner, in an amount equal to, $100,000 or 25 percent of the aggregate premiums billed during the 12 prior months attributable to New Hampshire residents, whichever is greater. All income from deposits shall belong to the depositing arrangement and shall be paid to it as it becomes available. An arrangement that has made a securities deposit may withdraw that deposit, or any part of such deposit, after making a substitute deposit of cash, securities, or any combination of these or other measures of equal amount and value, upon approval by the commissioner. No judgment creditor or other claimant of a multiple-employer welfare association shall have the right to levy upon any of the assets or securities held in this state as a deposit under this section.

II. In lieu of the deposit required under paragraph I, an arrangement may file with the commissioner a surety bond in like amount. The bond shall be one issued by an authorized surety insurer, shall be for the same purpose as the deposit in lieu of which it is filed, and shall be subject to the commissioner's approval. No bond shall be canceled or subject to cancellation unless at least 60 days' advance notice of cancellation in writing is filed with the commissioner. No bond shall be approved unless it covers liabilities arising from all policies and contracts issued and entered into during the time the bond is in effect and unless the commissioner is satisfied that the bond provides the same degree of security as would be provided by a deposit of securities.

III. In the event of an insolvency termination, the deposit held by the commissioner pursuant to RSA 415-E:7, I, or the bond held by the commissioner pursuant to RSA 415-E:7, II, shall be applied to the extent of the insolvency. Any deposit funds remaining in excess of the amount needed to make the arrangement solvent shall be distributed in accordance with RSA 415-E:10.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:406, eff. Dec. 1, 2021.

    415-E:8 Policy Forms. 

I. Whether an arrangement is self-funded or fully insured, no policy or contract form, application form, certificate, rider, endorsement, summary plan description, or other evidence of coverage shall be sponsored or issued by an arrangement unless the form and all changes to it have been filed with the commissioner by or on behalf of the arrangement which proposed to use such form and have been approved by the commissioner.

II. The commissioner shall disapprove any form filed under this section, or withdraw any previous approval, only if the form:

(a) Is in any respect in violation of, or does not comply with, this chapter.

(b) Contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.

(c) Has any title, heading, or other indication of its provisions which is misleading.

(d) Is printed or otherwise reproduced in such manner as to render any material provision of the form substantially illegible.

(e) Contains provisions which are unfair or inequitable, or contrary to the public policy of this state or which encourage misrepresentation.

III. Each self-funded arrangement shall issue to each covered employee a policy contract, certificate, summary plan description, or other evidence of the benefits and coverages provided. The evidence of the benefits and coverages provided shall contain in boldfaced print in a conspicuous location, the following statement: "The benefits and coverages described herein are provided through a trust fund established and funded by a group of employers."

IV. Each self-funded arrangement shall provide to each covered employee, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407, eff. Dec. 1, 2021.

    415-E:9 Self-Funded Arrangements;  Employer Participants' Liability. 

For self-funded arrangements:

I. The liability of each employer participant for the obligations of the multiple-employer welfare arrangement shall be individual, several, and proportionate, but not joint.

II. Each employer participant shall have a contingent assessment liability pursuant to 415-E:10 for payment of actual losses and expenses incurred while the policy was in force.

III. Each policy issued by the arrangement shall contain a statement of the contingent liability. Both the application for insurance and policy shall contain, in contrasting color and not less than 10-point type, the following statement: "This is a fully assessable policy. In the event the arrangement is unable to pay its obligations, policyholders (employers) shall be required to contribute on a pro rata earned premium basis the money necessary to meet any unfulfilled obligations."


Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407, eff. Dec. 1, 2021.

    415-F:1 Definitions. 

In this chapter:

I. "Applicant" means:

(a) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and

(b) In the case of a group Medicare supplement policy, the proposed certificate holder.

II. "Certificate" means any certificate advertised, solicited, delivered or issued for delivery in this state under a group Medicare supplement policy.

III. "Certificate form" means the form on which the certificate is advertised, solicited, delivered or issued for delivery by the issuer.

IV. "Issuer" includes insurance companies, fraternal benefit societies, nonprofit health service corporations, health maintenance organizations, and any other entity advertising, soliciting, delivering or issuing for delivery in this state Medicare supplement policies or certificates.

V. "Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the Social Security Amendments of 1965,
 as then constituted or later amended.

VI. "Medicare supplement policy" means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service corporations, nonprofit health service corporations, or health maintenance organizations other than a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act (42 U.S.C. Section 1395 et seq.), or an issued policy under a demonstration project specified in 42 U.S.C. Section 1395 (a)(1), which is advertised, marketed or designed primarily as a supplement to reimbursements under Medicare or the hospital, medical or surgical expenses of persons eligible for Medicare.

VII. "Policy form" means the form on which the policy is delivered or issued for delivery by the issuer.


Source. 1994, 233:1. 1996, 188:15, 16, eff. Jan. 1, 1997.

    415-F:2 Applicability and Scope. 

I. Except as otherwise specifically provided in RSA 415-F:4, this chapter shall apply to:

(a) All Medicare supplement policies delivered or issued for delivery in this state on or after January 1, 1995; and

(b) All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this state.

II. This chapter shall not apply to a policy of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees or a combination of employees or former employees, or for members or former members, or a combination of members or former members, of the labor organizations.

III. Except as otherwise specifically provided in RSA 415-F:5, III, the provisions of this chapter are not intended to prohibit or apply to insurance policies or health care benefit plans, including group conversion policies, provided to Medicare eligible persons, which policies are not marketed or held to be Medicare supplement policies or benefit plans.


Source. 1994, 233:1. 1996, 188:17, eff. Jan. 1, 1997.

    415-F:3 Standards for Policy Provisions and Authority to Adopt Rules. 

I. No Medicare supplement policy or certificate in force in the state shall contain benefits that duplicate benefits provided by Medicare.

II. Notwithstanding any other provision of law of this state, a Medicare supplement policy or certificate shall not exclude or limit benefits for loss incurred more than 6 months from the effective date of coverage because it involved a preexisting condition. The policy or certificate shall not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within 6 months before the effective date of coverage.

III. The commissioner shall adopt reasonable rules under RSA 541-A to establish specific standards for policy provisions of Medicare supplement policies and certificates. Such standards shall be in addition to and in accordance with applicable laws of this state. No requirement of the insurance code relating to minimum required policy benefits, other than the minimum standards contained in this chapter, shall apply to Medicare supplement policies and certificates. The standards may cover, but not be limited to:

(a) Terms of renewability.

(b) Initial and subsequent conditions of eligibility.

(c) Nonduplication of coverage.

(d) Probationary periods.

(e) Benefit limitations, exceptions, and reductions.

(f) Elimination periods.

(g) Requirements for replacement.

(h) Recurrent conditions.

(i) Definitions of terms.

IV. The commissioner may adopt reasonable rules under RSA 541-A to establish minimum standards for benefits, claims payment, marketing practices, compensation arrangements and reporting practices for Medicare supplement policies and certificates.

V. The commissioner may adopt rules, under RSA 541-A, as are necessary to conform Medicare supplement policies and certificates to the requirements of federal law and regulations promulgated under such federal law, including but not limited to:

(a) Requiring refunds or credits if the policies or certificates do not meet loss ratio requirements.

(b) Establishing a uniform methodology for calculating and reporting loss ratios.

(c) Assuring public access to policies, premiums, and loss ratio information of issuers of Medicare supplement insurance.

(d) Establishing a process for approving or disapproving policy forms, certificate forms, and proposed premium increases.

(e) Establishing a policy for holding public hearings prior to approval of premium increases.

(f) Establishing standards for medicare select policies and certificates.

VI. The commissioner may adopt rules under RSA 541-A that specify prohibited policy provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair or unfairly discriminatory to any person insured or proposed to be insured under a Medicare supplement policy or certificate.


Source. 1994, 233:1, eff. Jan. 1, 1995.

    415-F:4 Loss Ratio Standards. 

Medicare supplement policies shall return to policyholders benefits which are reasonable in relation to the premium charged. The commissioner shall issue reasonable regulations to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses where coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices.


Source. 1994, 233:1, eff. Jan. 1, 1995.

    415-F:5 Disclosure Standards. 

I. In order to provide for full and fair disclosure in the sale of Medicare supplement policies, no Medicare supplement policy or certificate shall be delivered in this state unless an outline of coverage is delivered to the applicant at the time application is made.

II. The commissioner shall prescribe the format and content of the outline of coverage required by 415-A:5, I. For purposes of this section, "format" means style, arrangements and overall appearance, including such items as size, color, and prominence of type and arrangement of text and captions. Such outline of coverage shall include:

(a) A description of the principal benefits and coverage provided in the policy.

(b) A statement of the renewal provisions, including any reservations by the issuer of a right to change premiums, and disclosure of the existence of any automatic renewal premium increases based on the policyholder's age.

(c) A statement that the outline of coverage is a summary of the policy issued or applied for and that the policy should be consulted to determine governing contractual provisions.

III. The commissioner may prescribe by rule a standard form and the contents of an informational brochure for persons eligible for Medicare, which is intended to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare. Except in the case of direct response insurance policies, the commissioner may require by rule that the informational brochure be provided to any prospective insureds eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by rule that the prescribed brochure be provided upon request to any prospective insureds eligible for Medicare, but in no event later than the time of policy delivery.

IV. The commissioner may adopt rules under RSA 541-A for captions or notice requirements, determined to be in the public interest and designed to inform prospective insureds that particular insurance coverages are not Medicare supplement coverages, for all accident and sickness insurance policies sold to persons eligible for Medicare, other than:

(a) Medicare supplement policies.

(b) Disability income policies.

V. The commissioner may adopt rules under RSA 541-A to govern the full and fair disclosure of the information in connection with the replacement of accident and sickness policies, subscriber contracts or certificates by persons eligible for Medicare.


Source. 1994, 233:1. 1996, 188:18, eff. Jan. 1, 1997.

    415-F:6 Notice of Free Examination. 

Medicare supplement policies and certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto stating in substance that the applicant shall have the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section shall be paid directly to the applicant by the issuer in a timely manner.


Source. 1994, 233:1, eff. Jan. 1, 1995.

    415-F:7 Filing Requirements for Advertising. 

Every issuer of Medicare supplement insurance policies or certificates in this state shall provide a copy of any Medicare supplement advertisement intended for use in this state whether through written, radio or television medium to the commissioner of this state for review or approval by the commissioner to the extent it may be required under state law.


Source. 1994, 233:1, eff. Jan. 1, 1995.

    415-F:8 Penalties. 

In addition to any other applicable penalties for violations of the insurance code, the commissioner may require issuers violating any provision of this chapter or rules adopted pursuant to this chapter to cease marketing any Medicare supplement policy or certificate in this state which is related directly or indirectly to a violation or may require such issuer to take such actions as are necessary to comply with the provisions of this chapter, or both.


Source. 1994, 233:1, eff. Jan. 1, 1995.

    415-F:9 Premiums. 

Upon a Medicare eligible disabled member attaining the age of 65, no issuer shall continue to charge that member the under age 65 premium.


Source. 2021, 119:2, Pt. IV, Sec. 1, eff. Jan. 1, 2022.

    415-H:1 Purpose and Intent. 

This chapter shall be known as the Stop Loss Insurance Act. The purpose of this chapter is to establish criteria for the issuance of stop loss insurance policies. Nothing in this chapter shall be construed as imposing any requirement or duty on any person other than an insurer or as treating any stop loss policy as a direct policy of health insurance.


Source. 2006, 217:1, eff. Jan. 1, 2007.

    415-H:2 Definitions. 

I. "
Actuarial certification
" means a written statement by a member of the American Academy of Actuaries, or other individual acceptable to the commissioner, that an insurer is in compliance with the provisions of this chapter, based upon the individual's examination and including a review of the appropriate records and the actuarial assumptions and methods used by the insurer in establishing attachment points and other applicable determinations in conjunction with the provision of stop loss insurance coverage.

II. "
Attachment point
" means the claims amount incurred by an insured group beyond which the insurer incurs a liability for payment.

III. "
Expected claims
" means the amount of claims that, in the absence of a stop loss policy or other insurance, are projected to be incurred by an insured group through its health plan.


Source. 2006, 217:1, eff. Jan. 1, 2007.

    415-H:3 Stop Loss Insurance Coverage Standards. 

I. An insurer shall not issue or renew a stop loss insurance policy or certificate that:

(a) Has an annual attachment point for claims incurred per individual which is lower than $20,000;

(b) Has an annual aggregate attachment point, for groups of 50 or fewer, that is lower than the greater of:

(1) $4,000 times the number of group members;

(2) 120 percent of expected claims; or

(3) $20,000;

(c) Has an annual aggregate attachment point for groups of 51 or more that is lower than 110 percent of expected claims; or

(d) Provides direct coverage of health care expenses of an individual.

II. An insurer shall determine the number of persons in a group, for the purposes of this section, on a consistent basis, at least annually.

III. For the purposes of determining the dollar amounts set forth in paragraph I, and upon consideration of the medical components of the Consumer Price Index (CPI), the commissioner may amend these dollar amounts and shall publish any change in these dollar amounts at least 6 months prior to their effective dates.


Source. 2006, 217:1, eff. Jan. 1, 2007.

    415-H:4 Actuarial Certification. 

An insurer shall file with the commissioner annually on or before March 15, an actuarial certification certifying that the insurer is in compliance with this chapter. The certification shall be in a form and manner, and shall contain information, specified by the commissioner. A copy of the certification shall be retained by the insurer at its principal place of business.


Source. 2006, 217:1, eff. Jan. 1, 2007.

    415-H:5 Rulemaking. 

The commissioner may adopt rules in accordance with RSA 541-A that carry out the requirements of this chapter and prescribe additional standards for stop loss insurance policies.


Source. 2006, 217:1, eff. Jan. 1, 2007.

    415-I:1 Title. 

This chapter shall be known as the Discount Medical Plan Act.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:10 Marketing Requirements. 

I. A discount medical plan organization may market directly or contract with other marketers for the distribution of its product.

II. The discount medical plan organization shall have an executed written agreement with a marketer prior to the marketer's marketing, promoting, selling, or distributing the discount medical plan.

III. The agreement between the discount medical plan organization and the marketer shall prohibit the marketer from using advertising, marketing materials, brochures, and discount medical plan cards without the discount medical plan organization's approval in writing.

IV. The discount medical plan organization shall be bound by and responsible for the activities of the marketer that are within the scope of the marketer's agency relationship with the organization.

V. A discount medical plan organization shall approve in writing all advertisements, marketing materials, brochures, and discount cards used by marketers to market, promote, sell, or distribute the discount medical plan prior to their use.

VI. Upon request, a discount medical plan organization shall provide to the commissioner any advertising, marketing materials, and brochures regarding a discount medical plan requested by the commissioner.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:11 Marketing Restrictions and Disclosure Requirement. 

I. All advertisements, marketing materials, brochures, discount medical plan cards, and any other communications of a discount medical plan organization provided to prospective members and members shall be truthful and not misleading in fact or in implication.

II. An advertisement, any marketing material, brochure, discount medical plan card, or other communication is misleading in fact or in implication if it has a capacity or tendency to mislead or deceive based on the overall impression that it is reasonably expected to create within the segment of the public to which it is directed.

III. A discount medical plan organization shall not:

(a) Except as a disclaimer of any relationship between discount medical plan benefits and insurance or as a description of an insurance product connected with a discount medical plan, use in its advertisements, marketing material, brochures, and discount medical plan cards the term insurance.

(b) Use in its advertisements, marketing material, brochures, and discount medical plan cards the terms "health plan," "coverage," "copay," "copayments," "deductible," "preexisting conditions," "guaranteed issue," "premium," "PPO," "preferred provider organization," or other terms in a manner that could mislead an individual into believing that the discount medical plan is health insurance.

(c) Use language in its advertisements, marketing material, brochures, and discount medical plan cards with respect to being registered by the state insurance department in a manner that could mislead an individual into believing that the discount medical plan is insurance or has been endorsed by the state.

(d) Make misleading, deceptive, or fraudulent representations regarding the discount or range of discounts offered by the discount medical plan or the access to any range of discounts offered by the discount medical plan.

(e) Have restrictions on access to discount medical plan providers, including, except for hospital services, waiting periods and notification periods.

(f) Pay providers any fees for medical or ancillary services or collect or accept money from a member to pay a provider for medical or ancillary services provided under the discount medical plan, unless the discount medical plan organization has an active certificate of authority to act as a health carrier or as a third party administrator in accordance with RSA 402-H:11.

IV. (a) Each discount medical plan organization shall make the following disclosures to prospective members.

(1) That the plan is not insurance.

(2) That the discounts for medical or ancillary services provided under the plan are available only from participating providers and will vary depending on the provider and medical or ancillary service received.

(3) That the discount medical plan organization does not make payments to providers for the medical or ancillary services received under the discount medical plan.

(4) That the plan member is obligated to pay for all medical or ancillary services, but will receive a discount from those providers that have contracted with the discount medical plan organization.

(5) The toll-free telephone number and Internet website address for the licensed discount medical plan organization for prospective members and members to obtain additional information about and assistance on the discount medical plan and up-to-date list of providers participating in the discount medical plan.

(6) Information that generally describes or summarizes the terms and conditions of the discount medical plan, including any limitations or restrictions on the refund of any processing fees or periodic charges associated with the discount medical plan.

(b) The disclosures required under subparagraph IV(a) shall be in writing in at least 12-point font and shall be provided along with any enrollment forms given to a prospective member and on the first content page of any advertisements, marketing materials, or brochures made available to the public relating to the discount medical plan. If the initial contact with a prospective member is by telephone, the disclosures required under subparagraph IV(a) shall be made orally and included in the initial written materials that describe the benefits under the discount medical plan provided to the prospective or new member.

(c) Each discount medical plan organization shall provide to each new member a written document that contains the terms and conditions of the discount medical plan. This written document shall be clear and include the following information:

(1) The name of the member.

(2) The benefits to be provided under the discount medical plan.

(3) Any processing fees and periodic charges associated with the discount medical plan, including any limitations or restrictions on the refund of any processing fees and periodic charges.

(4) The mode of payment for any processing fees and periodic charges and procedures for changing the mode of payment.

(5) Any limitations, exclusions, or exceptions regarding the receipt of discount medical plan benefits.

(6) Procedures for obtaining discounts under the discount medical plan, such as requiring members to contact the discount medical plan organization to make an appointment with a provider on the member's behalf.

(7) Cancellation procedures, including information on the member's 30-day cancellation rights and refund requirements and procedures for obtaining refunds.

(8) Renewal, termination, and cancellation terms and conditions.

(9) Procedures for adding new members to a family discount medical plan, if applicable.

(10) Procedures for filing complaints under the discount medical plan organization's complaint system and information that, if the member remains dissatisfied after completing the organization's complaint system, the plan member may contact his or her local state insurance department.

(11) The name and mailing address of the licensed discount medical plan organization or other entity where the member can make inquiries about the plan, send cancellation notices, and file complaints.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:12 Notice of Change in Name or Address. 

Each discount medical plan organization shall provide the commissioner at least 30 days' advance notice of any change in the discount medical plan organization's name, address, principal business address or mailing address, or Internet website address.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:13 Administrative Penalties. 

In addition to the penalties and other enforcement provisions of this chapter, any person who willfully violates this chapter is subject to administrative penalties of up to $2,500 per violation.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:14 Injunctions. 

I. In addition to the penalties and other enforcement provisions of this chapter, the commissioner may seek both temporary and permanent injunctive relief when:

(a) A discount medical plan is being operated by a person or entity that is not registered pursuant to this chapter; or

(b) Any person, entity, or discount medical plan organization has engaged in an activity prohibited by this chapter or rule adopted pursuant to this chapter.

II. The commissioner's authority to seek injunctive relief is not conditioned on having conducted any proceeding pursuant to the provisions of RSA 400-A:15 or RSA 541-A.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:15 Additional Penalties. 

Any violation of RSA 415-A:11, I, II, and III shall constitute an unfair or deceptive act or practice within the meaning of RSA 417:4.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:16 Rules. 

The commissioner may adopt rules, pursuant to RSA 541-A, to carry out the provisions of this chapter.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:17 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 severable.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:2 Purpose. 

The purpose of this chapter is to promote the public interest by establishing standards for discount medical plans to protect consumers from unfair or deceptive marketing, sales, or enrollment practices and to facilitate consumer understanding of the role and function of discount medical plan organizations in providing access to medical or ancillary services.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:3 Definitions. 

In this chapter:

I. "
Ancillary services
" includes, but is not limited to, audiology, dental, vision, mental health, substance abuse, chiropractic, and podiatry services.

II. "
Commissioner
" means the insurance commissioner.

III. "
Discount medical plan
" means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, offers access for its members to providers of medical or ancillary services and the right to receive discounts on medical or ancillary services provided under the discount medical plan from those providers. "Discount medical plan" does not include:

(a) Any discount arrangement that involves the transfer of insurance risk from a subscriber to another entity, or arrangement or contract for claim processing functions.

(b) A plan that does not charge a membership or other fee to the member to use the plan's discount medical card.

(c) A plan that provides a Medicare Part D prescription drug benefit in accordance with the requirements of the federal Medicare Prescription Drug Improvement and Modernization Act of 2003.

(d) A plan that provides direct primary care meeting the requirements of RSA 329:1-e.

IV. "
Discount medical plan organization
" means an entity that, in exchange for fees, dues, charges, or other consideration, provides access for discount medical plan members to providers of medical or ancillary services and the right to receive medical or ancillary services from those providers at a discount. "
Discount medical plan organization
" is the organization that contracts with providers, provider networks, or other discount medical plan organizations to offer access to medical or ancillary services at a discount and determines the charge to discount medical plan members. "Discount medical plan organization" does not include a provider that offers discounts to its own patients without any cost or fee of any kind to the patient. "Discount medical plan organization" shall not include providers of direct primary care meeting the requirements of RSA 329:1-e.

V. "
Health care professional
" means a physician, pharmacist, or other health care practitioner who is licensed, accredited, or certified to perform specified medical or ancillary services within the scope of his or her license, accreditation, certification, or other appropriate authority and consistent with state law.

VI. "
Health carrier
" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits, or medical or ancillary services.

VII. "
Marketer
" means a person or entity that markets, promotes, sells, or distributes a discount medical plan, including a private label entity that places its name on and markets or distributes a discount medical plan pursuant to a marketing agreement with a discount medical plan organization.

VIII. "
Medical services
" means any service, supply, or drug intended for the maintenance care of, or preventive care for, the human body or the care, or treatment of an illness or dysfunction of, or injury to, the human body. "Medical services" includes, but is not limited to, physician care, inpatient care, hospital surgical services, emergency services, ambulance services, laboratory services, pharmaceutical supplies, prescription drugs, and medical equipment and supplies. "Medical services" does not include ancillary services.

IX. "
Member
" means any individual who pays fees, dues, charges, or other consideration for the right to receive the benefits of a discount medical plan.

X. "
Participating provider
" means any health care professional or facility that has contracted, directly or indirectly, with a discount medical plan organization to provide medical or ancillary services to members.

XI. "
Person
" means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, any similar entity, or any combination of the foregoing.

XII. "
Provider
" means an institution or individual that offers medical or medically-related services in a health care setting.

XIII. "
Third party administrator
" means a third party administrator as defined by RSA 402-H.


Source. 2008, 206:1, eff. Jan. 1, 2009. 2019, 330:2, 3, eff. Oct. 15, 2019.

    415-I:4 Applicability and Scope. 

I. This chapter applies to all discount medical plan organizations doing business in or from this state.

II. This chapter shall not apply to any discount medical plan offered by, or in cooperation with, or pursuant to an agreement with the state of New Hampshire or any political subdivision of the state.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:5 Registration Requirement. 

I. Before doing business in or from this state as a medical discount plan organization, a person or entity:

(a) Shall be authorized to transact business in this state under RSA 293-A or RSA 294-A; and

(b) Shall register with the commissioner to operate as a discount medical plan organization on a form prescribed by the commissioner. The registration form shall be filed annually by June 1 of each year.

II. The provisions of subparagraph I(b) shall not apply to any person licensed in this state as a health insurer, hospital service corporation, medical service corporation, or fraternal benefit society, or any affiliate owned or controlled by such health insurer, hospital service corporation, medical service corporation, or fraternal benefit society, which may offer medical discount plans in this state pursuant to such licensure and in accordance with the provisions of this chapter.

III. Each applicant for a certificate of registration shall make an application to the commissioner upon a form to be furnished by the commissioner and fee paid pursuant to RSA 400-A:29, XXII(a). The application shall include or be accompanied by the following information and documents:

(a) Whether a previous application for a certificate of registration has been denied, revoked, suspended, or terminated for cause in any jurisdiction.

(b) Whether the applicant is under investigation for or the subject of any pending action or has been found in violation of a statute or regulation in any jurisdiction within the previous 5 years.

(c) Information, as the commissioner may require, that permits the commissioner, after reviewing all of the information submitted pursuant to this section, to make a determination that the applicant:

(1) Is financially responsible and maintains a net worth of at least $150,000 at all times;

(2) Has adequate expertise or experience to operate a discount medical plan organization; and

(3) Is competent, trustworthy, financially responsible, or of good personal and business reputation.

IV. Each certificate of registration shall expire each year on June 1. At least 60 days before a certificate of registration expires, the discount medical plan organization shall submit a renewal application to the commissioner upon a form to be furnished by the commissioner and fee paid pursuant to RSA 400-A:29, XXII(b).


Source. 2008, 206:1, eff. Jan. 1, 2009. 2022, 214:1, eff. Aug. 16, 2022.

    415-I:6 Suspension and Revocation of Registration. 

I. The commissioner may suspend or revoke the registration of a discount medical plan organization to operate in the state if the commissioner finds that any of the following conditions exist:

(a) The discount medical plan organization is not operating in compliance with this chapter.

(b) The discount medical plan organization has advertised, merchandised, or attempted to merchandise its services in such a manner as to misrepresent its services or capacity for service or has engaged in a deceptive, misleading, or unfair practice.

(c) The discount medical plan organization is not fulfilling its obligations as a discount medical plan organization.

(d) The discount medical plan organization does not have the minimum net worth as required RSA 415-I:5, III(c)(1).

(e) The continued operation of the discount medical plan organization would be hazardous to its members.

II. If the commissioner has cause to believe that grounds for the non-renewal, suspension, or revocation of the registration exists, the commissioner shall notify the discount medical plan organization in writing stating the grounds for the action and may pursue a hearing on the matter.

III. When the registration of a discount medical plan organization is suspended or revoked, the discount medical plan organization shall proceed, immediately following the effective date of the order of revocation or, in the case of a non-renewal, the date of expiration of the license, to wind up its affairs transacted. The discount medical plan organization shall not engage in any further advertising, solicitation, collecting of fees, or renewal of contracts.

IV. In lieu of or in addition to revoking a discount medical plan organization's registration under paragraph II, whenever the discount medical plan organization has been found to have violated any provision of this chapter, the commissioner may:

(a) Issue and cause to be served upon the organization charged with the violation a copy of the findings and an order requiring the organization to cease and desist from engaging in the act or practice that constitutes the violation; and

(b) Impose a civil penalty of not more than $2,500 for each violation.

V. Each registered discount medical plan organization shall notify the commissioner immediately whenever the discount medical plan organization's certificate of registration or other form of authority, to operate as a discount medical plan organization in another state is suspended, revoked, or non-renewed in that state.


Source. 2008, 206:1, eff. Jan. 1, 2009. 2022, 214:2, eff. Aug. 16, 2022.

    415-I:7 Examinations and Investigations. 

I. The commissioner may examine or investigate the business and affairs of any discount medical plan organization as necessary to protect the interests of the residents of this state.

II. An examination or investigation conducted as provided in paragraph I shall be performed in accordance with RSA 400-A:37.

III. The commissioner may:

(a) Order any discount medical plan organization or applicant that operates a discount medical plan organization to produce any records, books, files, advertising and solicitation materials or other information; and

(b) Take statements under oath to determine whether the discount medical plan organization or applicant is in violation of the law or is acting contrary to the public interest.

IV. The discount medical plan organization or applicant that is the subject of the examination or investigation shall pay the expenses reasonably incurred in conducting the examination or investigation. Failure by the discount medical plan organization or applicant to pay the expenses is grounds for denial of authority to operate as a discount medical plan organization or revocation of a registration as a discount medical plan organization.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:8 Fees;  Refund Requirements;  Bundling of Services. 

I. A discount medical plan organization may charge a periodic charge as well as a reasonable one-time processing fee for a discount medical plan.

II. If a member cancels his or her membership in the discount medical plan within the first 30 days after the date of receipt of the written document for the discount medical plan described in RSA 415-I:11, IV, the member shall receive a reimbursement of all periodic charges.

(a) Cancellation occurs when notice of cancellation is given to the discount medical plan organization.

(b) Notice of cancellation is deemed given when delivered by hand or deposited in a mailbox, properly addressed and postage prepaid to the mailing address of the discount medical plan organization or e-mailed to the e-mail address of the discount medical plan organization.

III. A discount medical plan organization shall return within 30 days any periodic charge charged or collected after the member has given the discount medical plan organization notice of cancellation.

IV. If the discount medical plan organization cancels a membership for any reason other than nonpayment of fees by the member, the discount medical plan organization shall reimburse within 30 days all periodic charges collected for membership from the date of cancellation to the member.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-I:9 Provider Agreements;  Participating Provider Listing Requirements. 

I. (a) A discount medical plan organization shall have a written provider agreement with all participating providers. The written provider agreement shall be entered into directly with the provider or indirectly with a provider network to which the provider belongs.

(b) An agreement between a discount medical plan organization and a participating provider shall include the following:

(1) A list of the medical or ancillary services and products to be provided at a discount;

(2) The amount or amounts of the discounts or, alternatively, a fee schedule that reflects the provider's discounted rates; and

(3) A statement that the provider will not charge members more than the discounted rates.

(c) An agreement between a discount medical plan organization and a provider network shall require that the provider network have written agreements with its providers that:

(1) Contain the provisions described in subparagraph (b);

(2) Authorize the provider network to contract with the discount medical plan organization on behalf of the provider; and

(3) Require the provider network to maintain an up-to-date list of its contracted providers and to provide the list on a monthly basis to the discount medical plan organization.

(d) An agreement between a discount medical plan organization and an entity that contracts with a provider network shall require that the entity, in its contract with the provider network, require the provider network to have written agreements with its providers that comply with subparagraph (c).

(e) The discount medical plan organization shall maintain a copy of each active provider agreement into which it has entered.

II. Each discount medical plan organization shall maintain on an Internet website page an up-to-date list of the names and addresses of the providers with which it has contracted directly or through a provider network. The Internet website address shall be prominently displayed on all of its advertisements, marketing materials, brochures, and discount medical plan cards.


Source. 2008, 206:1, eff. Jan. 1, 2009.

    415-J:1 New Hampshire Telemedicine Act. 

This chapter shall be known and may be cited as the New Hampshire telemedicine act.


Source. 2009, 259:1, eff. Oct. 14, 2009.

    415-J:2 Definitions. 

In this chapter:

I. "
Distant site
" means the location of the health care provider delivering services through telemedicine at the time the services are provided.

I-a. "
Health benefit policy
" means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the state of New Hampshire on behalf of state employees under RSA 21-I, by an insurer.

II. "
Insurer
" means an accident and sickness insurer, fraternal benefit society, hospital service corporation, medical service corporation, health care corporation, health maintenance organization, preferred provider organization, provider sponsored health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.

II-a. "
Originating site
" means the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including, but not limited to, a health care provider's office, a hospital, or a health care facility, or the patient's home or another nonmedical environment such as a school-based health center, a university-based health center, or the patient's workplace.

II-b. "
Remote patient monitoring
" means the use of electronic technology to remotely monitor a patient's health status through the collection and interpretation of clinical data while the patient remains at an originating site. Remote patient monitoring may or may not take place in real time. Remote patient monitoring shall include assessment, observation, education, and virtual visits provided by all covered providers including licensed home health care providers.

II-c. "
Store and forward
," as it pertains to telemedicine, means the use of asynchronous electronic communications between a patient at an originating site and a health care service provider at a distant site for the purpose of diagnostic and therapeutic assistance in the care of patients. This includes the forwarding and/or transfer of stored medical data from the originating site to the distant site through the use of any electronic device that records data in its own storage and forwards its data to the distant site via telecommunication for the purpose of diagnostic and therapeutic assistance.

III. "
Telemedicine
," as it pertains to the delivery of health care services, means the use of audio, video, or other electronic media for the purpose of diagnosis, consultation, or treatment. Telemedicine does not include the use of facsimile.


Source. 2009, 259:1, eff. Oct. 14, 2009. 2018, 267:1, 2, eff. Aug. 17, 2018. 2019, 321:3, eff. Jan. 1, 2020. 2020, 27:2, eff. Sept. 19, 2020.

    415-J:3 Coverage for Telemedicine Services. 

I. It is the intent of the general court to recognize the application of telemedicine for covered services provided within the scope of practice of a physician or other health care provider as a method of delivery of medical care by which an individual at an originating site shall receive medical services which are clinically appropriate for delivery through telemedicine from a health care provider at a distant site without in-person contact with the provider. For the purposes of this chapter, covered services include remote patient monitoring and store and forward.

II. An insurer offering a health plan in this state may not deny coverage on the sole basis that the coverage is provided through telemedicine if the health care service would be covered if it were provided through in-person consultation between the covered person and a health care provider.

III. An insurer offering a health plan in this state shall provide coverage and reimbursement for health care services provided through telemedicine on the same basis as the insurer provides coverage and reimbursement for health care services provided in person.

IV. An insurer shall provide reasonable compensation to an originating site operated by a health care provider or a licensed health care facility if the health care provider or licensed health care facility is authorized to bill the insurer directly for health care services. In the event of a dispute between a provider and an insurance carrier relative to the reasonable compensation under this section, the insurance commissioner shall have exclusive jurisdiction under RSA 420-J:8-e to determine if the compensation is commercially reasonable. The provider and the insurance carrier shall each make best efforts to resolve any dispute prior to applying to the insurance commissioner for resolution, which shall include presenting to the other party evidence supporting its contention that the compensation level it is proposing is commercially reasonable.

V. The combined amount of reimbursement that a health benefit plan allows for the compensation to the distant site and the originating site shall be the same as the total amount allowed for health care services provided in person.

VI. Nothing in this section shall be construed to prohibit an insurer from paying reasonable compensation to a provider at a distant site in addition to a fee paid to the health care provider.

VII. If an insurer excludes a health care service from its in-person reimbursable service, then comparable services shall not be reimbursable as a telemedicine service.

VIII. An insurer shall not impose on coverage for health care services provided through telemedicine any additional benefit plan limitations to include annual or lifetime dollar maximums on coverage, deductibles, copayments, coinsurance, benefit limitation or maximum benefits that are not equally imposed upon similar services provided in-person.

IX. Nothing in this section shall be construed to allow an insurer to reimburse more for a health care service provided through telemedicine than would have been reimbursed if the health care service was provided in person.

X. There shall be no restriction on eligible originating or distant sites for telehealth services. An originating site means the location of the member at the time the service is being furnished via a telecommunication system. A distant site means the location of the provider at the time the service is being furnished via a telecommunication system.

XI. An insurer shall provide reimbursement for all modes of telehealth, including video and audio, audio-only, or other electronic media provided by medical providers to treat all members for all medically necessary services.

XII. The following medical providers shall be allowed to perform health care services through the use of all modes of telehealth, including video and audio, audio-only, or other electronic media. Medical providers include, but are not limited to:

(a) Physicians and physician assistants, under RSA 329 and RSA 328-D;

(b) Advanced practice nurses, under RSA 326-B and registered nurses under RSA 326-B employed by home health care providers under RSA 151:2-b;

(c) Midwives, under RSA 326-D;

(d) Psychologists, under RSA 329-B;

(e) Allied health professionals, under RSA 328-F;

(f) Dentists, under RSA 317-A;

(g) Mental health practitioners governed by RSA 330-A;

(h) Community mental health providers employed by community mental health programs pursuant to RSA 135-C:7;

(i) Alcohol and other drug use professionals, governed by RSA 330-C;

(j) Dietitians, governed by RSA 326-H; and

(k) Professionals certified by the national behavior analyst certification board or persons performing services under the supervision of a person certified by the national behavior analyst certification board as required by RSA 417-E:2.

XIII. Nothing in this section shall be construed to prohibit an insurer from providing coverage for only those services that are medically necessary and subject to the terms and conditions of the covered person's policy.


Source. 2009, 259:1, eff. Oct. 14, 2009. 2018, 267:3, eff. Aug. 17, 2018. 2019, 321:4, eff. Jan. 1, 2020. 2020, 27:3, eff. Sept. 19, 2020.

    415:1 Filing Policies and Rates. 

No policy of insurance against loss or expense from the sickness, or from the bodily injury or death by accident of the insured shall be issued or delivered to any person in this state nor shall any application, rider or endorsement be used in connection therewith until a copy of the form thereof and of the classification of risks and the premium rates, or, in the case of cooperatives or assessment companies the estimated cost pertaining thereto have been filed with the insurance commissioner nor until the expiration of 30 days thereafter unless the commissioner shall sooner give his written approval thereof.


Source. 1913, 226:1. PL 281:1. RL 331:1. 1947, 162:1, eff. May 28, 1947.

    415:10 Acknowledgment of Notice. 

The acknowledgment by any insurer of the receipt of notice given under any policy covered by this chapter, or the furnishing of forms for filing proofs of loss, or the acceptance of such proofs, or the investigation of any claim thereunder, shall not operate as a waiver of any of the rights of the insurer in defense of any claim arising under such policy.


Source. 1913, 226:7. PL 281:16. RL 331:16.

    415:11 Alteration of Application. 

No alteration of any written application for insurance, by erasure, insertion or otherwise, shall be made by any person other than the applicant without his written consent, and the making of any such alteration without the consent of the applicant shall be a misdemeanor.


Source. 1913, 226:8. PL 281:17. RL 331:17.

    415:12 By Insurer. 

If such alteration shall be made by any officer of the insurer, or by any employee of the insurer with the insurer's knowledge or consent, such act shall be deemed to have been performed by the insurer thereafter issuing the policy upon such altered application.


Source. 1913, 226:8. PL 281:18. RL 331:18.

    415:13 Age Limit. 

If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force subject to any right of cancellation until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy.


Source. 1951, 207:2, par. 19, eff. July 1, 1951.

    415:14 Non-Application to Certain Policies. 

Except as otherwise specifically provided, nothing in this chapter shall apply to or affect (1) any policy of workers' compensation insurance or any policy of liability insurance with or without supplementary coverage therein; or (2) any policy or contract of reinsurance; or (3) any blanket or group policy of insurance; or (4) life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to accident and sickness insurance as (a) provide additional benefits in case of death or dismemberment or loss of sight by accident, or as (b) operate to safeguard such contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled, as defined by the contract or supplemental contract.


Source. 1913, 226:10. PL 281:20. RL 331:20. 1951, 207:2, par. 20. RSA 415:14. 1955, 128:1, eff. May 9, 1955.

    415:15 Discrimination. 

Discrimination between individuals of the same class in the amount of premiums or rates charged for any policy of insurance covered by this chapter, or in the benefits payable thereon, or in any of the terms or conditions of such policy, or in any other manner whatever, is prohibited. Discrimination on the basis of gender identity with respect to the availability of any covered services, medications, supplies, or durable medical equipment is specifically prohibited.


Source. 1913, 226:11. PL 281:21. RL 331:21. 2019, 332:19, eff. Jan. 1, 2020.

    415:16 Approval by Commissioner. 

No supplemental contract referred to in paragraph (4) of RSA 415:14 shall be issued or delivered to any person in this state until a copy of the form thereof has been submitted to, and approved by, the commissioner, under such reasonable rules and regulations as he shall make concerning the provisions in such contracts and their submission to and approval by him.


Source. 1913, 226:12. PL 281:24. RL 331:24. 1951, 207:3, eff. July 1, 1951.

    415:17 Fraternal Benefit Societies. 

This chapter shall not apply to or in any way affect fraternal benefit societies.


Source. 1913, 226:12. PL 281:25. RL 331:25.

    415:18-a Coverage for Mental or Nervous Conditions and Treatment for Chemical Dependency Required. 

I. (a) Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, coverage for expenses arising from the treatment of mental illnesses and emotional disorders which, in the professional judgment of:

(1) Psychiatrists;

(2) Licensed psychologists;

(3) Licensed pastoral psychotherapists;

(4) Psychiatric/mental health advanced practice registered nurses;

(5) Licensed clinical mental health counselors;

(6) Licensed alcohol and drug counselors;

(7) Licensed marriage and family therapists;

(8) Licensed clinical social workers; and

(9) Licensed, psychiatrist-supervised physician assistants 

are subject to significant improvement through short-term therapy, and benefits for expenses arising from diagnosis and evaluation of all other mental illnesses and emotional disorders.

(b) Benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders shall be at least as favorable to the certificate holder as the minimum benefits specified in paragraphs II, III, and IV.

(c) Policies written pursuant to this section shall include coverage for expenses arising from treatment for chemical dependency, including alcoholism, up to a specified limit which may be defined in terms of a dollar amount or a maximum number of days or visits. Coverage for expenses arising from treatment for chemical dependency, including alcoholism, shall include both an inpatient and an outpatient benefit for detoxification and rehabilitation.

II. In the case of policies or certificates providing benefits for hospital expenses on other than a major medical basis, benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders based upon confinement in a licensed or accredited general hospital, including psychiatric inpatient facilities included under the license of such a hospital, shall be at least as favorable as benefits provided for any other illness in such a hospital. Benefits based upon confinement in a public mental hospital shall be at least as favorable as benefits provided for confinement in a licensed or accredited general hospital.

III. In the case of policies or certificates providing benefits for medical expenses on other than a major medical basis:

(a) Benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders for services of a psychiatrist, licensed psychologist, licensed pastoral psychotherapist, psychiatric/mental health advanced practice registered nurse, licensed clinical mental health counselor, licensed alcohol and drug counselor, licensed marriage and family therapist, licensed clinical social worker who customarily bills patients directly, or of a licensed, psychiatrist-supervised physician assistant whose billing goes through their place of employment, shall be subject to terms and conditions at least as favorable as those which apply to the benefits for the services of physicians for other illnesses. The ratio of the benefits to the fees reasonably and customarily charged for the services of such:

(1) Psychiatrists;

(2) Licensed psychologists;

(3) Licensed pastoral psychotherapists;

(4) Psychiatric/mental health advanced practice registered nurses;

(5) Licensed clinical mental health counselors;

(6) Licensed alcohol and drug counselors;

(7) Licensed marriage and family therapists;

(8) Licensed clinical social workers; or

(9) Licensed, psychiatrist-supervised physician assistants 

shall be substantially the same as the ratio of the benefits for services of physicians for other illnesses to the fees reasonably and customarily charged for the services of such physicians for other illnesses.

(b) Each insurer, including health maintenance organizations pursuant to RSA 420-B, that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders for services rendered at a community mental health center or psychiatric residential program approved by the department of health and human services. Those benefits shall be subject to terms and conditions at least as favorable as those which apply to the benefits for the treatment of other illnesses. The ratio of the benefits to the full reasonable charges for the services of such a center or program shall be substantially the same as the ratio of the benefits for services of physicians for other illnesses to the fees reasonably and customarily charged for the services of such physicians for other illnesses.

(c) Benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders for outpatient services rendered at a public mental hospital shall be subject to terms and conditions at least as favorable as those which apply to the benefits for the treatment of other illnesses. The ratio of the benefits to the fees reasonably and customarily charged for the services of such a hospital shall be substantially the same as the ratio of the benefits for services of physicians for other illnesses to the fees reasonably and customarily charged for the services of such physicians for other illnesses.

(d) Benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders for outpatient services under this paragraph need not be provided for the first or second visit providing such a limitation applies in the case of services for other illnesses. Benefits for outpatient treatment may be otherwise limited to not less than 15 full hours of treatment in any consecutive 12-month period.

IV. (a) In the case of policies or certificates providing benefits for hospital and medical expenses on a major medical basis, benefits arising from treatment, diagnosis and evaluation of mental illnesses and disorders shall be subject to deductibles and coinsurance at least as favorable as those which apply to the benefits for any other illness, provided that benefits payable for expenses incurred in any consecutive 12-month period may be limited to an amount not less than $3,000 per covered individual, and to a lifetime maximum of not less than $10,000 per covered individual.

(b) In this paragraph, covered major medical expenses include the reasonable charges for services and treatment on an inpatient, outpatient or partial hospitalization basis by:

(1) A psychiatrist;

(2) A licensed psychologist;

(3) A licensed pastoral psychotherapist;

(4) A psychiatric/mental health advanced practice registered nurse;

(5) A licensed clinical mental health counselor;

(6) A licensed alcohol and drug counselor;

(7) A licensed marriage and family therapist;

(8) A licensed clinical social worker;

(9) A licensed, psychiatrist-supervised physician assistant;

(10) A licensed general hospital;

(11) A public or licensed mental hospital; or

(12) A community mental health center or psychiatric residential program approved according to rules adopted by the commissioner of the department of health and human services.

IV-a. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses shall offer to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, the option of purchasing, for a separate and identifiable premium, additional coverage for expenses incurred as a result of treatment or counseling by a licensed clinical social worker.

V. In this section:

(a) "
Psychiatrist
" means a licensed physician who is board-certified or board-eligible according to the most recently promulgated regulations of the American Board of Psychiatry and Neurology.

(b) "
Psychologist
" means a person who:

(1) Is licensed under RSA 329-B as a psychologist;

(2) Is certified or licensed under a statute in another state which meets or exceeds the standards under RSA 329-B; or

(3) Is certified or licensed in another state and is listed in the National Register of Health Service Providers in Psychology.

(c) "
Licensed pastoral psychotherapist
" means an individual who is licensed as a pastoral psychotherapist under RSA 330-A and is a fellow or diplomat in the American Association of Pastoral Counselors.

(d) "
Psychiatric/mental health advanced practice registered nurse
" means an individual who is licensed as an advanced practice registered nurse in psychiatric mental health nursing under RSA 326-B:18, who is defined by and whose scope of practice is described under the rules adopted pursuant to RSA 326-B, and who is a licensed registered nurse, educationally prepared in nursing at a minimum of the master's level, and certified in the specialty by a recognized national certifying agency, such as the American Nurses Credentialing Center.

(e) "
Licensed clinical social worker
" means an individual who is licensed as a clinical social worker under RSA 330-A:18.

(f) "
Licensed clinical mental health counselor
" means an individual who is licensed as a clinical mental health counselor under RSA 330-A:19.

(g) "
Licensed marriage and family therapist
" means an individual who is licensed as a marriage and family therapist under RSA 330-A:21.

(h) "
Licensed alcohol and drug counselor
" means an individual who is licensed as an alcohol and drug counselor under RSA 330-C and is practicing solely within the scope of practice of a licensed alcohol and drug counselor.

(i) "
Mental or nervous conditions
" or "
mental illness and emotional disorders
" means mental disorders, as defined in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" (DSM), excluding those disorders designated by a "V Code" and those disorders designated as criteria sets and axes provided for further study in the DSM. This term shall not include chemical dependency, including alcoholism.

(j) "
Licensed, psychiatrist supervised physician assistant
" means an individual who is licensed as a physician assistant under RSA 328-D whose supervising physician is a licensed psychiatrist.

VI. No services provided by a licensed pastoral psychotherapist to a member of his congregation in the course of the duties to which he has been called as a pastor, minister or staff person shall be covered under the provisions of this chapter. This limitation shall not apply to those licensed pastoral psychotherapists serving specifically and only as private, part-time consultants in pastoral psychotherapy to a parish under contract or otherwise for the purpose of providing services to individuals as a licensed pastoral psychotherapist. Nothing in this chapter shall be construed as allowing a parish, church or temple to provide religious ministrations to their parishioners or members under the provisions of this chapter which would normally be the responsibility of the clergy, religious or other religious staff duly called and employed by such congregations.

VII. No group policy or certificate subject to RSA 415:18-a issued, renewed or continued on or after January 1, 1993, shall contain any provision denying insurance benefits for psychiatric or psychological services, including psychological examinations, solely because they are rendered to an insured or a dependent in compliance with the lawful order of any court of this state. Benefits for such services shall be as favorable as for other psychiatric or psychological services, including psychological examinations, and shall be subject to the same dollar limits, deductibles, co-payments, and co-insurance factors and to terms and conditions of the policy or certificate, including any managed care provisions.

VIII. The commissioner may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Mental Health Parity Act of 2008 that relate to the business of insurance.


Source. 1975, 349:1. 1976, 57:1. 1979, 293:1-5. 1981, 492:30; 569:18, 21. 1983, 291:1, I; 413:1, 2; 453:11. 1986, 105:1. 1991, 343:1. 1992, 177:2. 1994, 396:1-4, 11-14. 1995, 310:181, 182. 1998, 234:8-14. 1999, 272:5-8; 310:1-4. 2002, 204:1. 2003, 276:4. 2005, 293:13. 2009, 54:5; 235:6. 2010, 188:13. 2012, 233:7, eff. July 1, 2013. 2019, 278:9, eff. Sept. 17, 2019.

    415:18-aa Coverage for Blood Lead Testing. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the costs of blood lead testing conducted pursuant to RSA 130-A:5-a. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2018, 4:12, eff. Feb. 8, 2018.

    415:18-b Cancellation or Nonrenewal of Group Insurance Contracts. 

No group accident or health insurance contract, authorized under this chapter, may be cancelled or nonrenewed by the insurer, except for nonpayment of premium, unless the group policyholder receives either a notice of cancellation or nonrenewal or an offer of renewal in accordance with this section. The notice of cancellation or nonrenewal or offer of renewal shall be delivered to the group policyholder or mailed to the group policyholder's last address as shown in the records of the insurer at least 45 days prior to the renewal date of the contract. Notice of cancellation for lack of participation, if permitted by the terms of the policy, shall be delivered to the group policyholder or mailed to the group policyholder's last address as shown in the records of the insurer, at least 30 days prior to the effective date of the cancellation.


Source. 1990, 194:2. 1991, 23:1, eff. Jan. 1, 1992.

    415:18-bb Coverage for Medically Necessary Dental Services. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for medically necessary dental services resulting from an accidental injury to sound natural teeth and gums when the course of treatment for the accidental injury is received or authorized within 3 months of the date of the injury. Treatment made necessary due to injury to the jaw and oral structures other than teeth shall be covered without time limit. Coverage under this section shall be subject to such other terms and conditions of the policy that may apply.


Source. 2019, 113:2, eff. Aug. 20, 2019.

    415:18-c Repealed by 2010, 61:3, I, eff. May 18, 2010. 

    415:18-cc Coverage for Perfluoroalkyls (PFAS) and Perfluorinated Compounds (PFCS) Blood Testing. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for coverage for perfluoroalkyls (PFAS) and perfluorinated compounds (PFCS) blood testing. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2020, 30:10, eff. Sept. 21, 2020.

    415:18-d Coverage for Scalp Hair Prostheses. 

I. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses and which also provides coverage for other prostheses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of alopecia areata, alopecia totalis, alopecia medicamentosa resulting from the treatment from any form of cancer or leukemia, or permanent loss of scalp hair due to injury. Such coverage, however, shall be subject to a written recommendation by the treating physician stating that the hair prosthesis is a medical necessity. Such coverage shall be subject to the same limitations and guidelines as other prostheses, provided, that such coverage for alopecia medicamentosa shall not exceed $350 per year.

II. For the purposes of this section:

(a) "Prostheses" means artificial appliances used to replace lost natural structures. Prostheses include, but are not limited to, artificial arms, legs, breasts or glass eyes.

(b) "Scalp hair prostheses" means artificial substitutes for scalp hair that are made specifically for a specific individual.


Source. 1992, 246:1. 2001, 276:3. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-dd Coverage for Epinephrine Auto-Injectors. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the cost of epinephrine auto-injectors. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer and shall be subject to the terms and conditions of the policy. In this section, "
epinephrine auto-injector
" means a single-use device used for the automatic injection of a pre-measured dosage of epinephrine into the human body.


Source. 2020, 13:10, eff. Jan. 1, 2021.

    415:18-e Coverage for Nonprescription Enteral Formulas. 

I. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.

II. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.

III. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the service provided.


Source. 1995, 235:1. 1996, 131:2. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-ee Coverage for Long-Term Antibiotic Therapy Tick-Borne Illness. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for long-term antibiotic therapy for tick-borne illness when determined to be medically necessary and ordered by a licensed infectious disease physician after making a thorough evaluation of the patient's symptoms, diagnostic test results or response to treatment. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer. In this section, "
long-term antibiotic therapy
" means the administration of oral, intramuscular, or intravenous antibiotics singly or in combination, for periods of time in excess of 4 weeks.


Source. 2020, 39:21, eff. June 30, 2021.

    415:18-f Coverage for Diabetes Services and Supplies. 

Each insurer that issues or renews any policy, plan, or contract of group accident or health insurance providing benefits for medical or hospital expenses, shall provide each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each insurer that issues or renews any group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy. Each insurer that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. Each insurer that issues or renews any group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides for durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy.


Source. 1997, 258:2. 2010, 188:13, eff. Aug. 20, 2010. 2020, 13:2, eff. Sept. 14, 2020.

    415:18-g Coverage for Dental Procedures;  Medical or Hospital;  Group. 

I. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of New Hampshire, coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:

(a) Is a child under the age of 13 who is determined by a licensed dentist in conjunction with a licensed physician to have a dental condition of significant dental complexity which requires certain dental procedures to be performed in a surgical day care facility or hospital setting; or

(b) Is a person who has exceptional medical circumstances or a developmental disability as determined by a licensed physician which place the person at serious risk.

II. All of the terms and conditions of the covered person's policy shall apply to these services.


Source. 1998, 280:2. 2003, 278:1. 2010, 188:13, eff. Aug. 20, 2010. 2018, 188:5, eff. Aug. 7, 2018.

    415:18-h Coverage for Dental Procedures;  Dental Offices. 

I. Each dental insurer or other similar entity, including Delta under RSA 420-F, that issues or renews any policy of group insurance providing benefits for oral surgical procedures, shall provide to each certificate holder who is a resident of New Hampshire coverage for the administration of general anesthesia administered by a licensed dentist for dental procedures performed in a dentist's office on a covered person who:

(a) Is a child under the age of 13 who is determined by a licensed dentist in conjunction with a licensed physician to have a dental condition of significant complexity which requires the child to receive general anesthesia for the treatment of such condition; or

(b) Is a person who has exceptional medical circumstances or a developmental disability as determined by a licensed physician which place the person at serious risk.

II. All of the terms and conditions of the covered person's policy shall apply to these services.


Source. 1998, 280:2. 2003, 278:2, eff. Jan. 1, 2004. 2018, 188:6, eff. Aug. 7, 2018.

    415:18-i Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. 

Each insurer that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "
Outpatient contraceptive services
" means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which have been approved by the U.S. Food and Drug Administration. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration. Coverage shall include contraceptives dispensed in a quantity intended to last for a 12-month period, if prescribed in that quantity. An insurer shall not impose utilization review requirements or other limitations to control the prescribing or dispensing of contraceptives to an amount that is less than a 12-month supply, if that quantity is prescribed. An insurer shall not be required to cover more than one 12-month contraceptive prescription in a single dispensing per plan year. A deductible, copayment, coinsurance, or other cost-sharing requirement shall not be imposed on the coverage of prescription contraceptive drugs and contraceptive devices approved by the FDA under this section. Notwithstanding any other provision of law, if there is a therapeutic equivalent of a drug or device for an FDA-approved contraceptive method, an insurer may impose cost-sharing requirements as long as at least one drug or device for that method is available without cost-sharing; provided that if an individual's provider recommends a particular FDA-approved contraceptive drug or device based on a medical determination, the insurer shall provide coverage for the prescribed contraceptive drug or device without cost-sharing. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 1999, 252:1. 2010, 188:13, eff. Aug. 20, 2010. 2018, 205:4, eff. Jan. 1, 2019; 361:9, eff. Jan. 1, 2019 at 12:01 a.m.

    415:18-j Off-Label Prescription Drugs. 

I. No insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses and providing coverage for prescription drugs shall:

(a) Exclude coverage for any such drug for a particular indication on the ground that the drug has not been approved by the Food and Drug Administration (FDA) for that indication, if such drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature; or

(b) As a condition of coverage, impose use of an alternative drug not approved by the FDA for the indication being treated, unless such alternative drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature. An override of such condition of coverage shall be expeditiously granted consistent with RSA 420-J:7-b, II whenever the prescriber can demonstrate that the alternative drug:

(1) Has been ineffective in the treatment of the insured's medical condition in the past;

(2) Is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) Will cause or will likely cause an adverse reaction or other physical harm to the insured; or

(4) Is not in the insured's best interest, based on medical necessity consistent with RSA 420-J:7-b, II.

II. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug.

III. Nothing in this section requires:

(a) Coverage for any drug if the FDA has determined its use to be contraindicated for the treatment of the particular indication for which the drug has been prescribed;

(b) Coverage for experimental or investigational drugs not approved for any indication by the FDA; and

(c) Reimbursement or coverage for any drug not included on the drug formulary or list of covered drugs specified in a health plan, contract, or policy.


Source. 1999, 323:6. 2010, 188:13. 2014, 226:2, eff. Sept. 12, 2014.

    415:18-k Prompt Payment Required. 

I. (a) Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered by New Hampshire health care providers within 30 calendar days upon receipt of a clean non-electronic claim or 15 calendar days upon receipt of a clean electronic claim.

(b) When the insurer is denying or pending the claim, the insurer shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or certificate holder of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the insurer's receipt of the requested additional information, the insurer shall adjudicate the claim within 45 calendar days. If the required notice is not provided, the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a).

(c) Payment of a claim shall be considered to be made on the date a check was issued or electronically transferred. The insurer shall mail checks no later than 5 business days after the date a check was issued. Failure to mail a check within 5 business days shall constitute a violation subject to enforcement under RSA 415:20.

(d) The insurer's failure to comply with the time limits in this section shall not have the effect of requiring coverage for an otherwise non-covered claim. This section shall only apply to payments made on a claims basis and shall not apply to capitation or other forms of periodic payment.

II. In this section:

(a) "
Clean claim
" means a claim for payment of covered health care expenses that is submitted to an insurer on the insurer's standard claim form using the most current published procedural codes, with all the required fields completed with correct and complete information in accordance with the insurer's published filing requirements.

(b) "
Electronic claim
" means the transmission of data for purposes of payment of covered health care services in an electronic data format specified by the insurer and, if covered by the Health Insurance Portability and Accountability Act (HIPAA),
 is in such form and substance as to be in compliance with such act.

III. Any initial clean claim submission not paid within the time periods specified in subparagraph I(a) shall be deemed overdue. In that case:

(a) The insurer shall pay the health care provider or the insured person the amount of the overdue claim plus an interest payment of 1.5 percent per month beginning from the date the payment was due; and

(b) The health care provider may recover from the insurer, upon a judicial finding of bad faith, reasonable attorney's fees for advising and representing a health care provider in a successful action against an insurer for payment of the claim.

IV. Exceptions to the requirements of this section are as follows:

(a) No insurer shall be in violation of this section for a claim submitted by a health care provider if:

(1) Failure to comply is caused by a directive from a court or a federal or state agency;

(2) The insurer is in liquidation or rehabilitation or is operating in compliance with a court-ordered plan of rehabilitation; or

(3) The insurer's compliance is rendered impossible due to matters beyond the insurer's control which are not caused by such insurer.

(b) No insurer shall be in violation of this section for any claim submitted more than 90 days after the service was rendered.

(c) No insurer shall be in violation of this section while the claim is pending due to a fraud investigation that has been reported to a state or federal agency, or an internal or external review process.

V. The commissioner may assess an administrative fine against any insurer or may suspend or revoke the license or certificate of authority of any insurer after determining that the insurer has established a pattern of overdue payments and that the contemplated enforcement action would not promote the deterioration of the financial condition of an at-risk insurer. Such fine shall not exceed $300,000 per calendar year examined. Nothing in this paragraph shall be construed to alter the commissioner's authority to investigate or take action, including, but not limited to, action pursuant to RSA 415:20, in response to individual instances of noncompliance.


Source. 2000, 274:3; 314:3. 2005, 162:2. 2009, 235:7. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-l Coverage Required for Qualified Clinical Trials. 

I. In this section:

(a) "
Clinical trials of emerging technologies
" mean Phase I and Phase II clinical trials.

(b) "
Clinical trials of leading therapeutic or diagnostic alternatives
" mean Phase III and Phase IV clinical trials.

(c) "
Cooperative group
" means a formal network of facilities that collaborate on research projects and have an established National Institute of Health (NIH) approved peer review program operating within the group.

(d) "
FDA
" means the federal Food and Drug Administration.

(e) "
Member
" means the policyholder, subscriber, insured, or certificate holder, or a covered dependent of a policyholder, subscriber, insured, or certificate holder.

(f) "
Multiple project assurance contract
" means a contract between an institution and the federal Department of Health and Human Services, that defines the relationship of the institution to the federal Department of Health and Human Services and sets out the responsibilities of the institution and the procedures that will be used by the institution to protect human subjects.

(g) "
NIH
" means the National Institutes of Health.

(h) "
Non-routine patient care cost
" means:

(1) The cost of an investigational new drug or device that is not approved for market for any indication by the FDA.

(2) The cost of a non-health care service that a member may be required to receive as a result of the treatment being provided for the purposes of the clinical trial.

(3) The costs of services that are clearly inconsistent with widely accepted and established regional or national standards of care for a particular diagnosis.

(4) Costs associated with managing the research associated with the clinical trial.

(5) Non-covered costs under the member's policy, plan, or contract.

(i) "
Routine patient care cost
" means the cost of any medically necessary health care service that is incurred as a result of the treatment being provided to a member of a health plan. Routine costs are those for which the health plan regularly reimburses its members, health care providers, or health care institutions subject to the terms and conditions of the member's policy and the provider's service agreement with the insurer.

II. A policy, plan, or contract subject to this section shall provide coverage for all medically necessary routine patient care costs incurred as a result of a treatment being provided in accordance with a clinical trial to the extent such costs would be covered for noninvestigational treatments if the treatment is being provided or the studies are being conducted in a phase I, phase II, phase III, or phase IV clinical trial for cancer or the treatment is being provided for any other life-threatening condition. Coverage for phase I or phase II clinical trials shall be decided on a case by case basis.

III. The coverage required under paragraph II shall be required if:

(a) The treatment is being provided to the member in a clinical trial approved by:

(1) One of the National Institutes of Health;

(2) An NIH cooperative group or an NIH center;

(3) The FDA in the form of an investigational new drug application or exemption;

(4) The federal department of Veterans Affairs or Defense; or

(5) An institutional review board of an institution in this state that has a multiple assurance contract approved by the Office of Protection from Research Risks of the NIH.

(b) Standard treatment has been or would be ineffective, does not exist, or there is no superior non-investigational treatment alternative;

(c) The facility and personnel providing the treatment are capable of doing so by virtue of their experience, training, and volume of patients treated to maintain expertise; and

(d) The available clinical or preclinical data provide a reasonable expectation that the treatment will be at least as effective as the non-investigational alternative.

IV. A policy, plan, or contract subject to this section shall provide coverage for routine patient care costs incurred for drugs and devices provided to the member during the clinical trial, which are not the subject of the clinical trial, provided that those drugs or devices have been approved for sale by the FDA, whether or not the FDA has approved the drug or device for use in treating the member's particular condition. Nothing in this section shall be construed to abrogate the provisions of RSA 415:6-g or RSA 420-J:7-b. This coverage shall include coverage for reasonable and medically necessary services necessary to administer the drug or use the device under evaluation in the clinical trial.

V. The provisions of this section shall apply to group hospital and medical expense policies subject to RSA 415, health service corporations under RSA 420-A, health maintenance organizations under RSA 420-B, and managed care organizations under RSA 420-J.

VI. For the purposes of this section, providers participating in clinical trials shall obtain a patient's informed consent for participation in the clinical trial in a manner that is consistent with current legal and ethical standards. Such document shall be available to the health insurer upon request.

VII. Health plans providing coverage under this section and the providers participating in those same clinical trials shall develop a mutually agreed upon process to share appropriate aggregate clinical and financial data on the progress and outcome of clinical trials subject to this section. Health plans and the providers participating in clinical trials shall establish reasonable requirements for communication with the member's primary care provider regarding the member's clinical data.

VIII. The provisions of this section shall not apply to a policy, plan, or contract paid for under the federal Medicare program nor the state children's health insurance program.


Source. 2000, 264:1, eff. Jan. 1, 2001.

    415:18-m Retroactive Denials Prohibited;  Exceptions. 

I. In this section, "
retroactive denial of a previously paid claim
" means any attempt by an insurer to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments currently owed to the provider, withholding or setting off against future payments, reducing or affecting the future claim payments to the provider in any other manner.

II. No insurer shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:

(a) The insurer has provided the reason for the retroactive denial in writing to the health care provider; and

(b) The time which has elapsed since the date of payment of the challenged claim does not exceed 18 months. The retroactive denial of a previously paid claim may be permitted beyond 18 months from the date of payment only for the following reasons:

(1) The claim was submitted fraudulently;

(2) The claim payment was incorrect because the health care provider or the insured was already paid for the health care services identified in the claim;

(3) The health care services identified in the claim were not delivered by the health care provider;

(4) The claim payment was for services covered by Title XVIII,
 Title XIX,
 or Title XXI
 of the Social Security Act;

(5) The claim payment is the subject of an adjustment with a different insurer, administrator, or payor and such adjustment is not affected by a contractual relationship, association, or affiliation involving claims payment, processing, or pricing; or

(6) The claim payment is the subject of legal action.

III. An insurer shall notify a health care provider at least 15 days in advance of the imposition of any retroactive denials of previously paid claims. The health care provider shall have 6 months from the date of notification under this paragraph to determine whether the insured has other appropriate insurance, which was in effect on the date of service. Notwithstanding the contractual terms between the insurer and provider, the insurer shall allow for the submission of a claim that was previously denied by another insurer due to the insured's transfer or termination of coverage.


Source. 2002, 143:2. 2006, 104:2, eff. Aug. 7, 2006.

    415:18-n Coverage for Certain Prosthetic Devices. 

I. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, except for supplemental policies covering a specified disease or other limited benefit, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, coverage for benefits for prosthetic devices under the same terms and conditions that apply to other durable medical equipment covered under the policy, except as otherwise provided in this section.

II. In this section, "
prosthetic device
" means an artificial limb device to replace, in whole or in part, an arm or leg.

III. An insurer shall not impose any annual or lifetime dollar maximum on coverage for prosthetic devices other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.

IV. An insurer shall not apply amounts paid for prosthetic devices to any annual or lifetime dollar maximum applicable to other durable medical equipment covered under the policy other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.

V. The provisions of this section shall apply to group health service plan contracts issued pursuant to RSA 420-A, and to health maintenance organization policies and plans issued pursuant to RSA 420-B.


Source. 2003, 216:1. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-o Group or Blanket Plan Prescription Drug Information Cards. 

I. Each insurer that issues or renews any policy of group accident or health insurance which provides coverage for prescription drugs or devices, or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to certificate holders a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued, shall include the information required under RSA 400-A:15-c, and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

(b) The certificate holder's name and identification number.

(c) All of the electronic transaction routing information required by the insurer or its benefit administrator in order for the pharmacy to electronically process a prescription claim, including but not limited to the BIN number labeled as such or the Processor Control Number labeled as such, or both.

II. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph I.

III. A new uniform prescription drug information card, as required under this section, shall be issued by an insurer upon enrollment of new members and when reissuing a new card to current members when there is a change in the certificate holder's pharmacy coverage that affects data contained on the card.


Source. 2003, 286:3. 2010, 188:13, eff. Aug. 20, 2010. 2016, 111:3, eff. Jan. 1, 2017.

    415:18-p Third-Party Payment of Covered, Court-Ordered Services. 

The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such services shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to the terms and conditions of the policy or certificate, including any managed care provisions. However, the claimant or claimant's representative shall have 48 hours from the commencement of a court-ordered service, placement, or program to seek any pre-authorization, pre-certification, or referral required under the terms of the policy. The determination of these preservice claims for court-ordered services for a minor shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 48 hours after receipt of the request and sufficient information, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the insurer shall notify the claimant or claimant's representative within 24 hours of receipt of the request and shall advise the claimant or claimant's representative of the specific information necessary to determine to what extent benefits are covered or payable. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the claim determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of:

I. The insurer's receipt of the specified additional information; or

II. The end of the period afforded the claimant or claimant's representative to provide the specified additional information.


Source. 2004, 117:1, eff. Aug. 15, 2004.

    415:18-q Coverage for Certified Midwives. 

Each insurer that issues or renews any policy of group accident or health insurance providing maternity benefits shall also provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage consistent with the terms and conditions of the policy for services rendered by a midwife certified under RSA 326-D. Such coverage shall be subject to each insurer's standards and mechanisms for credentialing and contracting pursuant to RSA 420-J:4 and RSA 420-J:8 respectively, where applicable, and contingent upon services being provided in a licensed health care facility or at home and within the scope of practice of a certified midwife. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2006, 8:2. 2008, 298:2. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-r Coverage for the Cost of Testing for Bone Marrow Donation. 

I. Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and who meet the criteria for testing as established by the Match Registry (the National Marrow Donor Program), coverage for laboratory fee expenses up to $150 arising from human leukocyte antigen testing, also referred to as histocompatibility locus antigen testing, for utilization in bone marrow transplantation. The testing shall be performed in a facility that is accredited by the American Association of Blood Banks or its successors, or the College of American Pathologists, or its successors, or any other national accrediting body with requirements that are substantially equivalent to or more stringent than those of the College of American Pathologists, and is licensed under the Clinical Laboratory Improvement Act of 1967, 42 U.S.C. section 263a, as amended. At the time of the new testing, the person tested shall complete and sign an informed consent form that also authorizes the results of the test to be used for participation in the National Marrow Donor Program and shall acknowledge a willingness to be a bone marrow donor if a suitable match is found.

II. In addition to paragraph I, the testing facility shall not bill, charge, collect a deposit from, seek payment or reimbursement from, or have recourse against a covered person or a person acting on behalf of the covered person for any portion of the laboratory fee expenses.


Source. 2006, 187:2. 2010, 188:13. 2011, 133:6, eff. Jan. 1, 2012.

    415:18-s Coverage for Children's Early Intervention Services. 

Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for expenses arising from the services of licensed and credentialed occupational therapists, physical therapists, speech-language pathologists, and clinical social workers working with children from birth to 36 months of age with an identified developmental disability and/or delay as specified in rules adopted pursuant to RSA 171-A:18, IV as long as the providing therapist receives a referral from the child's primary care provider if applicable. The benefits in this section shall not be subject to deductibles, copayments, or coinsurance; provided that the benefits included in this section may have a cap of $3,200 per child per year not to exceed $9,600 by the child's third birthday. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2) or a catastrophic health plan, as defined under the Patient Protection and Affordable Care Act of 2009, a carrier shall be exempt from the deductible provisions of this section and may apply a deductible to children's early intervention therapy services until an enrollee's deductible has been satisfied for the year. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 2007, 338:2. 2010, 188:13, eff. Aug. 20, 2010. 2020, 26:40, eff. Sept. 18, 2020. 2021, 56:9, eff. July 24, 2021.

    415:18-t Coverage for Obesity and Morbid Obesity;  Group. 

Each insurer that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the diseases and ailments caused by obesity and morbid obesity and treatment for such, including bariatric surgery, when the prescribing physician has issued a written order stating that treatment is medically necessary and in accordance with the patient qualifications and treatment standards set forth by the American Society for Metabolic and Bariatric Surgery or the American College of Surgeons. Such treatment standards may include, but not be limited to, pre-operative psychological screening and counseling, behavior modification, weight loss, exercise regimens, nutritional counseling, and post-operative follow-up, overview, and counseling of dietary, exercise, and lifestyle changes. The covered insured shall be at least 18 years of age. The benefits included in this section shall be subject to the terms and conditions of the policy and shall be no less extensive than coverage provided for similar conditions or illnesses.


Source. 2008, 389:2. 2010, 188:13, eff. Aug. 20, 2010.

    415:18-u Coverage for Hearing Aids. 

Each insurer that issues or renews any policy or certificate for delivery in this state of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide coverage for the professional services associated with the practice of fitting, dispensing, servicing, or sale of hearing instruments or hearing aids by a hearing instrument dispenser or other hearing care professional. The benefits included in this section shall not be subject to any greater deductible or coinsurance or copay than any other benefits provided by the insurer. Insurers are required to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid with a maximum for the hearing aid and related services of no less than $1,500 per hearing aid every 60 months. The insured may choose a higher price hearing aid and pay the difference in cost. The hearing aid shall be prescribed and dispensed by a licensed audiologist or hearing instrument specialist. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall not apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:

I. "
Hearing care professional
" means a person who is a licensed audiologist, a licensed hearing instrument dispenser, or a licensed physician.

II. "
Hearing instrument
" or "
hearing aid
" means any instrument or device designed, intended, or offered for the purpose of improving a person's hearing and any parts, attachments, or accessories, including earmolds. Batteries, cords, and individual or group auditory training devices and any instrument or device used by a public utility in providing telephone or other communication services are excluded.

III. "
Hearing instrument dispenser
" means a person who is a hearing care professional that engages in the selling, practice of fitting, selecting, recommending, dispensing, or servicing of hearing instruments or the testing for means of hearing instrument selection or who advertises or displays a sign or represents himself or herself as a person who practices the testing, fitting, selecting, servicing, dispensing, or selling of hearing instruments.

IV. "
Practice of fitting, dispensing, servicing, or sale of hearing instruments
" means the measurement of human hearing with an audiometer, calibrated to the current American National Standard Institute standards, for the purpose of making selections, recommendations, adoptions, services, or sales of hearing instruments including the making of earmolds as a part of the hearing instrument.


Source. 2010, 362:2, eff. Jan. 1, 2011.

    415:18-v Reimbursement for Ambulance Service Providers. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance that constitutes health coverage under RSA 420-G:2, IX, and that provides benefits for medically necessary ambulance services shall reimburse the ambulance service provider directly or by a check payable to the insured and the ambulance service provider subject to the terms and conditions of the policy, plan, or contract. Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a non-participating ambulance provider that establishes rates of reimbursement for emergency medical services.


Source. 2011, 133:2, eff. Jan. 1, 2012.

    415:18-w Naturopathy Providers;  Payment for Equivalent Types of Services;  Group. 

Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses may provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for expenses arising from a health service performed by a doctor of naturopathic medicine licensed under RSA 328-E if that particular type of service is within the scope of practice of such doctor and if the insurer would reimburse for that type of service when performed by any other type of health care provider. Such coverage, if provided, shall be subject to each insurer's standards and mechanisms for determining medical necessity, for credentialing pursuant to RSA 420-J:4, and for contracting pursuant to RSA 420-J:8. Any such benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2012, 278:2, eff. Jan. 1, 2013.

    415:18-x Repealed by 2014, 299:8, II, eff. Oct. 1, 2017. 

    415:18-y Oral Anti-Cancer Therapies. 

I. No insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for anti-cancer medications that are injected or intravenously administered by a health care provider and patient administered anti-cancer medications, including but not limited to those orally administered or self-injected, shall require a higher copayment, deductible, or coinsurance amount for patient administered anti-cancer medication than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.

II. An insurer shall not comply with paragraph I by:

(a) Increasing the copayment, deductible, or coinsurance amount required for injected or intravenously administered anti-cancer medication that are covered under the policy or plan.

(b) Reclassifying benefits with respect to anti-cancer medications.

III. In this section, "
anti-cancer medication
" means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.

IV. If the cost-sharing requirements for orally administered anti-cancer medications do not exceed $200 per prescription fill, the health plan shall be deemed in compliance with this section.

V. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2), a carrier shall be exempt from the provisions of paragraphs I-IV until an enrollee's deductible has been satisfied for the year.

VI. This section shall apply only to oral anti-cancer medications where an intravenously administered or injected anti-cancer medication is not medically appropriate.

VII. This section shall not apply to policies which are solely to replace income or pay a predetermined fixed amount based on the occurrence of a specified medical or health event.


Source. 2015, 263:7, eff. Jan. 1, 2017.

    415:18-z Coverage for Early Refills of Prescription Eye Drops. 

I. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for one early refill of a prescription for eye drops if the following criteria are met:

(a) For prescription eye drops dispensed as a 30-day supply, the enrollee requests the refill no earlier than 21 days after the later of the following dates:

(1) The date the original prescription was dispensed to the enrollee; or

(2) The date that the most recent refill of the prescription was dispensed to the enrollee;

(b) For prescription eye drops dispensed as a 90-day supply, the enrollee requests the refill no earlier than 63 days after the later of the following dates:

(1) The date the original prescription was dispensed to the enrollee; or

(2) The date that the most recent refill of the prescription was dispensed to the enrollee;

(c) The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;

(d) The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;

(e) The prescription has not been refilled more than once during the 30-day or 90-day period prior to the request for an early refill; and

(f) The prescription eye drops are a covered benefit under the enrollee's health plan.

II. Benefits provided under this section shall not be subject to any greater copayment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2016, 326:2, eff. Aug. 23, 2016.

    415:18 General Group or Blanket Policy Provisions. 

I. Policies, certificates and other forms attached to group or blanket accident or health insurance, or accident and health insurance, shall comply with all applicable laws, including RSA 420-G, and with rules adopted by the commissioner. No such policy or certificate shall be delivered or issued for delivery in this state to a resident of this state without the prior written approval of the commissioner. The commissioner shall adopt rules, pursuant to RSA 541-A, establishing conditions by which insurers may deem such policies or certificate forms approved upon the expiration of a 30-day period following the commissioner's receipt of the insurer's submission of the policy and certificate forms for approval. No policy of group or blanket accident or health insurance, or accident and health insurance affecting a resident of New Hampshire, whether such policy is delivered or issued for delivery in this state or any other state, and no certificate thereunder shall, except as provided in paragraph III of this section, be delivered or issued for delivery in this state unless the policy or certificate contains in substance each and all of the provisions set forth in the following subparagraphs or provisions which in the opinion of the commissioner are more favorable to the holders of such certificates or not less favorable to the holders of such certificates and more favorable to policyholders:

(a) A provision that no statement made by the applicant for insurance shall avoid the insurance or reduce benefits thereunder unless contained in the written application signed by the applicant; and a provision that no agent has authority to change the policy or to waive any of its provisions; and that no change in the policy shall be valid unless approved by an officer of the insurer and evidenced by endorsement on the policy, or by amendment to the policy signed by the policyholder and the insurer.

(b) A provision that all statements contained in any such application for insurance shall be deemed representations and not warranties.

(c) A provision that all new employees or new members, as the case may be, in the groups or classes eligible for such insurance must be added to such groups or classes for which they are respectively eligible.

(d) A provision that all premiums due under the policy shall be remitted by the employer or employers of the persons insured or by some other designated person acting on behalf of the association or group insured, to the insurer on or before the due date thereof, with such grace period as may be specified therein.

(e) A provision stating the conditions under which the insurer may decline to renew the policy.

(f) A provision that the insurer shall issue to the employer or other person or association in whose name such policy is issued, for delivery to each member of the insured group, an individual certificate setting forth in summary form a statement of the essential features of the insurance coverage of such employee or such member, to whom the benefits thereunder are payable, and in substance the provisions of subparagraphs (g) to (s) inclusive.

(g) A provision specifying the ages, if any there be, to which the insurance provided therein shall be limited; and the ages, if any there be, for which additional restrictions are placed on benefits, and the additional restrictions placed on the benefits at such ages.

(h) A provision that written notice of sickness or of injury must be given to the insurer within 20 days after the date when such sickness or injury occurred. Failure to give notice within such time shall not invalidate nor reduce any claim if it shall be shown not to have been reasonably possible to give such notice and that notice was given as soon as was reasonably possible.

(i) A provision that in the case of claim for loss of time for disability, written proof of such loss must be furnished to the insurer within 30 days after the commencement of the period for which the insurer is liable, and that subsequent written proofs of the continuance of such disability must be furnished to the insurer at such intervals as the insurer may reasonably require, and that in the case of claim for any other loss, written proof of such loss must be furnished to the insurer within one year after the date of such loss in the case of a group Medicare supplement insurance policy or certificate and within 90 days after the date of such loss in the case of any other group accident and health insurance policy or certificate. Failure to furnish such proof within such time shall not invalidate nor reduce any claim if it shall be shown not to have been reasonably possible to furnish such proof and that such proof was furnished as soon as was reasonably possible.

(j) A provision that the insurer will furnish to the policyholder such forms as are usually furnished by it for filing proof of loss. If such forms are not furnished before the expiration of 15 days after the insurer receives notice of any claim under the policy, the person making such claim shall be deemed to have complied with the requirements of the policy as to proof of loss upon submitting within the time fixed in the policy for filing proof of loss, written proof covering the occurrence, character and extent of the loss for which claim is made.

(k) A provision that the insurer shall have the right and opportunity to examine the person of the insured when and so often as it may reasonably require during the pendency of claim under the policy and also the right and opportunity to make an autopsy in case of death where it is not prohibited by law.

(l) A provision that all benefits payable under the policy other than benefits for loss of time will be payable not more than 60 days after receipt of proof, and that, subject to due proof of loss all accrued benefits payable under the policy for loss of time will be paid not later than at the expiration of each period of 30 days during the continuance of the period for which the insurer is liable, and that any balance remaining unpaid at the termination of such period will be paid immediately upon receipt of such proof.

(m) A provision that indemnity for loss of life of the insured is payable to the beneficiary if surviving the insured, and otherwise to the estate of the insured; and that all other indemnities of the policy are payable to the insured, except as provided in paragraph IV of this section; and that if a beneficiary is designated, the consent of the beneficiary shall not be requisite to change of beneficiary, or to any other changes in the policy or certificate, except as may be specifically provided by the policy.

(n) A provision that no action at law or in equity shall be brought to recover on the policy prior to the expiration of 60 days after proof of loss has been filed in accordance with the requirements of the policy and that no such action shall be brought at all unless brought within 3 years from the expiration of the time within which proof of loss is required by the policy.

(o) A provision that if loss of time benefits payable to the holder of the certificate are reduced by reason of benefits payable to the holder of the certificate under the federal Social Security Act
, such benefits shall not be further reduced by reason of any increase in benefits payable under the federal Social Security Act which takes effect after the first month that benefits are payable for a period of disability; except that if benefits under the policy are provided on a specified dollar amount basis, then such benefits shall not be further reduced by reason of any increase in benefits payable under the federal Social Security Act which takes effect after the effective date of the policy.

(p) A provision that the policyholder is entitled to a grace period of 31 days for the payment of any premium due except the first, during which grace period the coverage shall continue in force, unless the policyholder has given the insurer written notice of discontinuance in advance of the period for which payment is due, and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a portion of the premium corresponding to the time within the grace period during which the policy was in force.

(q) A provision that the insurer shall not exclude part-time employees and shall offer the same group health benefits to part-time employees as it offers to the employee groups of which the part-time employees would be members if they were full-time employees. The insurer shall offer to include the part-time employees as part of the employer's employee group, at the full rate to be paid by the employer, at a rate prorated between the employer and the employee, or at the employee's expense. A part-time employee shall be any employee who regularly works at least half of the weekly hours of the full-time employee in the employee group of which the part-time employee would be a member if he were a full-time employee, but who works a minimum of at least 15 hours per week. An insurer, however, may exclude part-time employees from eligibility for group health coverages providing disability or income replacement benefits, whether short- or long-term.

(r) A provision that the validity of the policy shall not be contested except for nonpayment of premiums, after it has been in force for 2 years from its date of issue; and that no statement made by any person covered under the policy relating to insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person's lifetime, nor unless it is contained in a written instrument signed by the person making such statement. No such provision, however, shall preclude the assertion, at any time, of defenses based upon the person's ineligibility for coverage under the policy or upon other provisions in the policy, except for any provisions establishing, as a requirement of eligibility, the furnishing of satisfactory evidence of insurability to the insurer.

(s) [Repealed.]

(t) A provisions as follows: Payment of Claims. Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured. (The following provisions, or either of them, may be included with the foregoing provision at the option of the insurer:

(1) If any indemnity of this policy or certificate shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the insurer may pay such indemnity, up to an amount not exceeding $ (insert an amount which shall not exceed $1,000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment.

(2) Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy or certificate on account of hospital, nursing, medical, or surgical services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the service be rendered by a particular hospital or person.)

(u) A provision that in the event that a person is covered by more than one plan that requires pre-certification, the member shall obtain pre-certification from the primary plan. Although the member shall not be required to obtain pre-certification from the secondary plan, the secondary plan shall not be required to treat such services as covered services if the services do not meet its certification criteria. The secondary plan shall not refuse payment for such services solely on the basis that the services were not pre-certified by the secondary plan.

I-a. "
Blanket accident and health insurance
" means that form of accident and health insurance that is not "health coverage" under RSA 420-G:2, IX, that does not require individual applications from covered persons, and that does not require a carrier to furnish each person with a certificate of coverage. Blanket health coverage shall be issued only to the following groups and cover only the following defined persons in the groups:

(a) A common carrier, which shall be deemed the policyholder, and which shall cover a group defined as all or any of the class of persons who may become passengers on such a common carrier.

(b) An employer, which shall be deemed the policyholder, and which shall cover all employees or any subset of employees defined solely by reference to exceptional hazards incident to such employment.

(c) A volunteer fire department, first aid, or other such volunteer group, which shall be deemed the policyholder, and which shall cover all the members of such department or group.

(d) A sports team or a camp, which team or camp shall be deemed the policyholder and which shall cover all members or campers.

(e) A travel agency, or other organization that provides travel-related services, which organization shall be deemed the policyholder and which shall cover all persons for whom travel-related services are provided. Notwithstanding anything herein to the contrary, blanket accident and health coverage for travel-related services issued to a travel agency or to an organization that provides travel-related services may require individual applications or enrollment forms from covered persons and premium payments from covered persons, and the carrier may furnish each covered person with a summary of benefits.

(f) A school, institution of higher education, or other educational organization, which shall be deemed the policyholder and which shall cover all persons who are students, employees, or unpaid volunteers performing services for the policyholder.

I-b. The benefits payable under blanket accident and health insurance shall not be assigned to a health care provider.

II. Any portion of any policy of group or blanket accident or health insurance affecting a resident of New Hampshire, whether such policy is delivered in this state or any other state, and any certificate under such policy, which purports, by reason of the circumstances under which a loss is incurred, to reduce any benefits promised thereunder to an amount less than that provided for the same loss occurring under ordinary circumstances, shall be printed, in such policy and in each certificate issued under such policy, in boldface type and with greater prominence than any other portion of the text of such policy or certificate, respectively; and all other exceptions of the policy shall be printed in the policy and in the certificate, with the same prominence as the benefits to which they apply.

III. The commissioner may approve any form of blanket accident or health or accident and health insurance policy, or any form of certificate to be issued under such policy, which omits or modifies any of the provisions hereinbefore required, if he deems such omission or modification suitable for the character of such insurance and not unjust to the persons insured thereunder.

IV. Any such group policy may include benefits payable on account of hospital or medical or surgical aid for an employee or other member of the group insured by such policy, his or her spouse, child or children or other dependents, and may provide that any such benefits be paid by the insurer directly to the hospital, physician, surgeon, doctor, nurse or other person furnishing services covered by such provision of said policy.

IV-a. [Repealed.]

V. (a) The coverage of any dependent of any employee or member of the group insured by such policy, pursuant to paragraph IV, who is mentally or physically incapable of earning his or her own living on the date as of which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another group policy as long as such incapacity continues and as long as said dependent remains chiefly financially dependent on the employee or member of the group or the employee or his or her estate is chargeable for the care of said dependent, provided that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

(b) If the coverage for dependent children under paragraph IV includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this subparagraph. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this subparagraph. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this subparagraph commences.

VI. Notwithstanding any provision of any policy of insurance issued under the provisions of this section, whenever such policy provides for reimbursement for any service which may be legally performed by a person licensed in this state for the practice of osteopathy, chiropractic, podiatry, optometry, or licensed as an advanced practice registered nurse, reimbursement under such policy shall not be denied when such service is rendered by a person so licensed.

VII. (a) If a group policy affecting a resident of New Hampshire is delivered or issued for delivery in this state or any other state, and such policy provides hospital or surgical expense insurance or major medical expense insurance for other than specific diseases, accidents only, or student major medical expense coverage insurance where the policyholder is the school, the policy and any certificate issued under such policy to a New Hampshire resident shall contain a provision to the effect that in case of termination for any reason whatever of coverage, including termination of eligibility for continuation coverage, provided any employee while insured under a group policy issued to his or her employer, if the employee or member is not then covered by another policy of hospital or surgical expense insurance or hospital service or medical expense indemnity corporation subscriber contract providing similar benefits or if the employee or member is not covered by or eligible to be covered by a group contract or policy providing similar benefits or is not provided with similar benefits required by any statute or provided by any welfare plan or program, the employee or member, if he or she has been insured under the group policy for at least 60 days, shall be entitled to have issued to him or her by the New Hampshire high risk pool without evidence of insurability upon application to the New Hampshire high risk pool within 31 days after such termination and upon payment of the applicable premium, an individual policy of insurance under RSA 404-G or shall be entitled to elect the 39-week extension period pursuant to RSA 415:18, XVII.

(b) The effective date of the individual policy shall be the date of the termination of the individual's insurance under the group policy. The individual policy shall not exclude any other preexisting condition.

(c) The option to obtain coverage from the New Hampshire high risk pool under RSA 404-G shall also be available, upon the death of the employee or member, to the surviving spouse with respect to those family members who are then covered by the group policy, to a child solely with respect to himself or herself upon his or her attaining the limiting age of coverage under the group policy while covered as a dependent thereunder, and to a former dependent spouse upon remarriage of the group plan member. The option to obtain coverage from the New Hampshire high risk pool shall be exercised within 31 days of the qualifying event.

(d) Each certificate holder in the insured group shall be given written notice of the option and its duration within 30 days after the date of termination of the group contract or policy. Such notice shall be mailed by the insurer to the certificate holder at the last address furnished to the insurer by the contract holder at the same time as the notice required by RSA 415:18, XVII is mailed. Each certificate holder shall have the option of electing an individual policy from the New Hampshire high risk pool under RSA 404-G, or the 39-week extension period provided pursuant to RSA 415:18, XVII. The election of the 39-week extension period upon termination by any person or member shall not preclude such person or member from electing to exercise the option of obtaining coverage from the New Hampshire high risk pool under RSA 404-G at the expiration of the 39-week extension period.

VII-a. Any employee whose compensation includes group hospital or surgical expense insurance or major medical expense insurance for other than specific diseases or accidents only the premiums for which are paid in full or in part by an employer including the state of New Hampshire, its political subdivisions, or municipal corporations, or paid by payroll deduction, may pay the premiums as they become due directly to the policyholder whenever the employee's compensation is suspended or terminated directly or indirectly as the result of a strike, lockout, or other labor dispute for a period not exceeding 6 months and at the rate and coverages as the policy provides.

(a) During said 6-month period, the policy may not be altered or changed, except that nothing in this section shall be deemed to impair the right of the insurer to make normal decreases or increases of the premium rate upon expiration and renewal of the policy, in accordance with the provisions of the policy.

(b) When the employee's compensation is so suspended or terminated, the employee shall be notified immediately by the policyholder in writing, by mail addressed to the address last on record with the policyholder, that the employee may pay the premiums to the policyholder as they become due as provided in this section.

(c) The policyholder shall remit any premiums paid by the employees on a timely basis to the insurer.

(d) Nothing herein shall be deemed to require the continuation of any such group coverage to any individual employee beyond the time that he takes full-time employment with another employer; nor shall anything herein be deemed to require continuation of the group coverage more than 6 months after compensation is suspended or terminated as the result of a labor dispute, nor to require the insurer to continue coverage as to any employee for whose coverage premiums have not been remitted in accordance with the provisions of the policy.

(e) After the 6-month period, the employee shall have the right to continue the benefits being continued under this paragraph for an additional 12 months as if the employee originally had elected the extension period provided by RSA 415:18, XVI and subject to the same conditions. At the end of the additional 12 months, the employee shall have the right, if the group insurance coverage is no longer available, to obtain coverage from the high risk pool.

(f) The provisions of this paragraph shall apply to group hospital and medical expense policies subject to RSA 415 and group health service plan contracts issued pursuant to RSA 420-A, and to health maintenance organization policies and plans issued pursuant to RSA 420-B.

VII-b. Any group accident and health insurance policy covering a resident of New Hampshire shall contain the following provisions:

(a) Upon a final decree of divorce or legal separation, if one spouse is a member of a group accident and health insurance policy, the former spouse who is a family member or eligible dependent under said policy prior to the date of the decree shall be and remain eligible for group benefits as a family member or eligible dependent under said policy, without additional premium or examination, as if said decree had not been issued. Such eligibility shall not be required if the decree expressly provides otherwise.

(b) The former spouse shall be eligible for coverage pursuant to this section through the member's participation in a group accident and health insurance policy, while such policy remains in force or is replaced by another group policy covering the member, until the earliest of the following events occurs:

(1) The 3-year anniversary of the final decree of divorce or legal separation;

(2) The remarriage of the former spouse;

(3) The remarriage of the member;

(4) The death of the member; or

(5) Such earlier time as provided by the final decree of divorce or legal separation.

(c) Upon the occurrence of the earliest of the events set forth in subparagraph (b), other than remarriage of the former spouse, the former spouse shall have the right to continuation coverage under RSA 415:18, XVI. An insurance carrier may charge a premium for the former spouse's continuation coverage under this subparagraph, in accordance with RSA 415:18, XVI. The former spouse shall request enrollment under RSA 415:18, XVI, in writing, within 30 days after the first occurring of the events set forth in subparagraph (b), provided that the former spouse may not request enrollment upon remarriage of the former spouse. If the first occurring event is the member's remarriage or death, the former spouse may request enrollment under RSA 415:18, XVI, in writing, within 30 days after receiving notice of said event.

(d) In the event of the former spouse's remarriage, the former spouse shall notify the insurance carrier, in writing, within 30 days after the date of remarriage, and the effective date of termination of the former spouse's eligibility pursuant to this section shall be the date of remarriage.

(e) The member or former spouse shall submit to the insurance carrier evidence of the former spouse's eligibility under this section within 30 days after the final decree of divorce or legal separation. If the group accident and health insurance policy existing as of the date of the decree is replaced by another group policy covering the member that is issued by a different insurance carrier, said carrier may request that the member or former spouse submit evidence of the former spouse's eligibility under this section within 30 days of the effective date of the member's coverage under the replacement policy. A former spouse's coverage under the member's group accident and health insurance policy pursuant to this section shall be effective as of the date of the final decree of divorce or legal separation in the case of a then existing policy, or, in the case of a replacement policy, the effective date of the member's coverage under such policy.

(f) The former spouse shall notify the insurance carrier, in writing, of any address other than the member's address to which notices and correspondence pertaining to the former spouse's coverage should be mailed, including but not limited to notice of cancellation and any right to reinstate coverage, and the carrier shall use such address until it receives written notice from the former spouse of a change.

(g) Upon termination of the eligibility of a former spouse for group coverage pursuant to this section, said former spouse may apply for individual coverage or the high risk pool, whichever is applicable.

(h) Eligibility of a former spouse for group coverage pursuant to this section exists independent of any right to continuation of coverage under RSA 415:18, XVI. To the extent that there is a conflict between this paragraph and RSA 415:18, XVI with respect to eligibility for group coverage upon a final decree of nullity, divorce or legal separation, the provisions that confer greater rights on the former spouse shall apply unless the decree expressly provides otherwise.

VIII. Notwithstanding any provision of any policy of insurance issued under the provisions of this section, whenever the terms "physician" or "doctor" are used in any such policy, said terms shall include within their meaning those persons licensed under RSA 317-A in respect to any care, services, procedures or benefits covered by said policy which the persons so licensed are authorized to perform.

IX. [Repealed.]

X. [Repealed.]

XI. [Repealed.]

XII. No insurer shall, when issuing or renewing a group policy or contract of hospital or surgical expense or major medical expense insurance or any certificate under such policy or contract covered by this chapter, deny coverage or limit coverage to any resident of this state and who is principally employed in this state and to any other person who is a non-resident but who is principally employed in this state on the basis of health risk or condition except that a waiting period consistent with insurance department rules may be imposed for pre-existing medical conditions. If an insurer accepts an application for group hospital or surgical expense or major medical expense coverage, such acceptance shall be subject to the following:

(a) If the group has coverage in effect through another plan, the insurer shall accept all persons covered under the existing plan. If the group does not have coverage in effect through another plan, the insurer shall accept all persons for which the group seeks coverage.

(b) Once a group policy has been issued, any person becoming eligible for coverage shall become covered by enrolling within 31 days after first becoming eligible. Any person so enrolling shall not be required to submit evidence of insurability based on medical conditions. If a person does not enroll at this time, he is a late enrollee.

(c) Once a group policy has been issued, the insurer shall provide the group with an annual open enrollment period for late enrollees. During the open enrollment period, any late enrollee shall be permitted to enroll without submitting any evidence of insurability based on medical conditions. For late enrollees in a large employer group only, the pre-existing condition provisions shall apply for 18 months from the date of enrollment. However, an eligible employee or dependent shall not be considered a late enrollee if the individual:

(1) Was covered under a public or private health insurance or other health benefit arrangement at the time the individual was eligible to enroll; and

(2) Has lost coverage under a public or private health insurance or other health benefit arrangement as a result of termination of employment or eligibility, the termination of the other plan's coverage, death of a spouse, or divorce; and

(3) Requests enrollment within 60 days after termination of coverage provided under a public or private health insurance or other health benefit arrangement; or

(i) The individual is employed by an employer which offers multiple health benefit plans and the individual elects a different plan during an open enrollment period; or

(ii) A court has ordered coverage to be provided for an ex-spouse or minor child under a covered employee's health benefit plan and request for enrollment is made within 30 days after issuance of such court order.

XIII. An insurer issuing policies of group insurance shall allocate the costs associated with maternity and childbirth over both males and females covered by its entire block of business in this state. In cases in which, because of the amount written in the state, allocation to an entire block of business needs to occur, the carrier may apply for a waiver from the insurance commissioner.

XIV. An insurer issuing policies, plans, or contracts of group insurance providing accident or health insurance providing benefits for medical or hospital expenses shall provide to each new certificate holder who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.

XV. In paragraphs XVI and XVII:

(a) "
Carrier
" means an entity that offers or provides a policy, contract, or certificate of insurance coverage in this state. "
Carrier
" shall include an insurer, a health maintenance organization, or any other entity providing a policy, contract, or certificate of insurance coverage subject to state insurance regulation.

(b) "
Cancellation
" means the circumstance when the employer/employee relationship ceases to exist.

(c) "
Individual
" means any person covered under a group health plan, including but not limited to, the covered employee, the spouse of the covered employee, whether surviving, dependent, former dependent, divorced or legally separated; or the dependent child of the employee, and any other person including a child born or placed for adoption with the covered employee, who is covered under a group health plan through the employment relationship.

(d) "
Health insurance
" means all group hospital and medical expense policies subject to RSA 415, group health service plan contracts pursuant to RSA 420-A, and health maintenance organization policies and plans issued pursuant to RSA 420-B, and all other plans that are additionally subject to RSA 420-G, except for small employers of size one defined pursuant to RSA 420-G:2, XVI.

(e) "
Entire group termination
" means that circumstance when all health insurance coverage to the group ends.

XVI. Continuation of Coverage.

(a) Carriers shall provide continuation of coverage when an individual covered by a plan of group health insurance or a health maintenance organization that provides medical, hospital, dental, and/or surgical expense benefits, except student major medical expense coverage where the policyholder is the school, loses coverage under the plan. Any group policy of health insurance that affects a resident of New Hampshire that is delivered or issued for delivery in this state or any other state shall contain a provision that allows each subscriber or member on the policy who is a resident of New Hampshire to obtain continuation coverage under this section. Coverage shall be provided in accordance with the procedures described in this section.

(b) Continuation coverage shall be identical to the coverage provided to other similarly situated members of the group that are still covered by the plan. The policy shall not be changed from the underlying group coverage, except that normal premium rate increases or decreases upon renewal affecting the group plan may also affect the continuation premium rate. The effective date of continuation coverage shall be the date the individual's coverage under the group plan ceased.

(c) Periods of coverage shall be as follows:

(1) Eighteen month period-When any individual loses coverage under a group health insurance plan for any reason except dismissal from employment for gross misconduct or carrier termination, coverage shall continue subject to this section for a period of 18 months, unless the individual is eligible for coverage under subparagraphs (2), (3), (4), or (5).

(2) Thirty-nine week period (entire group insurance termination)-Whenever the entire group is terminated, coverage shall continue subject to this section for a period of 39 weeks. Where an individual has continuation coverage, coverage shall continue until it would have expired had the plan not been terminated or for 39 weeks, whichever occurs first.

(3) Twenty-nine month period (disability)-An individual who is determined to be disabled within the first 60 days of the date such individual loses coverage shall be entitled to 29 months of continuation coverage. Determination of disability shall be under Title II or XVI 
 of the federal Social Security Act or any future act that has the same purpose.

(4) Thirty-six month period-Subject to subparagraph (e), coverage shall continue subject to this section for a period of 36 months if any individual loses coverage under a group health insurance plan for one of the following reasons:

(A) Death of a covered employee;

(B) The divorce or the legal separation of the covered employee or, if the employee's former spouse has been covered pursuant to RSA 415:18, VII-b, the first occurring of any of the following events:

(i) The remarriage of the covered employee;

(ii) The death of the covered employee;

(iii) The 3-year anniversary of the final decree of divorce or legal separation; or

(iv) Such earlier time as provided by said decree;

(C) A substantial loss of coverage by retirees and dependents within one year of the employer filing for protection under the bankruptcy provisions of Title 11 of the United States Code; or

(D) A dependent child ceasing to be a dependent child.

(5) When the surviving spouse, divorced spouse, or legally separated spouse is 55 years of age or older and loses coverage because of the death, divorce, or legal separation of the covered employee, coverage shall continue subject to this section until such time as the spouse becomes eligible for participation in another employer-based group plan or becomes eligible for Medicare.

(d) Premium Payments. When an individual's coverage has ended, the amount of the premium charged to the individual electing continuation coverage shall not exceed 102 percent of the group premium amount as allocated for that individual's coverage.

(e) Responsibilities.

(1) When an individual loses coverage, it shall be the responsibility of the carrier to notify the individual of the right to elect continuation coverage.

(2) It shall be the responsibility of the individual electing continuation coverage to make timely premium payments. A 30-day grace period for payment of the premium shall be provided. Failure to make a timely remittance of the premium shall be grounds for cancellation. Whenever a carrier fails to notify an individual that his or her coverage will not continue unless the individual so elects, the carrier shall be liable, in accordance with the terms of the policy, for claims accrued until such notice is made, except that any carrier that in good faith mailed a notice to the last known address of the individual shall not be held liable. Such carrier's liability shall in no way diminish the liability of the employer if the employer fails to notify the carrier of a member's loss of coverage.

(f) Notice Requirements and Procedures. A carrier shall notify the members and subscribers of their continuation rights as follows:

(1) The carrier shall provide, at the time of commencement of coverage under the health benefit plan, a summary plan description to each eligible member or subscriber of the rights provided under this section.

(2) Notice of the right to continue coverage also shall be set forth in each master policy and individual certificate of coverage.

(3) When coverage for an individual will cease under the group policy, the carrier shall notify the individual of the individual's right to continue, the amount of the premium required to continue coverage, and the procedure for electing continuation coverage. The notice of continuation shall specify the election period that shall not be less than 45 days after the date of the notice and shall be mailed to the last known address of the individual provided by the employer or plan administrator.

(4) The carrier shall specify in each notice of continuation how premium payments are to be remitted.

(5) The carrier shall notify the individual of the right to continue coverage within 30 days of receiving notice from the plan administrator or employer of the loss of coverage.

(g) Election Requirements and Procedures.

(1) An individual electing continuation coverage shall notify the carrier in writing with a copy of the notice provided to the employer or plan administrator when the election is made. Such election shall be made within 45 days of the date of notice.

(2) Where the employee's spouse is also covered by the group plan, and there is a divorce or legal separation, the employee shall notify the employer of the divorce or separation within 30 days, and shall provide the employer and carrier with the employee's spouse's mailing address. In case of a divorce or legal separation, the carrier shall provide a separate notice of the right to continue to the divorced or separated spouse. The divorced or separated spouse may elect to continue coverage pursuant to this section by notifying the carrier within 45 days of the date of the notice and remitting the premium payment. The notice and election provisions of this paragraph shall also apply if the divorced or legally separated spouse of the employee has been covered pursuant to RSA 415:18, VII-b, upon the occurrence of any of the following events:

(A) The remarriage of the employee;

(B) The death of the employee;

(C) The 3-year anniversary of the final decree of divorce or legal separation; or

(D) Such earlier time as provided by the final decree of divorce or legal separation.

(3) Election by the individual shall be made within the period of time stated in the notice of the right to continue, by written notice to the carrier and the employer. The required premium payment, as specified in the notice of the right to continue, shall be remitted as required in the notice with the written notice of election.

(4) Where an individual declines the right to continue coverage pursuant to this section, waiver shall be made by an affirmative means of declination, including but not limited to written declination of continuation coverage or electronic contact to the employer or plan administrator. An individual shall have the right to revoke the notice of declaration anytime within the specified election period.

(5) Where proper notice has been given, and no response is made within the election period, coverage may be deemed waived if the carrier has in good faith made reasonable efforts to contact the eligible individual. However, no carrier may deem any coverage waived if a notice does not fully comply with this section.

(6) Where an individual has attempted to notify the carrier, employer, or plan administrator of election, and where the written election has not included a premium payment, the carrier shall allow the individual to comply by paying the full amount of the unpaid premiums within 30 days of the date of election.

(7) Where more than one person covered by the group health insurance plan will lose coverage as a result of the covered employee's termination from the group, each individual shall be provided with a notice and shall have the opportunity to elect or waive coverage. Where there is a choice among plans, each individual shall have the opportunity to choose a plan.

(8) An election of continuation of coverage by a subscriber shall be deemed to include an election of continuation coverage on behalf of any other of the subscriber's dependents or beneficiaries who would lose coverage under the health benefit plan.

(h) End of Continuation Coverage. Nothing in this paragraph shall require a carrier to continue coverage pursuant to this section beyond:

(1) The first day of the month following the individual's eligibility for a group plan through a different employer;

(2) In the case of an individual that is eligible for Medicare, the date of the first Medicare open enrollment period following the date the individual became ineligible for continued participation under the group plan;

(3) In the case of a period of extended coverage for a person who has been determined to be disabled during the first 60 days of continuation coverage, the month that begins more than 30 days after the date of a final determination that the person is no longer disabled;

(4) The date on which continuation coverage ceases because the individual has failed to pay the premium. The individual shall be given a 30-day grace period before coverage is cancelled, and shall be provided with a notice within 15 days of the date of termination that the coverage will be cancelled if the premium is not paid; or

(5) The date on which the group plan terminates subject to the continuation rights set forth in RSA 415:18, XVII.

(i) The provisions of this paragraph shall apply to group hospital and medical expense policies subject to RSA 415, group health service plan contracts issued pursuant to RSA 420-A, and to health maintenance organization policies and plans issued pursuant to RSA 420-B, and to group policies that cover New Hampshire residents who work in other states. The provisions of this section shall not apply to individuals covered under group policies issued to small employers of size one, as defined pursuant to RSA 420-G:2, XVI.

(j) Relationship to Federal Law. In any circumstance where more extensive notice requirements or other procedural requirements apply, the health benefit plan shall satisfy the specific requirements of federal law with respect to those procedural requirements.

XVII. Termination of Coverage.

(a) Whenever any group hospital, surgical, dental insurance plan, medical insurance plan, or health maintenance organization coverage terminates for any reason, the benefits of such plan shall be available at the same group rate to the covered members of the group plan, for an extension period of 39 weeks, or until such member of the group plan becomes eligible for benefits under another group plan, whichever occurs first.

(b) Written notice of the right to continue such group coverage upon termination shall be given by the carrier in each master policy, certificate, and group policy.

(c) Upon termination of the group policy for nonpayment of premiums the carrier shall give notice within 30 days of the effective date of termination of the policy to the policyholder and each certificate holder under the policy. Termination of the group policy for nonpayment of premiums shall occur no earlier than the date of expiration of the grace period, pursuant to RSA 415:18, I(p), for which premium was due but not paid. The notice shall provide that the certificate holder or policyholder may elect coverage from the date of termination to the date of notice; or elect coverage from the date of termination to the date of notice and continue such coverage in force pursuant to subparagraphs (d), (e), and (f).

(d) The member electing coverage under this subparagraph shall provide the carrier written notice of election together with the required premium contribution within 31 days of the date of the notice. The group rate shall be paid by the member directly to the carrier. The premium rate shall be that required for the coverage being continued and shall not exceed the applicable group rate, but a reasonable administrative fee not to exceed 2 percent of the monthly premium may be charged to offset billing and payment costs.

(e) If group members become entitled to the 39-week extension period due to termination of the policy, the carrier shall:

(1) Notify such person or member of the option to elect continuation of coverage for the extension period of 39 weeks and the conditions applicable to such coverage within 30 days of the date the plan terminates.

(2) If the carrier fails to notify the members of the termination of the group plan within 30 days of the date of termination of the group coverage, the members shall not be liable for any premiums that have not been paid prior to the date the notice was sent. In no event shall a person or member entitled to coverage for the extension period of 39 weeks be responsible for premiums accrued and unpaid prior to the date of the termination or cancellation of the coverage.

(3) Where coverage has ended as a result of an employer's nonpayment of premiums, the member electing continuation coverage shall not be liable for any accrued and unpaid premium that was the employer's responsibility under the policy, or any amount previously paid by the person for coverage under the policy that due to the employer's actions was not paid to the carrier.


Source. 1941, 110:2. RL 331:26. 1947, 141:1, 2. RSA 415:18. 1969, 163:1; 271:2. 1973, 445:1, 2. 1975, 111:2; 333:2; 500:1-3, 5. 1979, 418:3. 1981, 391:1. 1983, 473:16, VII. 1985, 239:2; 316:3. 1986, 93:1, 3; 114:1; 163:1, 6. 1990, 267:1-5. 1992, 222:1, 5, 6. 1993, 162:1-3; 196:1. 1994, 138:2, 3; 166:2-6. 1995, 112:9-13, 23, I. 1996, 188:3, 4. 1997, 190:6, 7; 331:14; 344:3. 1998, 85:1. 1999, 316:1, 2. 2001, 276:1, 2. 2002, 207:3, 4. 2006, 321:3. 2007, 289:2-7, 41; 379:3, 5-10. 2009, 54:5; 235:4, 5. 2010, 188:1, 5, 6, 13; 351:2. 2011, 189:5. 2012, 99:1, 4. 2014, 90:1, eff. Aug. 10, 2014. 2016, 111:2, eff. Jan. 1, 2017. 2022, 42:8, eff. July 2, 2022.

    415:19-a Student Insurance Policies. 

Student major medical expense coverage is hereby declared to be that form of accident and health insurance issued as large group coverage to enrolled students at an accredited college, university, or other educational institution. No coverage other than student major medical expense coverage shall be issued as student large group coverage. Student major medical expense plan coverage shall:

I. Provide the same form of major medical expense coverage under an arrangement whereby the premiums for such policies are paid to the insurer by the college, the university, or other educational institution.

II. Not include a pre-existing condition exclusion period.

III. Be considered large group coverage, subject to all applicable laws and rules that generally apply to large group accident and health insurance coverage, except those set forth in RSA 420-G and RSA 415:18, VII, VII-a, VII-b, XVI, and XVII.


Source. 2010, 188:2, eff. Aug. 20, 2010.

    415:19-b Debt-Related Mortgage Disability and Mortgage Accidental Death Insurance. 

A group of individuals may be insured under a mortgage disability or mortgage accidental death policy issued to a creditor, or to the trustee of a creditor, which creditor or trustee shall be deemed the policyholder, to insure debtors of the creditor or creditors, subject to the following requirements:

I. The debtors eligible for insurance under the policy shall be all the debtors of the creditor or creditors whose indebtedness is repayable in installments, or all of any class or classes thereof determined by conditions pertaining to the indebtedness or to the purchase giving rise to the indebtedness. The policy may provide that the term "
debtors
" shall include the debtors of one or more subsidiary corporations, and the debtors of one or more affiliated corporations, proprietors, or partnerships if the business of the policyholder and of such affiliated corporations, proprietors, or partnerships is under common control through stock ownership, contract, or otherwise.

II. The premium for the policy shall be paid by the policyholder, either from the creditor or creditor's funds, or from charges collected from the insured debtors, or from both.

III. The amount of indemnity payable with respect to any debtor shall at no time exceed the amount owed by the debtor which is repayable in installments to the debtor's creditor.

IV. The insurance shall be payable to the policyholder. Such payment shall reduce or extinguish the unpaid indebtedness of the debtor to the extent of such payment.

V. All the provisions of RSA 417, and specifically RSA 417:4, XVI, shall apply to any policy issued under this section.


Source. 2012, 103:1, eff. July 28, 2012.

    415:19-c Credit Union Accidental Death and Dismemberment Insurance. 

A group of individuals who are members of a credit union may be insured under an accidental death and dismemberment policy issued to that credit union, which shall be deemed the policyholder.


Source. 2014, 19:1, eff. July 22, 2014.

    415:19 Policies Under Franchise Plan. 

RSA 415:15 shall not be construed to prohibit the issuance or delivery in this state of policies under the franchise plan herein defined provided the rates charged, benefits payable, or underwriting procedure used do not discriminate between franchise plans. Accident and health insurance on a franchise plan is hereby declared to be that form of accident and health insurance issued to (1) 3 or more employees of any corporation, copartnership, or individual employer or any governmental corporation, agency or department thereof; or (2) 10 or more members of any trade or professional association or of a labor union or of any other association having had an active existence for at least 2 years where such association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance; where such persons, with or without their dependents, are issued the same form of an individual policy varying only as to amounts and kinds of coverage applied for by such persons, under an arrangement whereby the premiums on such policies may be paid to the insurer periodically by the employer, with or without payroll deductions, or by the association for its members.


Source. 1947, 162:4. RSA 415:19. 1973, 74:1, eff. April 9, 1973.

    415:2 Disapproval of Forms. 

I. The commissioner may, within 30 days after the filing of any such form, disapprove such form if:

(a) The benefits provided therein are unreasonable in relation to the premium charged;

(b) It contains a provision or provisions which are unjust, unfair, inequitable, misleading, deceptive or encourage misrepresentation of such policy; or

(c) It does not comply with the requirements of law.

II. The 30-day period under paragraph I may be extended by the commissioner if the insurer has not provided all necessary information required to make a determination under paragraph I.

III. If the commissioner shall notify the insurer which has filed any such form that it does not comply with the provisions of this chapter, it shall be unlawful thereafter for such insurer to issue such form or use it in connection with any policy. In such notice the commissioner shall specify the reasons for his disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer.


Source. 1913, 226:1. PL 281:2. RL 331:2. 1947, 162:2. 2008, 212:7, eff. June 16, 2008.

    415:20 Penalty. 

Any insurer, agent, broker or any person, firm, association or corporation that violates any provision of this chapter or any rule issued pursuant to it, or any relevant provision of RSA 161-H, may at the discretion of the commissioner be subject to paragraph I or II, or both.

I. Its certificate of authority may be indefinitely suspended or revoked.

II. A civil fine not to exceed $2,500 may be imposed for each violation. Repeated violations of the same provision or regulation shall constitute separate civil offenses.


Source. 1913, 226:13. PL 281:27. RL 331:28. RSA 415:20. 1975, 494:4. 1994, 214:5, eff. Oct. 1, 1994.

    415:21 Health Insurance Through Joint Action. 

I. Notwithstanding any contrary provision of this chapter or of any other law, 2 or more insurance companies authorized to carry on the business of health insurance in this state may join together to offer to any resident of this state who has reached or passed his sixty-fifth birthday and to the spouse of such resident, insurance against major financial loss from accident or disease. Such insurance may be offered by such companies in their own names or in the name of a voluntary unincorporated association or other organization formed by such companies solely for the purpose of offering this type of insurance. The forms of applications, certificates and policies of such insurance and the applicable premium rates shall be filed with the insurance commissioner and shall conform to the requirements of this chapter as to forms of policies of accident and sickness insurance so far as practical and applicable and the commissioner may require such additional pertinent information as he may deem necessary and require deviation from the statutory provisions for the forms of such policies.

II. The joint action authorized by this section may be taken in connection with a plan to offer such insurance to residents of other states in combination with insurance offered to residents of this state subject to approval by the insurance commissioner.

III. A financial summary concerning any insurance written under the authority of this section shall be furnished annually to the insurance commissioner in such form as he may prescribe. If the insurance commissioner finds that any forms for such insurance are not in the public interest or that the premium rates charged are by reasonable assumptions excessive in relation to the benefits provided, he may disapprove such forms or premium rates after notice of at least 20 days and hearing. Any person aggrieved by any order or decision of the insurance commissioner under this section shall be entitled to a rehearing and appeal in accordance with the provisions of RSA 541.


Source. 1963, 295:1, eff. Sept. 1, 1963.

    415:22-a Coverage During Adoption Proceedings. 

All individual and group health insurance policies which provide coverage for a family member of the insured shall, as to such family member's coverage, also provide that health insurance benefits applicable for children are payable with respect to any minor from the date such minor is placed in the custody of the insured pursuant to an adoption proceeding under the provisions of RSA 170-B. Such health insurance benefits shall terminate upon dismissal or withdrawal of the petition for adoption.


Source. 1992, 222:7, eff. Jan. 1, 1993.

    415:22-b Notification of Allowable Benefit. 

All individual and group health insurers providing benefits for medical and hospital expenses shall provide to each certificate holder, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.


Source. 1993, 102:1, eff. Jan. 1, 1994.

    415:22 Newborn Children. 

I. All individual and group health insurance policies providing coverage on a provision of service or an expense incurred basis shall also provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber or a newly born child of a dependent child of the insured or subscriber from the moment of birth.

II. Coverage for newly born children shall consist of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.

III. If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fee must be furnished to the insurer or nonprofit service or indemnity corporation within 31 days after the date of birth in order to have the coverage continue beyond such 31-day period. Unless the policy or contract specifically provides that grandchildren of the insured or subscriber are eligible for coverage, coverage for newly born children of a dependent child of the insured or subscriber shall not continue beyond the initial 31-day period following birth. Nor shall such newly born children be considered dependents of the insured for any purpose addressed in this title.

IV. This section applies to all insurance policies and subscriber contracts delivered or issued for delivery in this state including those in force as of July 5, 1975.


Source. 1975, 110:1. 1994, 166:7. 1996, 188:5, 6. 1997, 190:8, eff. Jan. 1, 1998.

    415:23 Jurisdiction Over Certain Health Insurers. 

I. Notwithstanding any other provision of law, and except as provided in this section, any person or other entity which provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department unless the person or other entity shows that, while providing such services, it is subject to the jurisdiction of another agency of this or another state or of the federal government. The provisions of this section shall not apply to dental service corporations established by 1961, 345 or vision service corporations established by 1969, 614.

II. A person or entity may show that it is subject to the jurisdiction of another agency or department of this or another state or of the federal government by providing to the commissioner the appropriate certificate or license issued by the other governmental agency which permits or qualifies it to provide those services for which it is licensed or certificated.

III. Any person or entity which is unable to show that it is subject to the jurisdiction of another agency of this or another state or of the federal government shall submit to an examination by the commissioner to determine the organization and solvency of the person or the entity and to determine whether or not such person or entity is in compliance with the applicable provisions of Title XXXVII.

IV. Any person or entity unable to show that it is subject to the jurisdiction of another agency of this or another state or of the federal government shall be subject to all appropriate provisions of Title XXXVII regarding the conduct of its business.

V. The department shall prepare and maintain for public inspection a list of those persons or entities described in paragraph I which it knows to be operating in this state. There shall be no liability of any kind on the part of the state, the department, and its employees for the accuracy of such list or for any comments made with respect to it.

VI. Any production agency or administrator licensed by the department which advertises, sells, transacts, or administers coverage in this state described in paragraph I which is provided by any person or entity described in paragraph III shall, if that coverage is not fully insured or otherwise fully covered by an admitted life or disability insurer, nonprofit hospital service plan, or nonprofit health care plan, advise in writing, any purchaser, prospective purchaser, and covered person of such lack of insurance or other coverage and shall advise, in writing, the attending lack of guaranty association protection.

VII. Any administrator licensed by the department which advertises or administers coverage in this state, described in paragraph I, which is provided by any person or entity described in paragraph III, shall advise any production agency licensed by the department of the elements of the coverage including the amount of "stop-loss" insurance in effect.

VIII. Nothing in this section shall relieve any person of any liability, civil or criminal, arising from any other statute or rule of this state or of any other governmental unit.


Source. 1983, 342:1, eff. Aug. 17, 1983.

    415:24 Rate Modifications for Accident and Health Insurance Policies. 

I. Rate modifications on individual accident and health policy forms shall be filed with the commissioner prior to implementation.

II. At the time of filing new premium rates on any previously approved individual accident and health insurance policy form, other than forms for Medicare supplement policies and long-term care policies, the benefits provided by the policy form shall be deemed reasonable to the premium charge and the rates deemed approved, so long as the insurer complies with the terms of a loss ratio guarantee filed with the commissioner. The loss ratio guarantee agreement shall be in writing and shall include at least the following:

(a) A recitation of the anticipated annual and lifetime loss ratio standards included in the original actuarial memorandum filed with the policy form at the time of the initial approval of the policy form.

(b) A guarantee that the actual loss ratios in this state for the experience period in which the rates take effect, and for each experience period thereafter, will meet or exceed the anticipated annual loss ratio standards as recited in accordance with RSA 415:24, II(a). If the annual earned premium volume in this state under a policy form is less than $1,000,000, the loss ratio guarantee shall be based on the actual nationwide loss ratio for the policy form. If the annual earned premium volume nationwide is less than $1,000,000, the experience period shall be extended until the end of the calendar year in which $1,000,000 of earned premiums is attained.

(c) A guarantee that the actual loss ratio results for each calendar year the rates are in effect shall be independently audited during the second quarter of the following year at the expense of the insurer. The audited results shall be reported to the commissioner no later than the date for filing the applicable accident and health policy experience exhibit. The audit shall be conducted in accordance with generally accepted auditing or actuarial standards and shall be signed by a certified public accountant or a member of the American Academy of Actuaries.

(d) A guarantee that affected policyholders in this state shall be issued a proportional refund of premiums paid in the amount necessary to bring the actual loss ratio up to the anticipated annual loss ratio standards as recited in accordance with RSA 415:24, II(a). If national loss ratios are used, the total amount refunded in this state shall equal the dollar amount necessary to achieve the loss ratio standards, multiplied by the total premium earned in this state on the policy form and divided by the total premiums earned in all states on the policy form. The refund shall be made to all policyholders insured under the applicable policy form as of the last day of the experience period at issue and whose individual refund would equal $5 or more. The refund shall include interest at the then current accident and health reserve interest rate established by the National Association of Insurance Commissioners calculated from the last day of the experience period at issue until the date of payment, which shall be during the third quarter of the following year.

(e) A guarantee that refunds of less than $5 shall be aggregated by the insurer and paid to the department of insurance.

(f) A guarantee that no increase in premium rate obtained pursuant to this section will be implemented on any individual policy in this state until after the policyholder has received at least 30 days advance notice of the planned increase.

(g) For the purposes of this section, "loss ratio" means the ratio of incurred claims to earned premium by number of years of policy duration, for all combined durations.

(h) The commissioner shall adopt rules under RSA 541-A necessary for the proper administration of this section.


Source. 1992, 272:1, eff. Jan. 1, 1993.

    415:25 Repealed by 2014, 3:12, VII, eff. Dec. 31, 2018. 

    415:26 Price of Filling Prescriptions. 

I. A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy's usual and customary price of filling the prescription or the contracted copayment, whichever is less.

II. Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer shall pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.

III. The commissioner shall adopt rules under RSA 541-A to implement this paragraph. Such rules shall include procedures for addressing complaints, provisions for enforcement, the receipt of complaints referred to the insurance department under RSA 318:47-h, III(b), and for reporting to the board of pharmacy on the status of complaints referred.


Source. 2016, 221:7, eff. June 9, 2016.

    415:27 Medication Synchronization. 

I. An individual or group health insurance plan or policy providing prescription drug coverage in New Hampshire, shall permit and apply a prorated, daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed by an in-network pharmacy for less than a 30-day supply if the prescriber and pharmacist determine the fill or refill to be in the best interest of the patient for the management or treatment of a chronic, long-term care condition and the patient requests or agrees to less than a 30-day supply for the purpose of synchronizing the patient's medications. For the purposes of this paragraph, the insured's or enrollee's maintenance prescription drugs to be synchronized shall meet all of the following requirements:

(a) They are covered by the policy, certificate, or contract described in this chapter.

(b) They are used for the management and treatment of a chronic, long-term care condition and have authorized refills that remain available to the insured or enrollee.

(c) Except as otherwise provided in this paragraph, they are not a controlled substance included in schedules II-V.

(d) They meet all utilization management requirements specific to the maintenance-prescription drugs at the time of the request to synchronize the insured's or enrollee's multiple, maintenance-prescription drugs.

(e) They are of a formulation that can be effectively split over required short-fill periods to achieve synchronization.

(f) They do not have quantity limits or dose-optimization criteria or requirements that will be violated when synchronizing the insured's or enrollee's multiple, maintenance-prescription drugs.

II. The plan or policy described in paragraph I shall apply a prorated, daily cost-sharing rate for maintenance-prescription drugs that are dispensed by an in-network pharmacy for the purpose of synchronizing the insured's or enrollee's multiple, maintenance-prescription drugs.

III. The plan or policy described in paragraph I shall not reimburse or pay any dispensing fee that is prorated. The insurer shall only pay or reimburse a dispensing fee that is based on each maintenance-prescription drug dispensed.

IV. A synchronization shall only occur once per year per maintenance-prescription drug.


Source. 2018, 103:1, eff. Jan. 1, 2019.

    415:3 Subsequent Disapproval. 

The commissioner may at any time, after a hearing of which not less than 20 days' written notice shall have been given to the insurer, withdraw his approval of any such form on any of the grounds stated in this chapter. It shall be unlawful for the insurer to issue such form or use it in connection with any policy after the effective date of such withdrawal of approval. The notice of any hearing called under this section shall specify the matters to be considered at such hearing and any decision affirming disapproval or directing withdrawal of approval under this chapter shall be in writing and shall specify the reasons therefor.


Source. 1947, 162:3, eff. May 28, 1947.

    415:4 Review of Disapproval. 

The action of the commissioner in this regard shall be subject to review by the superior court.


Source. 1913, 226:1. PL 281:3. RL 331:3.

    415:5 Form of Policy. 

I. No policy of accident and sickness insurance shall be delivered or issued for delivery to any person in this state unless:

(1) The entire money and other considerations therefor are expressed therein; and

(2) The time at which the insurance takes effect and terminates is expressed therein; and

(3)(a) It purports to insure only one person, except that a policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent on the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

(b) Nothing in this subparagraph shall be construed to require:

(1) Coverage for services provided to a dependent before the effective date of this section; or

(2) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this subparagraph.

(c) A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this subparagraph.

(d) Coverage for a dependent provided pursuant to this subparagraph shall be provided until the earlier of the following:

(1) The dependent is disqualified for dependent status as set forth in subparagraph I(3)(a); or

(2) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

(e) Nothing in this subparagraph shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to subparagraph (c), based upon the dependent's prior disqualification pursuant to subparagraph (d)(1).

(f) Notice regarding coverage for a dependent as provided pursuant to this subparagraph shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days following the effective date of this subparagraph. Such notice shall include information regarding the required special open enrollment period.

(3-a)(a) The coverage of any family member insured by such policy, pursuant to subparagraph (3), who is mentally or physically incapable of earning his or her own living on the date as of which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as said dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of said dependent, provided that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G;

(b) If the coverage for dependent children under subparagraph (3) includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this subparagraph. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this subparagraph. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this subparagraph commences; and

(4) The style, arrangement and over-all appearance of the policy give no undue prominence to any portion of the text, and unless every printed portion of the text of the policy and of any indorsements or attached papers is plainly printed in light-faced type of a style in general use, the size of which shall be uniform and not less than 10-point with a lower-case unspaced alphabet length not less than 120-point (the "text" shall include all printed matter except the name and address of the insurer, name or title of the policy, the brief description if any, and captions and subcaptions); and

(5) The exceptions and reductions of indemnity are set forth in the policy, and, except those which are set forth in RSA 415:6, are printed, at the insurer's option, either included with the benefit provision to which they apply, or under an appropriate caption such as "Exceptions," or "Exceptions and Reductions," provided that if an exception or reduction specifically applies only to a particular benefit of the policy, a statement of such exception or reduction shall be included with the benefit provision to which it applies; and

(6) Each such form, including riders and endorsements, shall be identified by a form number in the lower left-hand corner of the first page thereof; and

(7) It contains no provision purporting to make any portion of the charter, rules, constitution, or bylaws of the insurer a part of the policy unless such portion is set forth in full in the policy, except in the case of the incorporation of, or reference to, a statement of rates or classification of risks, or short-rate table filed with the commissioner; and

(8) Wherever such policy provides for reimbursement for any service which may be legally performed by a person licensed in this state for the practice of osteopathy, chiropractic, podiatry, optometry, or licensed as an advanced practice registered nurse, said policy contains a provision for reimbursement for such service when performed by a person so licensed.

(9) Notwithstanding any provisions in any such policy or contract for the provision of health care services or benefits provided by any health, medical or other service corporation licensed by the state, whenever the terms "physician" or "doctor" are used in any such policy or contract, said terms shall include within their meaning those persons licensed under RSA 317-A in respect to any care, services, procedures or benefits covered by said policy or contract which the persons so licensed are authorized to perform.

(10) It also conforms to the relevant provisions of RSA 420-G.

II. If any policy is issued by an insurer domiciled in this state for delivery to a person residing in another state, and if the official having responsibility for the administration of the insurance laws of such other state shall have advised the commissioner that any such policy is not subject to approval or disapproval by such official, the commissioner may by ruling require that such policy meet the standards set forth in paragraph I of this section and in RSA 415:6.

III. Nonrenewable, individual health insurance policies which provide medical, hospital, or major medical expense benefits for a specified term may be delivered or issued for delivery to any person in this state for purposes of providing short-term, interim coverage only and no such policy shall provide coverage for a specified term in excess of 6 months, nor shall any such policy be issued in this state to a person who was previously covered under short-term medical policies providing in total more than 540 days of coverage within the preceding 24-month period.


Source. 1913, 226:2. PL 281:4. RL 331:4. 1951, 207:1, par. 4. RSA 415:5. 1969, 163:2; 271:1. 1973, 72:71. 1975, 111:1. 1985, 239:1. 1995, 112:5. 1997, 344:2. 2001, 112:1. 2006, 321:2. 2007, 352:1. 2009, 54:5; 177:1; 235:1, 2. 2010, 243:8, eff. Sept. 23, 2010.

    415:6-a Insurance Contracts;  Welfare Recipients. 

No accident or health insurance policy issued, renewed or continued after August 28, 1981 shall contain any provision denying or limiting insurance benefits because services are rendered to an insured or a dependent who is eligible for or who receives medical assistance under RSA 167 or RSA 161.


Source. 1981, 502:2, eff. Aug. 28, 1981.

    415:6-a1 Coverage for Long-Term Antibiotic Therapy for Tick-Borne Illness. 

Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for long-term antibiotic therapy for tick-borne illness when determined to be medically necessary and ordered by a licensed infectious disease physician after making a thorough evaluation of the patient's symptoms, diagnostic test results or response to treatment. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer. In this section, "
long-term antibiotic therapy
" means the administration of oral, intramuscular, or intravenous antibiotics singly or in combination, for periods of time in excess of 4 weeks.


Source. 2020, 39:20, eff. June 30, 2021.

    415:6-aa 90-Day Supply of Covered Prescription Drugs. 

An insurer issuing or renewing accident and health insurance policies shall allow its insureds to purchase an up-to-90-day supply of covered prescription drugs on the covered person's health plan formulary at one time at a pharmacy of the insured's choice within the insurer's network, provided that the insured can demonstrate that such drug has been taken by the insured for a continuous period of one year and provided that such drug is not subject to the health plan's utilization management, prior authorization, or pre-certification requirements. Controlled substances as identified by the United States Drug Enforcement Administration are exempt from this section. Nothing in this section shall be construed to limit the health plan's ability to establish co-payments, coinsurance deductibles, or other member cost shares. A retail pharmacy dispensing a 90-day supply of covered prescription drugs under this section shall comply with any specified terms, conditions, and reimbursement rate which the plan may require for mail order pharmacies that fill 90-day prescriptions.


Source. 2007, 73:1. 2014, 120:1, eff. Aug. 15, 2014.

    415:6-b Coverage of Certain Psychiatric and Psychological Services. 

No accident or health insurance policy issued, renewed or continued on or after January 1, 1993, shall contain any provision denying insurance benefits for psychiatric or psychological services, including psychological examinations, solely because they are rendered to an insured or a dependent in compliance with the lawful order of any court of this state. Benefits for such services shall be at least as favorable as for other psychiatric or psychological services, including psychological examinations, and shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to terms and conditions of the policy or certificate, including any managed care provisions.


Source. 1992, 177:1, eff. Jan. 1, 1993.

    415:6-c Coverage for Nonprescription Enteral Formulas. 

I. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.

II. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.

III. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the service provided.


Source. 1996, 131:1, eff. July 20, 1996.

    415:6-d Maternity Rider. 

Upon issuing any individual health insurance policy providing hospital, medical-surgical or major medical benefits, an insurer shall offer the insured the option of including a maternity benefits rider if maternity care is not covered under the policy. Nothing in this section shall be construed to apply to supplemental health insurance and disability insurance policies.


Source. 1996, 188:19, eff. Jan. 1, 1997.

    415:6-e Coverage for Diabetes Services and Supplies. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy. Each insurer that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides for durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy.


Source. 1997, 258:1, eff. Jan. 1, 1998. 2020, 13:1, eff. Sept. 14, 2020.

    415:6-f Patients' Bill of Rights. 

Any insurer issuing an individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses under this chapter shall provide to each new policyholder who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.


Source. 1997, 331:13, eff. Aug. 22, 1997. 2022, 42:7, eff. July 2, 2022.

    415:6-g Off-Label Prescription Drugs. 

I. No insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses and providing coverage for prescription drugs shall:

(a) Exclude coverage for any such drug for a particular indication on the ground that the drug has not been approved by the Food and Drug Administration (FDA) for that indication, if such drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature; or

(b) As a condition of coverage, impose use of an alternative drug not approved by the FDA for the indication being treated, unless such alternative drug is recognized for treatment of such indication in one of the standard reference compendia or in the medical literature. An override of such condition of coverage shall be expeditiously granted consistent with RSA 420-J:7-b, II whenever the prescriber can demonstrate that the alternative drug:

(1) Has been ineffective in the treatment of the insured's medical condition in the past;

(2) Is expected to be ineffective based on the known relevant physical or mental characteristics of the insured and the known characteristics of the drug regimen;

(3) Will cause or will likely cause an adverse reaction or other physical harm to the insured; or

(4) Is not in the insured's best interest, based on medical necessity consistent with RSA 420-J:7-b, II.

II. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug.

III. Nothing in this section requires:

(a) Coverage for any drug if the FDA has determined its use to be contraindicated for the treatment of the particular indication for which the drug has been prescribed;

(b) Coverage for experimental or investigational drugs not approved for any indication by the FDA; and

(c) Reimbursement or coverage for any drug not included on the drug formulary or list of covered drugs specified in a health plan, contract, or policy.


Source. 1999, 323:2. 2014, 226:1, eff. Sept. 12, 2014.

    415:6-h Prompt Payment Required. 

I. (a) Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered by New Hampshire health care providers within 30 calendar days upon receipt of a clean non-electronic claim or 15 calendar days upon receipt of a clean electronic claim.

(b) When the insurer is denying or pending the claim, the insurer shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or certificate holder of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the insurer's receipt of the requested additional information, the insurer shall adjudicate the claim within 45 calendar days. If the required notice is not provided, the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a).

(c) Payment of a claim shall be considered to be made on the date a check was issued or electronically transferred. The insurer shall mail checks no later than 5 business days after the date a check was issued. Failure to mail a check within 5 business days shall constitute a violation subject to enforcement under RSA 415:20.

(d) The insurer's failure to comply with the time limits in this section shall not have the effect of requiring coverage for an otherwise non-covered claim. This section shall only apply to payments made on a claims basis and shall not apply to capitation or other forms of periodic payment.

II. In this section:

(a) "
Clean claim
" means a claim for payment of covered health care expenses that is submitted to an insurer on the insurer's standard claim form using the most current published procedural codes, with all the required fields completed with correct and complete information in accordance with the insurer's published filing requirements.

(b) "
Electronic claim
" means the transmission of data for purposes of payment of covered health care services in an electronic data format specified by the insurer and, if covered by the Health Insurance Portability and Accountability Act (HIPAA),
 is in such form and substance as to be in compliance with such act.

III. Any initial clean claim submission not paid within the time periods specified in subparagraph I(a) shall be deemed overdue. In that case:

(a) The insurer shall pay the health care provider or the insured person the amount of the overdue claim plus an interest payment of 1.5 percent per month beginning from the date the payment was due; and

(b) The health care provider may recover from the insurer, upon a judicial finding of bad faith, reasonable attorney's fees for advising and representing a health care provider in a successful action against an insurer for payment of the claim.

IV. Exceptions to the requirements of this section are as follows:

(a) No insurer shall be in violation of this section for a claim submitted by a health care provider if:

(1) Failure to comply is caused by a directive from a court or a federal or state agency;

(2) The insurer is in liquidation or rehabilitation or is operating in compliance with a court-ordered plan of rehabilitation; or

(3) The insurer's compliance is rendered impossible due to matters beyond the insurer's control which are not caused by such insurer.

(b) No insurer shall be in violation of this section for any claim submitted more than 90 days after the service was rendered.

(c) No insurer shall be in violation of this section while the claim is pending due to a fraud investigation that has been reported to a state or federal agency, or an internal or external review process.

V. The commissioner may assess an administrative fine against any insurer or may suspend or revoke the license or certificate of authority of any insurer after determining that the insurer has established a pattern of overdue payments and that the contemplated enforcement action would not promote the deterioration of the financial condition of an at-risk insurer. Such fine shall not exceed $300,000 per calendar year examined. Nothing in this paragraph shall be construed to alter the commissioner's authority to investigate or take action, including, but not limited to, action pursuant to RSA 415:20, in response to individual instances of noncompliance.


Source. 2000, 274:2; 314:2. 2005, 162:1. 2009, 235:3, eff. Sept. 14, 2009.

    415:6-i Retroactive Denials Prohibited;  Exceptions. 

I. In this section, "
retroactive denial of a previously paid claim
" means any attempt by an insurer to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments currently owed to the provider, withholding or setting off against future payments, or reducing or affecting the future claim payments to the provider in any other manner.

II. No insurer shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:

(a) The insurer has provided the reason for the retroactive denial in writing to the health care provider; and

(b) The time which has elapsed since the date of payment of the challenged claim does not exceed 12 months. The retroactive denial of a previously paid claim may be permitted beyond 12 months from the date of payment only for the following reasons:

(1) The claim was submitted fraudulently;

(2) The claim payment was incorrect because the health care provider or the insured was already paid for the health care services identified in the claim;

(3) The health care services identified in the claim were not delivered by the health care provider;

(4) The claim payment was for services covered by Title XVIII,
 Title XIX 
, or Title XXI 
 of the Social Security Act;

(5) The claim payment is the subject of an adjustment with a different insurer, administrator, or payor and such adjustment is not affected by a contractual relationship, association, or affiliation involving claims payment, processing, or pricing; or

(6) The claim payment is the subject of legal action.

III. An insurer shall notify a health care provider at least 15 days in advance of the imposition of any retroactive denials of previously paid claims. The health care provider shall have 6 months from the date of notification under this paragraph to determine whether the insured has other appropriate insurance, which was in effect on the date of service. Notwithstanding the contractual terms between the insurer and provider, the insurer shall allow for the submission of a claim that was previously denied by another insurer due to the insured's transfer or termination of coverage.


Source. 2002, 143:1. 2006, 104:1, eff. Aug. 7, 2006. 2018, 317:1, eff. Jan. 1, 2019.

    415:6-j Coverage for Certain Prosthetic Devices. 

I. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance who are residents of this state, coverage for the provision of benefits for prosthetic devices under the same terms and conditions that apply to other durable medical equipment covered under the policy, except as otherwise provided in this section.

II. In this section, "
prosthetic device
" means an artificial limb device to replace, in whole or in part, an arm or leg.

III. An insurer shall not impose any annual or lifetime dollar maximum on coverage for prosthetic devices other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.

IV. An insurer shall not apply amounts paid for prosthetic devices to any annual or lifetime dollar maximum applicable to other durable medical equipment covered under the policy other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.


Source. 2003, 216:2, eff. Jan. 1, 2004.

    415:6-k Individual Policy Prescription Drug Information Cards. 

I. Each insurer that issues or renews any individual policy of accident or health insurance which provides coverage for prescription drugs or devices or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to certificate holders a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued, shall include the information required under RSA 400-A:15-c, and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

(b) The certificate holder's name and identification number.

(c) All of the electronic transaction routing information required by the insurer or its benefit administrator in order for the pharmacy to electronically process a prescription claim, including but not limited to the BIN number labeled as such or the Processor Control Number labeled as such, or both.

II. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph I.

III. A new uniform prescription drug information card, as required under this section, shall be issued by an insurer upon enrollment of new members and when reissuing a new card to current members when there is a change in the certificate holder's pharmacy coverage that affects data contained on the card.


Source. 2003, 286:2, eff. Sept. 16, 2003. 2016, 111:1, eff. Jan. 1, 2017.

    415:6-l Coverage for Certified Midwives;  Individual. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing maternity benefits, shall also provide to certificate holders of such insurance, who are residents of this state, coverage consistent with the terms and conditions of the policy for services rendered by a midwife certified under RSA 326-D. Such coverage shall be subject to each insurer's standards and mechanisms for credentialing and contracting pursuant to RSA 420-J:4 and RSA 420-J:8 respectively, where applicable, and contingent upon services being provided in a licensed health care facility or at home and within the scope of practice of a certified midwife. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2006, 8:1. 2008, 298:1, eff. Aug. 27, 2008.

    415:6-m Coverage for the Cost of Testing for Bone Marrow Donation. 

I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state and who meet the criteria for testing as established by the Match Registry (the National Marrow Donor Program), coverage for laboratory fee expenses up to $150 arising from human leukocyte antigen testing, also referred to as histocompatibility locus antigen testing, for utilization in bone marrow transplantation. The testing shall be performed in a facility that is accredited by the American Association of Blood Banks or its successors, or the College of American Pathologists, or its successors, or any other national accrediting body with requirements that are substantially equivalent to or more stringent than those of the College of American Pathologists, and is licensed under the Clinical Laboratory Improvement Act of 1967, 42 U.S.C. section 263a, as amended. At the time of the new testing, the person tested shall complete and sign an informed consent form that also authorizes the results of the test to be used for participation in the National Marrow Donor Program and shall acknowledge a willingness to be a bone marrow donor if a suitable match is found.

II. In addition to paragraph I, the testing facility shall not bill, charge, collect a deposit from, seek payment or reimbursement from, or have recourse against a covered person or a person acting on behalf of the covered person for any portion of the laboratory fee expenses.


Source. 2006, 187:1. 2011, 133:5, eff. Jan. 1, 2012.

    415:6-n Coverage for Children's Early Intervention Therapy Services. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for expenses arising from the services of licensed and credentialed occupational therapists, physical therapists, speech-language pathologists, and clinical social workers working with children from birth to 36 months of age with an identified developmental disability and/or delay as specified in rules adopted pursuant to RSA 171-A:18, IV as long as the providing therapist receives a referral from the child's primary care provider if applicable. The benefits in this section shall not be subject to deductibles, copayments, or coinsurance; provided that the benefits included in this section may have a cap of $3,200 per child per year not to exceed $9,600 by the child's third birthday. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2) or a catastrophic health plan, as defined under the Patient Protection and Affordable Care Act of 2009, a carrier shall be exempt from the deductible provisions of this section and may apply a deductible to children's early intervention therapy services until an enrollee's deductible has been satisfied for the year. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 2007, 338:1, eff. Sept. 14, 2007. 2020, 26:39, eff. Sept. 18, 2020. 2021, 56:8, eff. July 24, 2021.

    415:6-o Coverage for Obesity and Morbid Obesity;  Individual. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the diseases and ailments caused by obesity and morbid obesity and treatment for such, including bariatric surgery, when the prescribing physician has issued a written order stating that treatment is medically necessary and in accordance with the patient qualifications and treatment standards set forth by the American Society for Metabolic and Bariatric Surgery or the American College of Surgeons. Such treatment standards may include, but not be limited to, pre-operative psychological screening and counseling, behavior modification, weight loss, exercise regimens, nutritional counseling, and post-operative follow-up, overview, and counseling of dietary, exercise, and lifestyle changes. The covered insured shall be at least 18 years of age. The benefits included in this section shall be subject to the terms and conditions of the policy and shall be no less extensive than coverage provided for similar conditions or illnesses.


Source. 2008, 389:1, eff. Sept. 14, 2008.

    415:6-p Coverage for Hearing Aids. 

Each insurer that issues or renews any individual policy or certificate for delivery in this state, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide coverage for the professional services associated with the practice of fitting, dispensing, servicing, or sale of hearing instruments or hearing aids. The benefits included in this section shall not be subject to any greater deductible or coinsurance or copay than any other benefits provided by the insurer. Insurers are required to cover the cost of a hearing aid for each ear, as needed, as well as related services necessary to assess, select, and fit the hearing aid with a maximum for the hearing aid and related services of no less than $1,500 per hearing aid every 60 months. The insured may choose a higher price hearing aid and pay the difference in cost. The hearing aid shall be prescribed and dispensed by a licensed audiologist or hearing instrument specialist. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall not apply to the medical assistance program, pursuant to RSA 161 and RSA 167. In this section:

I. "
Hearing care professional
" means a person who is a licensed audiologist, a licensed hearing instrument dispenser, or a licensed physician.

II. "
Hearing instrument
" or "
hearing aid
" means any instrument or device designed, intended, or offered for the purpose of improving a person's hearing and any parts, attachments, or accessories, including earmolds. Batteries, cords, and individual or group auditory training devices and any instrument or device used by a public utility in providing telephone or other communication services are excluded.

III. "
Hearing instrument dispenser
" means a person who is a hearing care professional that engages in the selling, practice of fitting, selecting, recommending, dispensing, or servicing of hearing instruments or the testing for means of hearing instrument selection or who advertises or displays a sign or represents himself or herself as a person who practices the testing, fitting, selecting, servicing, dispensing, or selling of hearing instruments.

IV. "
Practice of fitting, dispensing, servicing, or sale of hearing instruments
" means the measurement of human hearing with an audiometer, calibrated to the current American National Standard Institute standards, for the purpose of making selections, recommendations, adoptions, services, or sales of hearing instruments including the making of earmolds as a part of the hearing instrument.


Source. 2010, 362:1, eff. Jan. 1, 2011.

    415:6-q Reimbursement for Ambulance Service Providers. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance that constitutes health coverage under RSA 420-G:2, IX, and that provides benefits for medically necessary ambulance services shall reimburse the ambulance service provider directly or by a check payable to the insured and the ambulance service provider subject to the terms and conditions of the policy, plan, or contract. Nothing in this section shall preclude an insurer from negotiating with and subsequently entering into a contract with a non-participating ambulance provider that establishes rates of reimbursement for emergency medical services.


Source. 2011, 133:1, eff. Jan. 1, 2012.

    415:6-r Naturopathy Providers;  Payment for Equivalent Types of Service;  Individual. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for expenses arising from a health service performed by a doctor of naturopathic medicine licensed under RSA 328-E if that particular type of service is within the scope of practice of such doctor and if the insurer would reimburse for that type of service when performed by any other type of health care provider. Such coverage shall be subject to each insurer's standards and mechanisms for determining medical necessity, for credentialing pursuant to RSA 420-J:4, and for contracting pursuant to RSA 420-J:8. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2012, 278:1, eff. Jan. 1, 2013.

    415:6-s Repealed by 2014, 299:8, I, eff. Oct. 1, 2017. 

    415:6-t Oral Anti-Cancer Therapies. 

I. No insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for anti-cancer medications that are injected or intravenously administered by a health care provider and patient administered anti-cancer medications, including but not limited to those orally administered or self-injected, shall require a higher copayment, deductible, or coinsurance amount for patient administered anti-cancer medication than it requires for injected or intravenously administered anti-cancer medications, regardless of the formulation or benefit category determination by the policy or plan.

II. An insurer shall not comply with paragraph I by:

(a) Increasing the copayment, deductible, or coinsurance amount required for injected or intravenously administered anti-cancer medication that are covered under the policy or plan.

(b) Reclassifying benefits with respect to anti-cancer medications.

III. In this section, "
anti-cancer medication
" means drugs and biologics that are used to kill, slow, or prevent the growth of cancerous cells.

IV. If the cost-sharing requirements for orally administered anti-cancer medications do not exceed $200 per prescription fill, the health plan shall be deemed in compliance with this section.

V. For a health care contract that meets the definition of a "
high deductible plan
" set forth in 26 U.S.C. section 223(c) (2), a carrier shall be exempt from the provisions of paragraphs I-IV until an enrollee's deductible has been satisfied for the year.

VI. This section shall apply only to oral anti-cancer medications where an intravenously administered or injected anti-cancer medication is not medically appropriate.

VII. This section shall not apply to policies which are solely to replace income or pay a predetermined fixed amount based on the occurrence of a specified medical or health event.


Source. 2015, 263:6, eff. Jan. 1, 2017.

    415:6-u Coverage for Early Refills of Prescription Eye Drops. 

I. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for one early refill of a prescription for eye drops if the following criteria are met:

(a) For prescription eye drops dispensed as a 30-day supply, the enrollee requests the refill no earlier than 21 days after the later of the following dates:

(1) The date the original prescription was dispensed to the enrollee; or

(2) The date that the most recent refill of the prescription was dispensed to the enrollee;

(b) For prescription eye drops dispensed as a 90-day supply, the enrollee requests the refill no earlier than 63 days after the later of the following dates:

(1) The date the original prescription was dispensed to the enrollee; or

(2) The date that the most recent refill of the prescription was dispensed to the enrollee;

(c) The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized;

(d) The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription;

(e) The prescription has not been refilled more than once during the 30-day or 90-day period prior to the request for an early refill; and

(f) The prescription eye drops are a covered benefit under the enrollee's health plan.

II. Benefits provided under this section shall not be subject to any greater copayment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2016, 326:1, eff. Aug. 23, 2016.

    415:6-v Coverage for Blood Lead Testing. 

Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for the costs of blood lead testing conducted pursuant to RSA 130-A:5-a. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2018, 4:11, eff. Feb. 8, 2018.

    415:6-w Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. 

Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "
Outpatient contraceptive services
" means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which have been approved by the U.S. Food and Drug Administration. Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses shall cover all prescription contraceptive drugs and contraceptive devices approved by the U.S. Food and Drug Administration. Coverage shall include contraceptives dispensed in a quantity intended to last for a 12-month period if prescribed in that quantity. An insurer shall not impose utilization review requirements or other limitations to control the prescribing or dispensing of contraceptives to an amount that is less than a 12-month supply, if that quantity is prescribed. An insurer shall not be required to cover more than one 12-month contraceptive prescription in a single dispensing per plan year. A deductible, copayment, coinsurance, or other cost-sharing requirement shall not be imposed on the coverage of prescription contraceptive drugs and contraceptive devices approved by the FDA under this section. Notwithstanding any other provision of law, if there is a therapeutic equivalent of a drug or device for an FDA-approved contraceptive method, an insurer may impose cost-sharing requirements as long as at least one drug or device for that method is available without cost-sharing; provided that if an individual's provider recommends a particular FDA-approved contraceptive drug or device based on a medical determination, the insurer shall provide coverage for the prescribed contraceptive drug or device without cost-sharing. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 2018, 205:7, eff. Jan. 1, 2019; 361:8, eff. Jan. 1, 2019 at 12:01 a.m.

    415:6-x Coverage for Medically Necessary Dental Services. 

Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for medically necessary dental services resulting from an accidental injury to sound natural teeth and gums when the course of treatment for the accidental injury is received or authorized within 3 months of the date of the injury. Treatment made necessary due to injury to the jaw and oral structures other than teeth shall be covered without time limit. Coverage under this section shall be subject to such other terms and conditions of the policy that may apply.


Source. 2019, 113:1, eff. Aug. 20, 2019.

    415:6-y Coverage for Perfluoroalkyls (PFAS) and Perfluorinated Compound (PFC) Blood Testing. 

Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for perfluoroalkyls (PFAS) and perfluorinated compound (PFC) blood testing. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2020, 30:9, eff. Sept. 21, 2020.

    415:6-z Coverage for Epinephrine Auto-Injectors. 

Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance, who are residents of this state, coverage for the cost of epinephrine auto-injectors. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer and shall be subject to the terms and conditions of the policy. In this section, "
epinephrine auto-injector
" means a single-use device used for the automatic injection of a pre-measured dosage of epinephrine into the human body.


Source. 2020, 13:9, eff. Jan. 1, 2021.

    415:6 Accident and Sickness Policy Provisions. 

I. 
Required Provisions. Except as provided in paragraph III of this section each such policy delivered or issued for delivery to any person in this state shall contain the provisions specified in this paragraph in the words in which the same appear in this section; provided, however, that the insurer may, at its option, substitute for one or more of such provisions corresponding provisions of different wording approved by the commissioner which are in each instance not less favorable in any respect to the insured or the beneficiary. Such provisions shall be preceded individually by the caption appearing in this paragraph or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the commissioner may approve.

(1) A provision as follows: Entire Contract; Changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions.

(2) A provision as follows: Time Limit on Certain Defenses:

(a) After 2 years from the date of issue of this policy no misstatements, except fraudulent misstatements, made by the applicant in the application for such policy shall be used to void the policy or to deny a claim for loss incurred or disability (as defined in the policy) commencing after the expiration of such 2-year period.

(The foregoing policy provision shall not be so construed as to affect any legal requirement for avoidance of a policy or denial of a claim during such initial 2-year period, nor to limit the application of RSA 415:6, II(1)-(5) in the event of misstatement with respect to age or occupation or other insurance.)

(A policy which the insured has the right to continue in force subject to its terms by the timely payment of premium (1) until at least age 50 or, (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue, may contain in lieu of the foregoing the following provision (from which the clause in parentheses may be omitted at the insurer's option) under the caption "Incontestable": After this policy has been in force for a period of 2 years during the lifetime of the insured (excluding any period during which the insured is disabled), it shall become incontestable as to the statements contained in the application.) 

(b) No claim for loss incurred or disability (as defined in the policy) commencing after 2 years from the date of issue of this policy shall be reduced or denied on the ground that a disease or physical condition not excluded from coverage by name or specific description effective on the date of loss had existed prior to the effective date of coverage of this policy.

(3) A provision as follows: Grace Period: A grace period of 
__________ (insert a number not less than "7" for weekly premium policies, "10" for monthly premium policies and "31" for all other policies) days will be granted for the payment of each premium falling due after the first premium, during which grace period the policy shall continue in force.

(A policy which contains a cancellation provision may add at the end of the above provision,

subject to the right of the insurer to cancel in accordance with the cancellation provision hereof.

A policy in which the insurer reserves the right to refuse any renewal shall have, at the beginning of the above provision,

Unless not less than 5 days prior to the premium due date the insurer has delivered to the insured or has mailed to his last address as shown by the records of the insurer written notice of its intention not to renew this policy beyond the period for which the premium has been accepted,).

(4) A provision as follows: Reinstatement: If any renewal premium is not paid within the time granted the insured for payment, a subsequent acceptance of premium by the insurer or by any agent duly authorized by the insurer to accept such premium, without requiring in connection therewith an application for reinstatement, shall reinstate the policy; provided, however, that if the insurer or such agent requires an application for reinstatement and issues a conditional receipt for the premium tendered, the policy will be reinstated upon approval of such application by the insurer or, lacking such approval, upon the forty-fifth day following the date of such conditional receipt unless the insurer has previously notified the insured in writing of its disapproval of such application. The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained on or after the date of reinstatement and loss due to such sickness as may begin on or after the date of reinstatement. In all other respects the insured and insurer shall have the same rights thereunder as they had under the policy immediately before the due date of the defaulted premium, subject to any provisions endorsed hereon or attached hereto in connection with the reinstatement. Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than 60 days prior to the date of reinstatement.

(The last sentence of the above provision may be omitted from any policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (1) until at least age 50 or, (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue.)

(4-a) With respect to policies subject to RSA 420-G, a provision as follows: Reinstatement: If any renewal premium is not paid within the time granted the insured for payment, a subsequent payment of the premium to the insurer or to any agent duly authorized by the insurer to receive such premium, without requiring in connection therewith an application for reinstatement, shall reinstate the policy; provided, however, that if the insurer or such agent requires an application for reinstatement and issues a receipt for the premium tendered, the policy will be reinstated upon receipt of such application by the insurer or such agent. The reinstated policy shall cover only loss resulting from such accidental injury as may be sustained on or after the date of reinstatement and loss due to sickness as may begin on or after the date of reinstatement. In all other respects the insured and insurer shall have the same rights thereunder as they had under the policy immediately before the due date of the defaulted premium. Any premium accepted in connection with a reinstatement shall be applied to a period for which premium has not been previously paid, but not to any period more than 60 days prior to the date of reinstatement.

(The last sentence of the above provision may be omitted from any policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (1) until at least age 50 or, (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue.)

(5) A provision as follows: Notice of Claim: Written notice of claim must be given to the insurer within 20 days after the occurrence or commencement of any loss covered by the policy, or as soon thereafter as is reasonably possible. Notice given by or on behalf of the insured or the beneficiary to the insurer at 
__________ (insert the location of such office as the insurer may designate for the purpose), or to any authorized agent of the insurer, with information sufficient to identify the insured, shall be deemed notice to the insurer.

(In a policy providing a loss-of-time benefit which may be payable for at least 2 years, an insurer may at its option insert the following between the first and second sentences of the above provision: Subject to the qualifications set forth below, if the insured suffers loss of time on account of disability for which indemnity may be payable for at least 2 years, he shall, at least once in every 6 months after having given notice of claim, give to the insurer notice of continuance of said disability, except in the event of legal incapacity. The period of 6 months following any filing of proof by the insured or any payment by the insurer on account of such claim or any denial of liability in whole or in part by the insurer shall be excluded in applying this provision. Delay in the giving of such notice shall not impair the insured's right to any indemnity which would otherwise have accrued during the period of 6 months preceding the date on which such notice is actually given.)

(6) A provision as follows: Claim Forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within 15 days after the giving of such notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made.

(7) A provision as follows: Proofs of Loss: Written proof of loss must be furnished to the insurer at its office in case of claim for loss for which this policy provides any periodic payment contingent upon continuing loss within 90 days after the termination of the period for which the insurer is liable and in case of claim for any other loss within one year after the date of such loss in the case of a Medicare supplement insurance policy and within 90 days after the date of such loss in the case of any other accident and health insurance policy. Failure to furnish such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible and in no event, except in the absence of legal capacity, later than one year from the time proof is otherwise required.

(8) A provision as follows: Time of Payment of Claims: Indemnities payable under this policy for any loss other than loss for which this policy provides any periodic payment will be paid immediately upon receipt of due written proof of such loss. Subject to due written proof of loss, all accrued indemnities for loss for which this policy provides periodic payment will be paid 
___ (insert period for payment which must not be less frequently than monthly) and any balance remaining unpaid upon the termination of liability will be paid immediately upon receipt of due written proof.

(9) A provision as follows: Payment of Claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation and the provisions respecting such payment which may be prescribed herein and effective at the time of payment. If no such designation or provision is then effective, such indemnity shall be payable to the estate of the insured. Any other accrued indemnities unpaid at the insured's death may, at the option of the insurer, be paid either to such beneficiary or to such estate. All other indemnities will be payable to the insured.

(The following provisions, or either of them, may be included with the foregoing provision at the option of the insurer:

If any indemnity of this policy shall be payable to the estate of the insured, or to an insured or beneficiary who is a minor or otherwise not competent to give a valid release, the insurer may pay such indemnity, up to an amount not exceeding $ 
___ (insert an amount which shall not exceed $1000), to any relative by blood or connection by marriage of the insured or beneficiary who is deemed by the insurer to be equitably entitled thereto. Any payment made by the insurer in good faith pursuant to this provision shall fully discharge the insurer to the extent of such payment.

Subject to any written direction of the insured in the application or otherwise all or a portion of any indemnities provided by this policy on account of hospital, nursing, medical, or surgical services may, at the insurer's option and unless the insured requests otherwise in writing not later than the time of filing proofs of such loss, be paid directly to the hospital or person rendering such services; but it is not required that the service be rendered by a particular hospital or person.)

(10) A provision as follows: Physical Examinations and Autopsy: The insurer at its own expense shall have the right and opportunity to examine the person of the insured when and as often as it may reasonably require during the pendency of a claim hereunder and to make an autopsy in case of death where it is not forbidden by law.

(11) A provision as follows: Legal Actions: No action at law or in equity shall be brought to recover on this policy prior to the expiration of 60 days after written proof of loss has been furnished in accordance with the requirements of this policy. No such action shall be brought after the expiration of 3 years after the time written proof of loss is required to be furnished.

(12) A provision as follows: Change of Beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change of beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy.

(The first clause of this provision, relating to the irrevocable designation of beneficiary, may be omitted at the insurer's option.)

(13) A provision as follows: Loss of Time Benefits: If loss of time benefits payable to the insured are reduced by reason of benefits payable to the insured under the federal Social Security Act,
 such benefits shall not be further reduced by reason of any increase in benefits payable under the federal Social Security Act which takes effect after the first month that benefits are payable for a period of disability; except that if benefits under the policy are provided on a specified dollar amount basis, then such benefits shall not be further reduced by reason of any increase in benefits payable under the federal Social Security Act which takes effect after the effective date of the policy.

(14) Refund upon cancellation: After the policy has been continued beyond its original term, the insured may cancel the policy at any time by written notice, delivered or mailed to the insurer or the insurer's representative. Such cancellation shall become effective upon receipt by the insurer or the insurer's representative, or on such later date as may be specified in such notice by the insured. If the insured cancels, the insurer shall promptly return any unearned portion of the premium paid, but in any event shall return the unearned portion of the premium within 30 days. The earned premium shall be computed on a pro-rata basis. Cancellation shall be without prejudice to any claim originating prior to the effective date of the cancellation.

(15) A provision as follows: Pre-certification: In the event that a person is covered by more than one plan that requires pre-certification, the member shall obtain pre-certification from the primary plan. Although the member shall not be required to obtain pre-certification from the secondary plan, the secondary plan shall not be required to treat such services as covered services if the services do not meet its certification criteria. The secondary plan shall not refuse payment for such services solely on the basis that the services were not pre-certified by the secondary plan.

II. 
Other Provisions. Except as provided in paragraph III of this section, no such policy delivered or issued for delivery to any person in this state shall contain provisions respecting the matters set forth below unless such provisions are in the words in which the same appear in this section; provided, however, that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the commissioner which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption appearing in this paragraph or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the commissioner may approve.

(1) A provision as follows: Change of Occupation: If the insured be injured or contract sickness after having changed his occupation to one classified by the insurer as more hazardous than that stated in this policy or while doing for compensation anything pertaining to an occupation so classified, the insurer will pay only such portion of the indemnities provided in this policy as the premium paid would have purchased at the rates and within the limits fixed by the insurer for such more hazardous occupation. If the insured changes his occupation to one classified by the insurer as less hazardous than that stated in this policy, the insurer, upon receipt of proof of such change of occupation, will reduce the premium rate accordingly, and will return the excess pro-rata unearned premium from the date of change of occupation or from the policy anniversary date immediately preceding receipt of such proof, whichever is the more recent. In applying this provision, the classification of occupational risk and the premium rates shall be such as have been last filed by the insurer prior to the occurrence of the loss for which the insurer is liable or prior to date of proof of change in occupation with the state official having supervision of insurance in the state where the insured resided at the time this policy was issued; but if such filing was not required, then the classification of occupational risk and the premium rates shall be those last made effective by the insurer in such state prior to the occurrence of the loss or prior to the date of proof of change in occupation.

(2) A provision as follows: Misstatement of Age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age.

(3) A provision as follows: Other Insurance in This Insurer: If an accident or sickness or accident and sickness policy or policies previously issued by the insurer to the insured be in force concurrently herewith, making the aggregate indemnity for 
___(insert type of coverage or coverages) in excess of $ 
___ (insert maximum limit of indemnity or indemnities) the excess insurance shall be void and all premiums paid for such excess shall be returned to the insured or to his estate.

or, in lieu thereof:

Insurance effective at any one time on the insured under a like policy or policies in this insurer is limited to the one such policy elected by the insured, his beneficiary or his estate, as the case may be, and the insurer will return all premiums paid for all other such policies.

(4) A provision in all nongroup policies as follows: Insurance with Other Insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on a provision of service basis or an expense incurred basis, payment shall not be prorated or reduced. If such a case, the insured shall be entitled to payment from both insurers. Provided, however, that the provisions of this subparagraph shall not prohibit the issuance of a "benefits deductible" on policies determined by the insurance commissioner as major medical policies. The term "benefits deductible", as used herein, means the value of any benefits provided on an expense incurred basis which are provided with respect to covered medical expenses by any other hospital, surgical or medical insurance policy or hospital or medical service subscriber contract or medical practice or other prepayment plan, or any other plan or program whether on an insured or uninsured basis. Provided, however, that the term "benefits deductible" shall not mean the value of benefits provided with respect to medical or liability insurance offered under either a general liability insurance policy or an auto insurance policy.

(5) A provision in all non-group policies as follows: Insurance with Other Insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on other than an expense incurred basis, payment shall not be prorated or reduced. In such a case, the insured shall be entitled to payment from both insurers.

(6) A provision as follows: Relation of Earnings to Insurance: If the total monthly amount of loss time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or his average monthly earnings for the period of 2 years immediately preceding a disability for which claim is made, whichever is the greater, the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such 2 years as shall exceed the pro-rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of $200 or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time.

(The foregoing policy provision may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (1) until at least age 50 or, (2) in the case of a policy issued after age 44, for at least 5 years from its date of issue. The insurer may, at its option, include in this provision a definition of "valid loss of time coverage," approved as to form by the commissioner, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the commissioner or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute (including any workers' compensation or employer's liability statute), or benefits provided by union welfare plans or by employer or employee benefit organizations.

(7) A provision as follows: Unpaid Premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom.

(8) A provision as follows: Cancellation; Refusal to Renew: The insurer may refuse to renew on the policy anniversary date, or may cancel this policy at any time by written notice delivered to the insured, or mailed to the insured's last address as shown by the records of the insurer, stating when, not less than 30 days thereafter, such cancellation or refusal to renew shall be effective. If the insurer cancels, the earned premium shall be computed pro-rata. Cancellation or refusal to renew shall be without prejudice to any claim originating prior to the effective date of the cancellation or refusal to renew. However, such cancellation or refusal to renew, if for reasons other than nonpayment of premium and other than specified in any time limits for certain defenses, shall be effected only if also effected on all policyholders of the same class. No such action shall be taken without prior written approval of the insurance commissioner. The insurer shall have the burden of proof that the classification of risk involved therein is reasonable and nondiscriminatory, pursuant to RSA 415:15.

(9) A provision as follows: Conformity with State Statutes: Any provision of this policy which, on its effective date, is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes.

III. 
Inapplicable or Inconsistent Provisions. If any provision of this section is in whole or in part inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the commissioner, shall omit from such policy any inapplicable provision or part of a provision, and shall modify any inconsistent provision or part of the provision in such manner as to make the provision as contained in the policy consistent with the coverage provided by the policy.

IV. 
Order of Certain Policy Provisions. The provisions which are the subject of paragraphs I and II of this section, or any corresponding provisions which are used in lieu thereof in accordance with such paragraphs shall be printed in the consecutive order of the provisions in such paragraphs or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse, or likely to mislead a person to whom the policy is offered, delivered or issued.

V. 
Third Party Ownership. The word "insured," as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits and rights provided therein.

VI. 
Requirements of Other Jurisdictions.

(1) Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state under which the insurer is organized.

(2) Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country.

VII. 
Filing Procedure. The commissioner may make such reasonable rules and regulations concerning the procedure for the filing or submission of policies subject to this chapter as are necessary, proper or advisable to the administration of this chapter. This provision shall not abridge any other authority granted the commissioner by law.


Source. 1913, 226:3. PL 281:5, 8. RL 331:5, 8. 1951, 207:1, par. 5. RSA 415:6. 1971, 553:1. 1973, 471:1, 2. 1975, 333:1; 494:2, 3. 1983, 474:1. 1990, 194:1. 1993, 167:1, 2. 1995, 112:6-8. 2007, 289:1, eff. Jan. 1, 2008.

    415:7 Conforming to Statute. 

I. 
Other Policy Provisions. No policy provision which is not subject to RSA 415:6 shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter.

II. 
Policy Conflicting With This Chapter. A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter.


Source. 1913, 226:5, 9. PL 281:13, 19. RL 331:13, 19. 1951, 207:1, par. 6, eff. July 1, 1951.

    415:8 Exceptions. 

A policy, rider or endorsement, which could have been lawfully used or delivered or issued for delivery to any person in this state immediately before July 1, 1951, may be used or delivered or issued for delivery to any such person during 5 years after July 1, 1951, without being subject to the provisions of RSA 415:5-415:7, 415:13, 415:14 and 415:16.


Source. 1951, 207:5, eff. July 1, 1951.

    415:9 Falsity in Application. 

The falsity of any statement in the application for any policy covered by this chapter shall not bar the right to recovery thereunder, unless such false statement was made with actual intent to deceive, or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer.


Source. 1913, 226:6. PL 281:15. RL 331:15.

    416-A:1 Short Title. 

This chapter shall be known and may be cited as "The Title Insurance Code".


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:10 Amount of Unearned Premium Reserve, Release. 

I. The unearned premium reserve of every title insurance company required to maintain such reserves in this state shall consist of:

(a) The amount of the unearned premium reserve held as of September 10, 1971, pursuant to law; and

(b) The amount of all additions required to be made to such reserve by this section, less the withdrawals therefrom as permitted by this section.

II. Every title insurance company shall add to its unearned premium reserve in respect to each title insurance policy, leasehold policy, contract, or reinsurance agreement issued by it, a sum equal to $1 for each such policy, contract, or agreement, plus $.15 for each $1,000 face amount of net retained liability on each such policy, contract, or reinsurance agreement, as defined in RSA 416-A:2, X, or the amount reinsured by it, and shall separately record the aggregate amounts so set aside and reserved in respect to such policies, contracts, or agreements written in each calendar year.

III. The amounts set aside as additions to the unearned premium reserve shall be deducted from income in determining net profits of any title insurance company.

IV. For the purposes of determining the amounts of the unearned premium reserve that may be withdrawn pursuant to paragraph V of this section, all policies, contracts of title insurance, or reinsurance agreements of title insurance shall be considered as dated July 1 in the year of issue.

V. The aggregate of the amounts set aside in unearned premium reserve in any calendar year pursuant to paragraph II of this section shall be released from said reserve and restored to income pursuant to the following formula: 
1/10 of said aggregate sum on July 1 of each of the 5 years next succeeding the year of addition to the reserve and 
1/30 of said aggregate sum on July 1 of each succeeding year thereafter until the entire sum shall have been so released and restored to income.

VI. The entire amount of the unearned premium reserve held as of September 10, 1971 pursuant to law shall be presumed to have been added to the reserve in the calendar year next preceding September 10, 1971 and shall be released from said reserve and restored to income under the formula set forth in paragraph V of this section.

VII. If substantially the entire outstanding liability under all policies, contracts of title insurance, and reinsurance agreements of any such title insurance company shall be reinsured, the value of the consideration received by a reinsuring title insurance company authorized to transact the business of title insurance in this state, shall constitute in its entirety, unearned portions of original premiums and shall be added to its unearned premium reserve, and shall be deemed, for recovery purposes, to have been provided for liabilities assumed during the year of such reinsurance. The amount of such addition to the unearned premium reserve of such assuming title insurance company shall be not less than 
2/3 of the amount of the unearned premium reserve required to be maintained by the ceding title insurance company at the time of such reinsurance.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:11 Reserve for Unpaid Losses and Loss Expense. 

I. Each title insurance company, in addition to other reserves, shall at all times establish and maintain reserves against unpaid losses, and against loss expense, and shall calculate such reserves by making a careful estimate in each case of the loss and loss expense likely to be incurred, by reason of every claim presented, pursuant to notice from or on behalf of the policyholder, of a title defect in or lien or adverse claim against the title insured, that may result in a loss or cause expense to be incurred for the proper disposition of the claim. The sums of the items so estimated shall be the total amounts of the reserves against unpaid losses and loss expenses of such title insurance company.

II. The amounts so estimated may be revised from time to time as circumstances warrant, but shall be redetermined at least once each year.

III. The amounts set aside in such reserves in any year shall be deducted in determining the net profits for such year of any title insurance company.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:12 Net Retained Liability. 

The net retained liability of any title insurance company under any single insurance risk as defined in RSA 416-A:2, IX and X, shall not exceed 50 percent of the net amount remaining after deducting from the sum of its capital, surplus, unearned premium reserve, and voluntary reserves, the value, if any, assigned in such summation to its title plant, all as shown in its most recent report on file with the commissioner. The same limitation shall apply to any secondary risk assumed by means of reinsurance or to any policy of excess coinsurance except, whenever the primary retained liability of a ceding company shall equal or exceed 10 percent of the single insurance risk liability, the net retained or assumed liability limit of this section may be increased by an additional $250,000, but in no event above 100 percent of the net amount remaining after deducting from the sum of its capital and surplus, the value, if any, assigned in such summation to its title plant, all as shown by its most recent report on file with the commissioner. Nothing in this section is intended to limit the amount of a single insurance risk, as defined in RSA 416-A:2, IX that may be written by a title insurance company; but it shall cede to one or more other title reinsurers on or before the effective date of such writing, such portion or portions of the said risk as shall be sufficient to bring its net retained liability thereunder within the limits prescribed in this section; and each such cession of risk shall be within the limits of this section as applied to the sum of the capital, surplus, unearned premium reserve, and voluntary reserves, less the value, if any, assigned in such summation to the title plants of the reinsuring company, as shown by its most recent report on file with the supervisory agency in the state of its domicile.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:13 Power to Reinsure. 

Any title insurance company may cede reinsurance of all or any part of its liability under one or more of its policies, contracts, or reinsurance agreements of title insurance to any reinsurer which meets or exceeds the financial requirements of a title insurance company to do business in this state and is authorized to engage in the business of reinsurance of title insurance in this or any other state; but, no larger amount of reinsurance shall be ceded to any reinsurer on a single policy or contract of title insurance, or on any single insurance risk as defined in RSA 416-A:2, IX, than such reinsurer would be permitted to retain if authorized to engage in the business of title insurance in this state. Any title insurance company may also reinsure policies of title insurance issued by other insurance companies on risks located in this state or elsewhere. Any domestic title insurance company or any foreign or alien title insurance company authorized to do business in this state shall pay to this state taxes required on all business taxable within this state and reinsured, as provided in this section, with any foreign or alien company not authorized to do business within this state. Issuance of contracts of reinsurance by a reinsurer not authorized to engage in the business of title insurance in this state, but authorized to engage in the business of title insurance or in the business of reinsurance of title insurance in any of the United States, which contracts reinsure policies of title insurance issued by a title insurance company authorized to engage in the business of title insurance in this state on real property located in this state, shall not of itself constitute the doing of business in this state by such reinsurer.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:14 Legal Investments. 

Title insurance companies shall comply with the investment requirements for other insurance companies, under the laws of this state, but, in addition, may invest in a title plant. Such title plant shall be considered an asset at the fair value thereof. In determining the fair value of a title plant, no value shall be attributed to furniture and fixtures. The real estate in which the title plant is housed shall be considered an investment. The value of title abstracts, title briefs, copies of conveyances or other documents, indices, and other records comprising the title plant shall be determined by considering the expenses incurred in obtaining them, the age thereof, the cost of replacements less depreciation, and all other relevant factors. Once the value of a title plant shall have been so determined, such value may be increased only by the acquisition of another title plant by purchase, consolidation, or merger. In no event shall the value of the title plant be increased by additions made thereto as part of the normal course of abstracting and insuring titles to real estate. Subject to the limitations of this section and with the approval of the commissioner, a title insurance company may enter into agreements with one or more other title insurance companies authorized to do business in this state whereby such companies shall participate in the ownership, management, and control of a title plant to serve the needs of all such companies, or such companies may hold stock of a corporation owning and operating a title plant for such purposes.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:15 Title Insurance Agent's License. 

I. Title insurance agents shall be licensed in the manner provided for agents of insurance companies by RSA 402-J, except as provided in subparagraphs (a) and (b).

(a) Nothing in this chapter shall be construed to require the licensing of an attorney at law in good standing and admitted to practice before the supreme court of New Hampshire for the purpose of an examination of title and report of title thereon to a title insurance company upon which such title insurance company may issue a policy of title insurance.

(b) Nothing in this chapter shall be construed to require the licensing of a law firm acting as agent of a title insurance company; provided that any sale, solicitation, or negotiation of a contract of title insurance is conducted by a duly licensed title insurance agent.

II. Employees of a corporate contractual agent of a title insurance company, authorized by such company, or such contractual agent, to issue or countersign binders or policies in behalf of such title insurance company shall be licensed.

III. The commissioner of insurance may require such examination of applicants for producer licenses as title insurance agents as he or she shall consider necessary to carry out the purposes of this chapter.


Source. 1971, 561:1. 2000, 315:19, 20. 2001, 95:13. 2009, 38:2, eff. July 14, 2009.

    416-A:16 Title Insurance Agents;  Certain Names Prohibited. 

No agent for a title insurance company shall adopt a firm name containing the words "title insurance", "title guaranty", or "title guarantee", unless such words are followed by the words "agent" or "agency". The words "agent" or "agency" must be in the same size and type as the words preceding them. This section shall not apply to any title insurance company acting as agent for another title insurance company.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:17-a Filing of Forms. 

Every insurer and advisory organization shall file policy forms, endorsements, and other contract language covered by this chapter within 30 days of the effective date.


Source. 2004, 156:7. 2005, 248:8, eff. Sept. 12, 2005.

    416-A:17 Rates and Rating Organizations. 

I. Title insurance rates and rating organizations should be regulated in the manner provided by RSA 412:13 through RSA 412:16, and RSA 412:20 through RSA 412:25, except as otherwise provided in this section.

II. Every title insurance company shall file with the commissioner its schedule of fees or premium rates, every manual of classifications, rules and plans pertaining thereto, and every modification of any of the foregoing which it proposes to use in this state. In every such filing, the company shall set forth that portion of the fee which is designated as premium as herein defined.


Source. 1971, 561:1. 2003, 150:13. 2004, 156:5, eff. July 23, 2004.

    416-A:18 Laws Applicable. 

I. In addition to the provisions of RSA 416-A, the laws governing insurance companies, except as they are inconsistent with the provisions of RSA 416-A shall apply to the business of title insurance and to title insurance companies.

II. The provisions of RSA 400-A:32 shall be applicable to title insurers.


Source. 1971, 561:1. 2010, 13:5, eff. July 1, 2010.

    416-A:19 Fees. 

The commissioner of insurance shall collect whatever fees he may establish by rule or regulation, provided however, said fees bear a reasonable relationship to the cost of administering the provisions of this chapter.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:2 Definitions. 

As used in this chapter, unless the context otherwise requires:

I. "Title insurance" means insuring, guaranteeing, or indemnifying owners of real property or others interested therein against loss or damage suffered by reason of liens, encumbrances upon, defects in, or the unmarketability of the title to said property.

II. The "business of title insurance" means the making or proposing to make, as insurer, guarantor, or surety, or any contract or policy of title insurance; or the transacting or proposing to transact, as insurer, guarantor, or surety, any phase of title insurance, including solicitation, negotiation preliminary to execution, execution of a contract of title insurance, and transacting matters subsequent to the execution of the contract and arising out of it, including reinsurance.

III. "Title insurance company" means any domestic company organized under the provisions of this chapter for the purpose of insuring titles to real property; any title insurance company organized under the laws of another state or foreign nation and licensed to insure titles to real estate within this state; and any domestic, foreign, or alien company having the power and authorized to insure titles to real estate within this state and which meets the requirements of this chapter.

IV. "Applicants for insurance" shall be deemed to include all those whether or not a prospective insured, who from time to time apply to a title insurance company, or to its agent, for title insurance, and who at the time of such application are not agents for a title insurance company.

V. "Premium" for title insurance is the amount charged by a title insurance company, agent for a title insurance company, or either of them, to an insured or an applicant for insurance for the assumption by the title insurance company of the risk created by the issuance of the title insurance policy.

VI. "Fee" for title insurance means and includes the premium, abstracting, and/or searching charge, examination charge, and every other charge, exclusive of settlement, closing or escrow charges, whether denominated premium or otherwise, made by a title insurance company, agent of a title insurance company, to an insured or to an applicant for insurance, for any policy or contract for the issuance of title insurance, but the term "fee" shall not include any charges paid to and retained by an attorney at law or abstracter acting as an independent contractor whether or not he is acting as an agent of a title insurance company or an approved attorney, or any charges made for special services not constituting title insurance, even though performed in connection with a title insurance policy or contract.

VII. "Title insurance agent" means a person authorized by a title insurance company to solicit insurance or to collect premiums, or to issue or countersign policies in its behalf.

VIII. "Approved attorney" means an attorney at law, who is not an employee of a title insurance company or of a title insurance agent, upon whose examination of title and report thereon a title insurance company may issue a policy of title insurance.

IX. "Single insurance risk" means the insured amount of any policy or contract of title insurance issued by a title insurance company unless 2 or more policies or contracts are simultaneously issued on different estates in identical real property, in which event, it means the sum of the insured amounts of all such policies or contracts. Any such policy or contract that insures a mortgage interest that is excepted in a fee or leasehold policy or contract, and which does not exceed the insured amount of such fee or leasehold policy or contract, shall be excluded in computing the amount of a single insurance risk.

X. "Net retained liability" means the total liability retained by a title insurance company under any policy or contract for insurance, or under a single insurance risk as defined in or computed in accordance with paragraph IX of this section, after the purchase of reinsurance.

XI. "Foreign title insurance company" means a title insurance company organized under the laws of any other state of the United States.

XII. "Alien title insurance company" means any title insurance company incorporated or organized under the laws of any foreign nation, or of any province or territory thereof, not included under the definition of foreign title insurance company.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:20 Examination, Exception. 

The commissioner shall waive the requirement of such examination in the following cases:

I. Nonresident applicants who are licensed as title insurance agents in the states in which they reside, or if no license is required in said states, then nonresident applicants who have engaged in the business of title insurance for a period of 6 months;

II. Residents of the state who (a) have been engaged in the business of title insurance prior to September 10, 1971 or (b) prove to the commissioner that they have passed a course on insurance conducted by an insurance company or an educational institution which course the commissioner has approved;

III. Attorneys at law.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:21 Rules and Regulations. 

The commissioner may make reasonable rules and regulations necessary to effect the purposes of this chapter.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:22 Applicability. 

The provisions of this chapter shall apply to all title insurance companies, title insurance rating organizations, title insurance agents, applicants for title insurance, policyholders, and to all persons and business entities deemed to be engaged in the business of title insurance.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:3 Compliance Required. 

No company shall underwrite or issue a policy of title insurance or otherwise engage in the business of title insurance in this state unless authorized by the provisions of RSA 416-A to transact such a business.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:4 Corporate Form Required. 

Any domestic title insurance company hereafter formed shall be organized as a stock corporation.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:5 Financial Requirements. 

Every title insurance company shall have a minimum capital, which shall be paid in and maintained, of not less than $200,000 and, in addition, paid-in surplus of at least $100,000.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:6 Determination of Insurability Required. 

No policy or contract of title insurance shall be written unless and until the title insurance company has caused to be conducted a reasonable examination of the title and has caused to be made a determination of insurability of title in accordance with sound underwriting practices for title insurance companies. Evidence thereof shall be preserved and retained in the files of the title insurance company or its agent or its approved attorney for a period of not less than 20 years after the policy or contract of title insurance has been issued. In lieu of retaining the original copy, the title insurance company or the agent of the title insurance company, may in the regular course of business, establish a system whereby all or part of these writings are recorded, copied, or reproduced by any photographic, photostatic, microfilm, microcard, miniature photographic, or other process which accurately reproduces or forms a durable medium for reproducing the original. This section shall not apply to either a company assuming no primary liability in a contract of reinsurance, or a company acting as a coinsurer if one of the other coinsuring companies has complied with this section.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:7 Powers. 

Every title insurance company shall have the following powers:

I. To do the business defined in RSA 416-A:2, II of this chapter.

II. To own, manage, and maintain sets of abstract books and, subject to the provisions of this chapter, make, compile, and sell abstracts of title to real estate.

III. To acquire by purchase or otherwise, and to hold, sell, mortgage, or otherwise dispose of real estate and personal property, or any interest therein, either within or without the state and to loan or borrow money upon such real estate or personal property.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416-A:8-a Compensation by Title Insurance Company. 

Nothing in this chapter, or in any other provision of law governing the insurance industry, shall be construed to prohibit:

I. Compensation by a title insurance company of an attorney who is licensed to practice for services actually rendered in connection with a real estate transaction, regardless of whether such attorney represents a client in such real estate transaction.

II. Payment to any person of a bona fide salary or compensation for payment of goods and facilities actually furnished or for services actually rendered.


Source. 2006, 196:10, eff. July 30, 2006.

    416-A:8 Prohibitions. 

I. A title insurance company shall not:

(a) Engage in the business of guaranteeing the payment of the principal or the interest of bonds, notes, or other obligations.

(b) Transact, underwrite, or issue any kind of insurance other than title insurance.

II. A title insurance company or a title insurance agent shall not:

(a) Give or receive or attempt to give or receive remuneration in any form pursuant to any agreement or understanding, oral or otherwise, for the referral of title insurance business.

(b) Give or receive or attempt to give or receive any portion or percentage of any charge made or received in connection with the business of title insurance if such portion or percentage of the charge given or received is not for services actually rendered. For purposes of this chapter, "
services actually rendered
" shall include, but not be limited to, a reasonable examination of a title, including instruments of record, and a determination of insurability of such title in accordance with sound underwriting practices. "Services actually rendered" shall not include the mere referral of title insurance business.


Source. 1971, 561:1. 2006, 196:9. 2009, 38:1, eff. July 14, 2009.

    416-A:9 Unearned Premium Reserve. 

In lieu of those reserves required for other insurance companies, every domestic title insurance company, and every foreign or alien title insurance company which under the state of domicile is not required to maintain a substantially equivalent unearned premium reserve shall, in addition to other reserves, establish and maintain a reserve to be known as the "unearned premium reserve" for title insurance, which shall, at all times and for all purposes, constitute the unearned portions of premiums due or received and shall be charged as a reserve liability of such title insurance company in determining its financial condition. The unearned premium reserve shall be retained and held by such title insurance company for the protection of the policyholders' interest in policies which have not expired. Except upon liquidation, dissolution, or insolvency, assets equal to the amount of such reserve shall not be subject to distribution among depositors or other creditors or stockholders of such title insurance company until all claims of policyholders or holders of other title insurance contracts or agreements of such title insurance company have been paid in full and all liability on the policies or other title insurance contracts or agreements, whether contingent or actual, has been discharged or lawfully reinsured. Income from the investment of the amount of such reserve shall be the unrestricted property of the title insurance company.


Source. 1971, 561:1, eff. Sept. 10, 1971.

    416:1 Determination of Solvency. 

Fifty percent of the amount received on all outstanding contracts shall be treated as a liability by the insurance commissioner in determining the question of the solvency of any surety company.


Source. 1885, 53:2. PS 172:2. PL 282:2. RL 332:2.

    416:2 Bonds, Approval. 

The judge, head of department, or other officer authorized to approve the bond of any person required by law to give a bond, may accept as a surety upon the bond any such company which has been licensed to do business in this state, and, if satisfied with the financial ability of the company, he need not require other sureties.


Source. 1885, 48:1. PS 172:3. PL 282:3. RL 332:3.

    416:3 Expense of Bond. 

A court or officer, whose duty it is to pass upon the account of any person required by law to give a bond, may, whenever the person has procured any such company as surety upon his bond, allow a reasonable sum for the expense of procuring such surety in the settlement of his account.


Source. 1885, 48:2. PS 172:4. PL 282:4. RL 332:4.

    416:4 Estoppel of Surety. 

Any company which shall execute a bond as surety under the provisions of this chapter shall be estopped to deny its corporate power to execute the instrument or to assume the liability.


Source. 1885, 48:3. PS 172:5. PL 282:5. RL 332:5.

    416:5 Reinsurance. 

No surety company, whether organized under the laws of this or any other state or territory, shall assume any liability as surety on any bond which shall in amount exceed 10 percent of its net assets, without reinsuring in some surety company authorized to do business in this state the amount by which any liability may exceed said 10 percent.


Source. 1913, 53:1. PL 282:6. RL 332:6.

    416:6 Investments. 

Surety companies organized under the laws of this state shall invest their funds in securities that are legal investments for savings banks, and in such other investments as may be approved by the insurance commissioner.


Source. 1913, 53:2. PL 282:7. RL 332:7.

    416:7 Conditions of Entry. 

Any surety company incorporated and organized under the laws of another state, for the purpose of transacting business as surety on obligations, may transact business in this state upon complying with the provisions of all laws relating to foreign insurance companies and their agents, and not otherwise.


Source. 1885, 53:1. PS 172:1. PL 282:1. RL 332:1.

    417-A:1 Definitions. 

As used in this chapter the following definitions shall apply:

I. "Policy of automobile insurance" means a policy delivered or issued for delivery in this state insuring a person as named insured or one or more related individuals resident of the same household, and under which the insured vehicles therein designated includes a private passenger automobile as defined in rules adopted by the commissioner pursuant to RSA 541-A.

II. "Renewal" or "to renew" means the issuance and delivery by an insurer of a policy superseding at the end of the policy period a policy previously issued and delivered by the same insurer, such renewal policy to provide types and limits of coverage at least equal to those contained in the policy being superseded, or the issuance and delivery of a certificate or notice extending the term of a policy beyond its policy period or term with types and limits of coverage at least equal to those contained in the policy being extended; provided, however, that any policy with a policy period or term of less than 12 months or any period with no fixed expiration date shall for the purpose of this chapter be considered as if written for successive policy periods or terms of 12 months.

III. "Insurer" means any insurance company, association or exchange authorized to issue policies of automobile insurance in the state of New Hampshire.

IV. "Nonpayment of premium" means failure of the named insured to discharge when due any of the named insured's obligations in connection with the payment of premiums on a policy, or any installment of such premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit.


Source. 1969, 487:1. 1992, 282:13. 1996, 285:20, eff. Jan. 1, 1997.

    417-A:10 Penalty;  Severability;  Records. 

I. Failure by an insurer to comply with any section of this chapter, or rules, regulations, and order issued pursuant thereto shall subject an insurer to a fine not exceeding $2,500 in the discretion of the insurance commissioner, or suspension or revocation of such insurers license, or both.

II. If any provisions or clause of this chapter or application thereof to any person or situation is held invalid, such invalidity shall not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or application, and to this end the provisions of this chapter are declared to be severable.

III. The insurance commissioner may require that each insurer shall maintain records of the numbers of cancellations and refusals to write or renew policies and the reasons therefor and shall supply to the insurance commissioner such information as the commissioner may request.


Source. 1969, 487:1. 1971, 453:5. 1996, 285:24. 2003, 144:11, eff. Jan. 1, 2004.

    417-A:11 Repealed by 2009, 215:14, eff. Sept. 13, 2009. 

    417-A:2 Application of Chapter. 

This chapter shall apply to that portion of policies of automobile insurance providing bodily injury and property damage liability, comprehensive, and collision coverages and to the provisions therein, if any, relating to medical payments and uninsured motorists coverage, which take effect subsequent to September 1, 1969.


Source. 1969, 487:1, eff. Sept. 1, 1969.

    417-A:3-a Coercion by Insurer. 

No insurer shall refuse to renew a policy of automobile insurance previously issued to an individual solely because such individual has no other policy of insurance with said insurer.


Source. 1971, 247:1, eff. Aug. 22, 1971.

    417-A:3-b Repealed by 2021, 147:3, II, eff. Sept. 21, 2021. 

    417-A:3-c Underwriting on the Basis of Credit Information. 

No insurer shall cancel, refuse to write, or refuse to renew a policy of automobile insurance solely on the basis of credit information obtained from a credit rating, a credit history, or a credit scoring model, without consideration of any other applicable and permitted underwriting factors independent of credit information.


Source. 2010, 125:1, eff. Jan. 1, 2011.

    417-A:3 Cancellation;  Refusal to Write;  Refusal to Renew;  Insufficient Grounds. 

No insurer shall cancel, refuse to write or refuse to renew a policy of automobile insurance on any person solely because of the age, residence, race, color, creed, national origin, ancestry, marital status or lawful occupation, including the military service, of anyone who is or seeks to become insured or solely because another insurer has refused to write a policy, or has cancelled or has refused to renew an existing policy in which that person was the named insured.


Source. 1969, 487:1. 1971, 453:3. 2014, 31:10, eff. July 26, 2014.

    417-A:4 Cancellation, Grounds. 

No insurer, after a policy has been in effect for 60 days, or if a policy is a renewal, effective immediately, shall cancel a policy except for one or more of the following reasons:

I. Nonpayment of premium;

II. [Repealed.]

III. Specific request of the insured.

IV. Named insured was not a resident of the state of New Hampshire at the time the policy was issued or renewed, unless the insured vehicle at issue was exclusively garaged in New Hampshire when the policy was issued or renewed.


Source. 1969, 487:1. 1990, 114:6, I. 2002, 207:17, eff. July 15, 2002. 2021, 147:2, eff. Sept. 21, 2021.

    417-A:5-a Notice of Nonrenewal Not Required. 

A notice of nonrenewal for nonpayment of premium on a policy written on other than a continuous basis is not required if the insurer has manifested in writing its willingness to renew by issuing or offering to issue a renewal policy certificate or other evidence of renewal or has manifested such intention in writing by other means.


Source. 1971, 561:6, eff. Sept. 10, 1971.

    417-A:5 Cancellation, Refusal to Renew, Notice. 

No cancellation or refusal to renew by an insurer of a policy of automobile insurance shall be effective unless the insurer or its agent either physically delivers or mails to the named insured, at the address shown in the policy, a written notice of the cancellation or refusal to renew or electronically delivers to the named insured a written notice of cancellation or refusal to renew. Such notice shall:

I. Be approved as to form by the insurance commissioner prior to use.

II. State the date on which such cancellation or refusal to renew shall become effective. The effective date shall not be less than 45 days after the date the notice is mailed or physically or electronically delivered to the named insured provided however, the effective date may be 10 days from the date of mailing or physical or electronic delivery when:

(a) The policy is being cancelled or not renewed for nonpayment of premium, provided that nonpayment notices shall not be issued until nonpayment has occurred; or

(b) The policy is not a renewal policy and the cancellation notice is mailed or delivered within 60 days of the policy's effective date and the insurer otherwise complies with all laws and rules related to cancellation of automobile insurance.

III. State the specific reason or reasons of the insurer for cancellation or refusal to renew.

IV. Advise the insured that the insured has the right to request that the insurance commissioner review the insurer's decision to cancel or not renew the policy. This notice shall advise the insured that in order to request the commissioner's review of the cancellation or nonrenewal, the insured must send a written request to the commissioner within 10 days of receiving the insurer's notice of cancellation or nonrenewal. The insurer shall also provide in the notice, the phone number and mailing address of the New Hampshire insurance department.

V. In case of an automobile policy, in the notice advise the insured of eligibility for insurance through the automobile reinsurance facility.


Source. 1969, 487:1. 1971, 453:4. 1996, 285:21. 2006, 196:12. 2009, 215:8, 9. 2010, 212:11, eff. Jan. 1, 2011. 2021, 57:1, 2, eff. July 24, 2021. 2022, 42:13, eff. July 2, 2022.

    417-A:6 Liability for Giving Information. 

There shall be no liability on the part of and no cause of action of any nature shall arise against the insurance commissioner, any insurer, the authorized representatives, agents and employees of either or any firm, person or corporation furnishing to the insurer information as to reasons for cancellation or refusal to write or renew for any statement made by any of them in complying with this chapter or for the providing of information pertaining thereto.


Source. 1969, 487:1, eff. Sept. 1, 1969.

    417-A:7 Review Request;  Reasons for Refusal. 

I. Any insured may within 10 days of the receipt by the insured of notice of cancellation or notice of intention not to renew, or of the receipt of the reason or reasons for the cancellation or refusal to renew if they were not stated in the notice, request in writing to the insurance commissioner that the commissioner review the action of the insurer in cancelling or refusing to renew the policy of such insured.

II. Any applicant for a policy who is refused such policy by an insurer may in writing within 10 days of notice of such refusal request the insurer to supply the reasons for such refusal. The insurer shall supply such reasons within 5 days of receipt by it of such request. Within 10 days of the receipt of such reasons, the applicant may request in writing to the insurance commissioner that the commissioner review the action of the insurer in refusing to write a policy for the applicant.


Source. 1969, 487:1. 1996, 285:22, eff. Jan. 1, 1997.

    417-A:8 Review Procedure;  Termination of Policy. 

On receipt of a request for review, the insurance commissioner or designated representative shall notify the insurer thereof and shall review the matter to determine whether the cancellation or refusal to renew or to write was in violation of this chapter, and shall within 60 days of the receipt of such request either order the policy written or reinstated or uphold the cancellation or refusal to renew. In the case of a cancellation of or refusal to renew a policy, such policy shall remain in effect until the conclusion of such review by the insurance commissioner or the date referred to in RSA 417-A:5, II, whichever is later, except for appeals from cancellations due to nonpayment of premiums, in which case the policy shall terminate as of the date provided in the notice under RSA 417-A:5, II unless the appeal is upheld or the policy reinstated.


Source. 1969, 487:1. 1996, 285:23, eff. Jan. 1, 1997.

    417-A:9 Rules and Regulations;  Review Fee;  Appeal From Review. 

The insurance commissioner shall promulgate rules and regulations necessary for the administration of this chapter. The commissioner may provide in such rules and regulations for the establishment of a filing fee not exceeding $15 to accompany the request for review. Should the insurance commissioner decide the appeal in favor of the insured, the filing fee shall be returned immediately and the fee shall be paid by the insurer. The policy in question shall remain in effect during the pendency of any appeal taken by the insurer pursuant to RSA 541. Should the commissioner find for the insurer, the policy in question shall be suspended and inoperative during the pendency of any appeal taken by the insured pursuant to RSA 541.


Source. 1969, 487:1, eff. Sept. 1, 1969.

    417-B:1 Application of Chapter. 

This chapter shall apply to policies of insurance other than automobile insurance and workers' compensation insurance on risks located or residents in this state which insure any of the following contingencies:

I. Loss of or damage to real property which is used solely for residential purposes, which is owner occupied, and which consists of not more than 4 dwelling units.

II. Loss of or damage to personal property owned by natural persons except personal property used in the conduct of a commercial or industrial enterprise.

III. Legal liability of a natural person or persons for loss of, damage to, or injury to, persons or property, but not including policies primarily insuring risks arising from the conduct of a commercial or industrial enterprise.


Source. 1971, 453:1. 1983, 396:1. 2006, 196:13, eff. July 30, 2006. 2021, 50:7, eff. July 24, 2021.

    417-B:2-a Underwriting on the Basis of Credit Information. 

No insurer shall cancel, refuse to write, or refuse to renew a policy under this chapter solely on the basis of credit information obtained from a credit rating, a credit history, or a credit scoring model, without consideration of any other applicable and permitted underwriting factor independent of credit information.


Source. 2010, 125:2, eff. Jan. 1, 2011.

    417-B:2 Cancellation;  Refusal to Write;  Refusal to Renew;  Insufficient Grounds. 

No insurer shall cancel or refuse to write or renew a policy of insurance insuring against any of the contingencies set forth in RSA 417-B:1 solely because of the age, residence, race, color, creed, national origin, ancestry, marital status, or lawful occupation, including the military service, of anyone who is or seeks to become insured or solely because another insurer has refused to write a policy, or has cancelled or has refused to renew an existing policy in which that person was the named insured.


Source. 1971, 453:1, eff. Aug. 29, 1971.

    417-B:3-a Nonrenewal for Filing a Claim. 

The nonrenewal of a homeowner's insurance policy is prohibited if the nonrenewal is based solely on the insured having filed a single valid claim within any one previous or current policy term. For policies that contain no fixed expiration date or that are issued for other than annual periods a term shall be considered each 12 month anniversary from the date of policy issuance. Inquiries about coverage on a policy do not constitute a valid claim and shall not be the basis for nonrenewals.


Source. 1992, 133:2. 2003, 144:12. 2014, 83:1, eff. Aug. 10, 2014. 2017, 55:9, eff. Aug. 1, 2017.

    417-B:3 Cancellation Grounds. 

No insurer, after a policy has been in effect for 90 days, or if a policy is a renewal, effective immediately, shall cancel a policy except for one or more of the following reasons:

I. Nonpayment of premium, including nonpayment of any additional premiums, calculated in accordance with the current rating manual of the insurer, justified by a physical change in the insured property or a change in its occupancy or use.

II. Conviction of the named insured of a crime having as one of its necessary elements an act increasing any hazard insured against.

III. Discovery of fraud or material misrepresentation by the named insured in pursuing a claim under the policy.

IV. Discovery of grossly negligent acts or omissions by the insured substantially increasing any of the hazards insured against.

V. Physical changes in the insured property which result in the property becoming uninsurable.

VI. Specific request of the insured.


Source. 1971, 453:1. 1983, 396:2. 2006, 196:16, eff. July 30, 2006.

    417-B:4 Cancellation;  Refusal to Renew;  Notice. 

No cancellation or refusal to renew by an insurer of a policy of insurance insuring against any of the contingencies set forth in RSA 417-B:1 shall be effective unless the insurer or its agent either physically delivers or mails to the named insured, at the address shown in the policy, a written notice of the cancellation or refusal to renew or electronically delivers to the named insured a written notice of cancellation or refusal to renew. Such notice shall:

I. State the date on which such cancellation or refusal to renew shall become effective. The effective date shall not be less than 45 days after the date the notice is mailed or physically or electronically delivered to the named insured provided however, the effective date may be 10 days from the date of mailing or physical or electronic delivery when:

(a) The policy is being cancelled or not renewed for nonpayment of premium; or

(b) The policy is not a renewal policy and the cancellation notice is mailed or delivered within 90 days of the policy's effective date.

II. State the specific reason or reasons of the insurer for cancellation or refusal to renew or be accompanied by a statement that upon written request of the named insured, mailed or delivered to the insurer not less than 10 days prior to the effective date of cancellation or refusal to renew, the insurer will specify the reason or reasons for such cancellation, or refusal to renew. The insurer shall supply such information within 5 days of receipt by it of such request.

III. Any policy written for a term of less than one year shall be considered as if written for a term of one year. Any policy written for a term longer than one year, or any policy with no fixed expiration date, shall be considered as if written for successive policy periods or terms of one year.


Source. 1971, 453:1. 1983, 396:3. 2009, 215:10. 2010, 212:12, eff. Jan. 1, 2011. 2021, 57:3, eff. July 24, 2021.

    417-B:5 Liability of Giving Information. 

There shall be no liability on the part of, and no cause of action of any nature shall arise against the insurance commissioner, any insurer, the authorized representatives, agents, and employees of either for any statement made by any of them in complying with this chapter or for the providing of information pertaining thereto.


Source. 1971, 453:1, eff. Aug. 29, 1971.

    417-B:6 Rules and Regulations. 

The commissioner may issue such rules, regulations, and orders as may be necessary to carry out the purposes and provisions of this chapter.


Source. 1971, 453:1, eff. Aug. 29, 1971.

    417-B:7 Penalty;  Severability;  Records. 

I. Failure by an insurer to comply with any section of this chapter, or rules, regulations and orders issued pursuant thereto shall subject an insurer to a fine not exceeding $500 in the discretion of the insurance commissioner, or suspension or revocation of such insurer's license, or both.

II. If any provisions or clause of this chapter or application thereof to any person or situation is held invalid, such invalidity shall 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 declared to be severable.

III. The insurance commissioner may require that each insurer shall maintain records of the numbers of cancellations and refusals to write or renew policies and the reasons therefor and shall supply to the insurance commissioner such information as he may request.


Source. 1971, 453:1, eff. Aug. 29, 1971.

    417-B:8 Insurers. 

As used in this chapter, "insurer" means any insurance company, association, or exchange authorized to issue policies of insurance in the state of New Hampshire.


Source. 1971, 561:10, eff. Sept. 10, 1971.

    417-C:1 Grounds for Cancellation. 

I. A notice of cancellation of a policy, to which RSA 417-C:2 applies, shall be effective only if it is based on one or more of the following reasons:

(a) Nonpayment of a premium, including nonpayment of any additional premiums due from an audit conducted in accordance with law for the prior policy term; or

(b) Fraud or material misrepresentation affecting the policy or in the presentation of a claim thereunder, or violation of any of the terms or conditions of the policy; or

(c) A change in the risk that substantially increases a hazard insured against after insurance coverage has been issued or renewed.

II. An insurer shall cancel a policy at the specific request of the insured subject to contractual notice provisions not to exceed 10 days.

III. Paragraph I shall not apply to any policy or coverage which has been in effect less than 60 days at the time notice of cancellation is mailed or delivered by the insurer unless it is a renewal policy.

IV. This section shall not apply to nonrenewal.


Source. 1986, 227:1. 2000, 166:6. 2009, 215:11. 2012, 100:3, eff. July 28, 2012. 2020, 37:42, eff. Sept. 27, 2020. 2021, 50:2, eff. July 24, 2021. 2022, 42:14, eff. July 2, 2022.

    417-C:2 Notice of Cancellation. 

I. No notice of cancellation shall be effective unless mailed, physically delivered, or electronically delivered by the insurer or its agent to the named insureds at least 60 days prior to the effective date of cancellation; provided, however, that where cancellation is for nonpayment of premium or substantial increase in hazard, or the cancellation notice is mailed, physically delivered, or electronically delivered within the first 60 days of the effective date for new policies, at least 10 days' notice of cancellation shall be given. In all instances, the reason or reasons for cancellation shall accompany or be included in the notice of cancellation. An insurer shall not be held liable in any claim or suit for damages arising solely from the insurer's compliance with the requirement that the reason for cancellation be specified.

II. The commissioner shall have the authority to waive any provision of paragraph I upon the written request of an insurer specifying the reasons therefor.

III. This section shall not apply to nonrenewal.


Source. 1986, 227:1. 2000, 166:7. 2002, 207:20. 2009, 215:12, eff. Sept. 13, 2009. 2018, 132:7, eff. July 29, 2018. 2021, 57:4, eff. July 24, 2021.

    417-C:3 Notice of Nonrenewal. 

No insurer shall refuse to renew a policy at its expiration or anniversary if written for a term of more than one year unless such insurer or its agent shall mail, physically deliver, or electronically deliver to the named insureds advance notice of its intention not to renew. The notice shall be at least 60 days in advance of the policy's scheduled expiration or anniversary date. If all or any part of the 60-day notice is not in advance of the expiration or anniversary date, renewal coverage shall be provided on the same terms and conditions as the expiring policy until the 60-day notice requirement has been fulfilled. This section shall not apply in case of nonpayment of premium, or if the insured fails to pay any advance premium required by the insurer for renewal. However, notwithstanding the failure of an insurer to comply with this section, any coverage shall terminate on the effective date of any other coverage acquired by the insured to the extent the acquired coverage substantially duplicates coverages of the renewal. Renewal of a policy shall not constitute a waiver or estoppel with respect to grounds for cancellation which existed before the effective date of such renewal.


Source. 1986, 227:1. 2002, 207:21, eff. May 16, 2002. 2021, 57:4, eff. July 24, 2021.

    417-C:4 Renewals;  Premiums. 

I. Any renewal premium increase in excess of 25 percent is controlled by the provisions of RSA 417-C:3. The notice may indicate that renewal is conditioned upon the premium increase without reference to nonrenewal.

II. Any renewal premium increase of 25 percent or less shall not be implemented until the insured has had a minimum of 30 days' notice of the renewal premium. 

III. If the applicable 60-day notice period required by RSA 417-C:3 or 30-day notice period required by paragraph II is not satisfied in advance of the policy's scheduled expiration or anniversary date, renewal coverage shall be provided, on a pro rata basis, at the rates or premiums in effect under the expiring policy until the applicable 60-day or 30-day notice requirement has been fulfilled. This paragraph shall not apply if the insured accepts the renewal policy.

IV. Development of renewal premium for the purpose of determining the percentage of change from expiring premium shall be based on the same coverages, conditions, and ratable exposures as those contained in the expiring policy.


Source. 1986, 227:1. 2002, 207:22, eff. May 16, 2002. 2021, 57:4, eff. July 24, 2021.

    417-C:5 Repealed by 2002, 207:23, eff. May 16, 2002. 

    417-C:6 Scope of Chapter. 

This chapter shall only apply to policies of insurance providing fire, inland marine, multi-peril, casualty and liability policies, and shall not apply to mortgage guaranty insurance, surety bonds, workers' compensation policies regulated under RSA 281-A or any policies provided and controlled by RSA 417-A or RSA 417-B.


Source. 2002, 207:18. 2009, 215:13. 2015, 92:1, eff. Aug. 4, 2015.

    417-D:1 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Insurer" means any entity issuing accident or health insurance or accident and health insurance policies, contracts, certificates, or other evidence of coverage pursuant to RSA 415, 415-A, 420-A, or 420-B.

III. "
Low-dose mammography
" means the X-ray examination of the breast using equipment dedicated specifically for mammography, including the X-ray tube, filter, compression device, screens, films, and cassettes, with a radiation exposure which is diagnostically valuable and in keeping with the recommended "Average Patient Exposure Guides" as published by the Conference of Radiation Control Program Directors, Inc. "Low-dose mammography" shall also include 3-D tomosynthesis mammography.


Source. 1988, 267:2. 1997, 190:12, eff. Jan. 1, 1998. 2018, 208:1, eff. Aug. 7, 2018.

    417-D:2-a Pregnancy, Delivery, and Postpartum Coverage. 

Each insurer that issues or renews any policy of accident and health insurance providing maternity benefits for hospital expense, medical-surgical expense, or major medical expense shall provide in each group or individual policy, contract, or certificate of insurance issued or renewed for persons who are residents of this state the following in providing coverage during pregnancy and delivery and the postpartum period:

I. The length of hospital stay and the number of postpartum visits shall be determined by the attending health care provider based on clinical information that demonstrates that the mother and infant are clinically stable based on nationally accepted guidelines pursuant to paragraph IV and that appropriate care for the mother and newborn can be provided for upon discharge. The length of stay shall not be determined by the health insurer or the hospital based on economic criteria.

II. Upon notification of the pregnancy by the insured to the insurer, the insurer shall inform the pregnant woman in writing regarding the insurer's prenatal, maternity, and postpartum benefits, including but not limited to prenatal visits, diagnostic tests, prenatal education, hospital length of stay, postpartum care, homemaker services, and contraceptive counseling and referrals.

III. The insurer shall pay for medically necessary prenatal homemaker services when a woman is confined to bedrest or her activities of daily living are otherwise restricted on the recommendation of her attending health care provider who shall consult with the applicable case manager.

IV. Any length of hospital stay shorter than the current minimum nationally accepted guidelines for perinatal care, such as Guidelines for Perinatal Care prepared by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, shall be at the recommendation of the attending health care provider in consultation with the mother. In such cases the insurer shall pay for at least 2 postpartum visits. During one such visit, the collection of an adequate sample from the newborn for screening for genetic and metabolic diseases shall take place in accordance with RSA 132 and applicable rules.

V. Postpartum visits shall include a physical assessment of mother and infant. The assessment shall include but not be limited to: infant nutrition and feeding, infant behavior, family interactions, safety and injury prevention, infant and maternal health promotion, and community resources. Providers of postpartum visits shall be licensed health care providers experienced in perinatal care.

VI. The insurer shall pay for appropriate medically necessary postpartum homemaker services as determined by the attending health care provider who shall consult with the applicable case manager.

VII. No attending health care provider shall be penalized by an insurer for following the provisions of this section. Insurers shall not deny payment for services that are within standards of good and generally accepted medical practice as reflected by scientific and peer medical literature and recognized within the organized medical community in the state of New Hampshire.


Source. 1996, 75:4, eff. Jan. 1, 1997.

    417-D:2-b Reconstructive Surgery. 

Every insurer subject to this chapter that provides individual or group coverage for mastectomy surgery shall provide coverage for reconstruction of the breast on which surgery has been performed and surgery and reconstruction of the other breast to produce a symmetrical appearance if the patient elects reconstruction and in the manner chosen by the patient and the physician.


Source. 1997, 311:1, eff. Jan. 1, 1998.

    417-D:2 Low-Dose Mammography Coverage. 

I. Each insurer that issues or renews any policy of accident and health insurance providing benefits for hospital expense, medical-surgical expense, or major medical expense shall provide in each group or individual policy, contract, or certificate of insurance issued or renewed for persons who are residents of this state, coverage for screening by low-dose mammography for all women 35 years of age or older for the presence of occult breast cancer within the provisions of the policy, contract, or certificate. The coverage shall be as follows:

(a) A baseline mammogram for women 35 to 39 years of age.

(b) A mammogram every 1 to 2 years, even if no symptoms are present, for women 40 to 49 years of age.

(c) An annual mammogram for women 50 years of age or older.

II. Such benefits shall be at least as favorable as for other radiological examinations and subject to the same dollar limits, deductibles, and co-insurance factors.


Source. 1988, 267:2. 1996, 75:3, eff. Jan. 1, 1997.

    417-D:3 Rulemaking. 

The commissioner may adopt rules, under RSA 541-A, relative to the administration of this chapter.


Source. 1988, 267:2, eff. Jan. 1, 1989.

    417-D:4 Penalty. 

Any insurer that violates any provision of this chapter or any rule adopted pursuant to it, may, at the discretion of the commissioner, have its certificate of authority indefinitely suspended or revoked.


Source. 1988, 267:2, eff. Jan. 1, 1989.

    417-E:1 Coverage for Certain Biologically-Based Mental Illnesses. 

I. For the purposes of this chapter "mental illness" means a clinically significant or psychological syndrome or pattern that occurs in a person and that is associated with present distress, a painful symptom or disability, impairment in one or more important areas of functioning, or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.


[Paragraph II effective until January 1, 2023; see also paragraph II set out below.]



II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.


[Paragraph II effective January 1, 2023; see also paragraph II set out above.]



II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under access standards established in RSA 420-J:7, and under terms and conditions which are no less extensive than the coverage provided for any other type of health care for physical illness.

III. The following mental illnesses, as defined in the most current edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders published by the American Psychiatric Association, shall be covered under this section:

(a) Schizophrenia and other psychotic disorders.

(b) Schizoaffective disorder.

(c) Major depressive disorder.

(d) Bipolar disorder.

(e) Anorexia nervosa and bulimia nervosa.


[Paragraph III(f) effective until July 1, 2024; see also paragraph III(f) set out below.]



(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders, when treatment, including the use of intravenous immunoglobulin therapy, is ordered by a physician.


[Paragraph III(f) effective July 1, 2024; see also paragraph III(f) set out above.]



(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders.

(g) Panic disorder.

(h) Pervasive developmental disorder or autism.

(i) Chronic post-traumatic stress disorder.

IV. The benefits required under this section shall begin when benefits provided under RSA 415:18-a and RSA 420-B:8-b, as applicable are exhausted.

V. The commissioner shall have the authority to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Act), including any amendments thereto and any federal rules adopted thereunder, and may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Act that relate to the business of insurance.

V-a. The commissioner shall periodically require health insurers, health service corporations, and health maintenance organizations to submit the comparative analysis described in 42 U.S.C. section 300gg-26(a)(8)(A) for review to ensure compliance with this chapter and with the Act. To the extent allowable under state and federal law, such analysis shall be made public.

V-b. (a) Health insurers, health service corporations, and health maintenance organizations shall include in their contracts with participating providers as defined under 420-J:3, reimbursement terms for mental health and substance use disorder treatment services that are on average, at least as favorable as those in their contracts for professional services provided by non-hospital affiliated primary care providers.

(1) Reimbursements for services paid to mental health and substance use disorder treatment providers shall meet the required standard if the reimbursement are, on average, equal to or greater than the relative Medicare reimbursements for the same service.

(2) Services considered in the comparison shall be those provided on an in-network basis in New Hampshire, and shall only consider comparisons for those services commonly provided by both non-hospital affiliated physicians and mental health and substance use disorder providers.

(3) Consistent with Medicare standards, professional licensure, certification, and telemedicine policies shall be recognized as factors warranting adjustment to reimbursement

(b) Compliance with subparagraph (a) shall not constitute compliance with the Mental Health Parity and Addiction Equity Act in 42 U.S.C. 300gg-26 and its implementing and related regulations in 45 C.F.R. 146.136, 45 C.F.R. 147.160, and 45 C.F.R. 156.115(a)(3). Health insurers, health service corporations, and health maintenance organizations shall, pursuant to 45 C.F.R. 146.136(c)(4)(i) and 45 C.F.R. 146.136(c)(4)(ii), ensure that when setting reimbursement rates for mental health and substance use disorder treatment providers, as written and in effect, any processes, strategies, evidentiary standards, or other factors used in establishing such reimbursement rates are comparable to, and are applied no more stringently than, any processes, strategies, evidentiary standards, or other factors used in establishing reimbursement rates for medical/surgical providers in the classification of benefits.

VI. Nothing in this section shall be construed to affect any obligation to provide services to an individual under an individualized family service plan or an individualized education program, as required under the federal Individuals With Disabilities Education Act, the state children's health insurance program authorized by 42 U.S.C. section 1397aa et seq., or the provision of services to an individual under any other federal or state law.


Source. 1994, 298:1. 1997, 190:13, 14. 2002, 204:3. 2009, 235:8. 2010, 188:13; 363:1. 2011, 224:282, eff. July 1, 2011. 2019, 277:1, 2, eff. Sept. 17, 2019; 277:3, eff. July 1, 2024; 283:1, 2, eff. Jan. 1, 2020. 2020, 39:51, eff. Sept. 27, 2020. 2022, 84:2, eff. Jan. 1, 2023; 337:1, eff. Sept. 23, 2022.

    417-E:2 Coverage for Treatment of Pervasive Developmental Disorder or Autism. 

I. For the purposes of this chapter, treatment of pervasive developmental disorder or autism as required under RSA 417-E:1, III(h) shall include the following:

(a) Professional services and treatment programs, including applied behavioral analysis, necessary to produce socially significant improvements in human behavior or to prevent loss of attained skill or function. To be eligible for coverage, applied behavior analysis must be provided by a person professionally certified by the national Behavior Analyst Certification Board or performed under the supervision of a person professionally certified by the national Behavior Analyst Certification Board.

(b) Prescribed pharmaceuticals subject to the same terms and conditions of the policy as other prescribed pharmaceuticals.

(c) Direct or consultative services provided by a licensed professional including a licensed psychiatrist, licensed advanced practice registered nurse, licensed psychologist, or licensed clinical social worker; and

(d) Services provided by a licensed speech therapist, licensed occupational therapist, or licensed physical therapist.

II. An insurer may require submission of a treatment plan, including the frequency and duration of treatment, signed by the primary care provider, an appropriately credentialed treating specialist, a child psychiatrist, a pediatrician with a specialty in behavioral-developmental pediatrics, a neurologist with a specialty in child neurology, or a licensed psychologist with training in child psychology, that the treatment is medically necessary for the patient and is consistent with nationally recognized treatment standards for the condition such as those set forth by the American Academy of Pediatrics. An insurer may require an updated treatment plan no more frequently than on a semi-annual basis. Coverage shall not be denied on the basis that services are habilitative in nature.

III. The policy, contract, or certificate may limit coverage for applied behavior analysis to $36,000 per year for children 0 to 12 years of age, and $27,000 from ages 13 to 21. An insurer may not apply payments for coverage unrelated to autism spectrum disorders to any maximum benefit established under this paragraph.

IV. Nothing in this section shall be construed to affect any obligation by a school district or the state of New Hampshire to provide services to an individual under an individualized family service plan or an individualized education program, as required under the federal Individuals With Disabilities Education Act, the state children's health insurance program authorized by 42 U.S.C. section 1397aa et seq., or the provision of services to an individual under any other federal or state law.

V. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the insurance coverage requirements established under this section.
417-E:2 Coverage for Treatment of Pervasive Developmental Disorder or Autism. 

I. For the purposes of this chapter, treatment of pervasive developmental disorder or autism as required under RSA 417-E:1, III(h) shall include the following:

(a) Professional services and treatment programs, including applied behavioral analysis, necessary to produce socially significant improvements in human behavior or to prevent loss of attained skill or function. To be eligible for coverage, applied behavior analysis must be provided by a person professionally certified by the national Behavior Analyst Certification Board or performed under the supervision of a person professionally certified by the national Behavior Analyst Certification Board.

(b) Prescribed pharmaceuticals subject to the same terms and conditions of the policy as other prescribed pharmaceuticals.

(c) Direct or consultative services provided by a licensed professional including a licensed psychiatrist, licensed advanced practice registered nurse, licensed psychologist, or licensed clinical social worker; and

(d) Services provided by a licensed speech therapist, licensed occupational therapist, or licensed physical therapist.

II. An insurer may require submission of a treatment plan, including the frequency and duration of treatment, signed by the primary care provider, an appropriately credentialed treating specialist, a child psychiatrist, a pediatrician with a specialty in behavioral-developmental pediatrics, a neurologist with a specialty in child neurology, or a licensed psychologist with training in child psychology, that the treatment is medically necessary for the patient and is consistent with nationally recognized treatment standards for the condition such as those set forth by the American Academy of Pediatrics. An insurer may require an updated treatment plan no more frequently than on a semi-annual basis. Coverage shall not be denied on the basis that services are habilitative in nature.

III. Nothing in this section shall be construed to affect any obligation by a school district or the state of New Hampshire to provide services to an individual under an individualized family service plan or an individualized education program, as required under the federal Individuals With Disabilities Education Act, the state children's health insurance program authorized by 42 U.S.C. section 1397aa et seq., or the provision of services to an individual under any other federal or state law.

IV. The commissioner may adopt rules, pursuant to RSA 541-A, relative to the insurance coverage requirements established under this section.



Source. 2010, 363:2. 2011, 224:283, eff. July 1, 2011. 2022, 337:2, eff. Sept. 23, 2022.

    417-F:1 Definitions. 

In this chapter:

I. "
Emergency services
" means health care services that are provided to an enrollee, insured, or subscriber in a licensed hospital emergency facility by a provider after the sudden onset of a medical condition that manifests itself by symptoms of sufficient severity that a prudent layperson with average knowledge of health and medicine could reasonably expect that the absence of immediate medical attention could be expected to result in any of the following:

(a) Serious jeopardy to the patient's health.

(b) Serious impairment to bodily functions.

(c) Serious dysfunction of any bodily organ or part.

II. "
Insurer
" means any entity providing managed care coverage or accident or health insurance or accident and health insurance policies, contracts, certificates, or other evidence of coverage to enrollees, insureds, or subscribers pursuant to RSA 415, 415-A, 419, 420, 420-A, 420-B, or 420-J.


Source. 1997, 134:1. 2000, 104:3, eff. July 7, 2000. 2018, 356:5, eff. July 1, 2018.

    417-F:2 Claims Processing. 

An insurer retrospective review of a claim for reimbursement for emergency services shall include consideration of presenting symptoms, along with final diagnosis, and shall give due consideration to the definitions of emergency medical condition and emergency services in RSA 420-J:3.


Source. 1997, 134:1, eff. Jan. 1, 1998. 2019, 16:1, eff. July 9, 2019.

    417-F:3 Prior Authorization. 

I. A participating provider or other authorized representative of the plan that gives prior authorization shall not rescind or modify the authorization after the health care provider has rendered the authorized emergency services care in good faith and the enrollee's, insured's, or subscriber's coverage was effective on the date of service.

II. When emergency services are a covered benefit under a health plan subject to this chapter, no prior authorization shall be required for emergency services necessary to screen and stabilize an individual.

III. No health benefit plan shall require a prior authorization for medically necessary interfacility transports for services related to the treatment and diagnosis of certain biologically-based mental illnesses.


Source. 1997, 134:1, eff. Jan. 1, 1998. 2020, 39:3, eff. July 29, 2020.

    417-F:4 Reimbursement for Emergency Room Boarding. 

Following the completion of an involuntary admission certificate for a patient meeting the criteria under RSA 135-C:27 and not rescinded under RSA 135-C:29-a, the insurer shall pay the acute care hospital a per diem day rate required to board and care for the patient, to be contracted between the insurer and acute care hospital, for each day the insured is waiting in an acute care medical hospital located in the state for admission for psychiatric treatment at New Hampshire Hospital, a community-based designated receiving facility, or a voluntary admission. The day rate required to board and care for the patient may be billed for up to 21 consecutive days or discharge, whichever is sooner, and shall be renewed as needed for patient protection. The rate is deemed to cover all costs incurred by a hospital for the boarding and non-medical care of the insured and shall not be billed to the insured. This does not preclude a hospital from billing for other medically necessary services. Any qualified mental health worker employed by or contracted with the hospital, community mental health care center, or affiliate providing mental health services and supports to an insured in an emergency department in the hospital service areas while they are waiting for an inpatient or other psychiatric admission shall be reimbursed for those mental health services including diagnostic services by the insurer at the negotiated rate. Mental health services provided in this setting under this section shall be deemed medically necessary and shall not require prior authorization by an insurer. This section shall apply to the Medicaid managed care organizations subject to contract and rate agreements between the state of New Hampshire and the managed care organizations. The reimbursement for emergency room board and care shall be incorporated into the capitated rate for managed care services.


Source. 2019, 41:6, eff. July 1, 2019; 326:9, eff. July 1, 2019 at 12:01 a.m.

    417-G:1 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Experimental infertility procedure
" means a procedure for which the published medical evidence regarding risks, benefits, and overall safety and efficacy is not sufficient to regard the procedure as an established medical practice.

III. "
Fertility treatment
" means health care services or products provided with the intent to achieve a pregnancy that results in a live birth with healthy outcomes.

IV. "
Health carrier
" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including an insurance company, a health maintenance organization, a health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services.

V. "
Infertility
" means a disease, caused by an illness, injury, underlying disease, or condition, where an individual's ability to become pregnant or to carry a pregnancy to live birth is impaired, or where an individual's ability to cause pregnancy and live birth in the individual's partner is impaired.

VI. "
Medically necessary
" means health care services or products provided to an enrollee for the purpose of preventing, stabilizing, diagnosing, or treating an illness, injury, or disease or the symptoms of an illness, injury, or disease in a manner that is:

(a) Consistent with generally accepted standards of medical practice;

(b) Clinically appropriate in terms of type, frequency, extent, site, and duration;

(c) Demonstrated through scientific evidence to be effective in improving health outcomes;

(d) Representative of "best practices" in the medical profession; and

(e) Not primarily for the convenience of the enrollee or physician or other health care provider.

VII. "
Standard fertility preservation services
" means procedures consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine or the American Society of Clinical Oncology.


Source. 2019, 307:2, eff. Jan. 1, 2020.

    417-G:2 Diagnosis of Infertility, Fertility Treatment, and Fertility Preservation. 

I. Each health carrier that issues or renews any group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance coverage for the diagnosis of the etiology of infertility.

II. Each health carrier that issues or renews any group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance coverage for medically necessary fertility treatment. Enrollees shall be provided coverage for evaluations, laboratory assessments, medications, and treatments associated with the procurement of donor eggs, sperm, and embryos.

III. Each health carrier that issues or renews any group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses, shall provide to certificate holders of such insurance coverage for fertility preservation when a person is expected to undergo surgery, radiation, chemotherapy, or other medical treatment that is recognized by medical professionals to cause a risk of impairment of fertility. Coverage under this section shall include coverage for standard fertility preservation services, including the procurement and cryopreservation of embryos, eggs, sperm, and reproductive material determined not to be an experimental infertility procedure. Storage shall be covered from the time of cryopreservation for the duration of the policy term. Storage offered for a longer period of time, as approved by the health carrier, shall be an optional benefit.

IV. Coverage under paragraphs I-III shall not apply to plans available through the Small Business Health Options Program (SHOP) or to Extended Transition to Affordable Care Act-Compliant Policies.


Source. 2019, 307:2, eff. Jan. 1, 2020.

    417-G:3 Prohibited and Permissible Limitations on Coverage. 

I. No health carrier shall:

(a) Impose deductibles, copayments, coinsurance, benefit maximums, waiting periods or any other limitations on coverage for required benefits which are different from those imposed upon benefits for services not related to infertility or any limitations on coverage of fertility medications that are different from those imposed on any other prescription medications.

(b) Impose pre-existing condition exclusions or pre-existing condition waiting periods on coverage for required benefits or use any prior diagnosis of or prior treatment for infertility as a basis for excluding, limiting or otherwise restricting the availability of coverage for required benefits.

(c) Impose limitations on coverage based solely on arbitrary factors including, but not limited to, number of attempts or dollar amounts or age, or provide different benefits to, or impose different requirements upon, a class protected under RSA 354-A than that provided to, or required of, other patients.

II. Limitations on coverage shall be based on clinical guidelines and the enrollee's medical history. Clinical guidelines shall be maintained in written form and shall be available to any enrollee upon request. Standards or guidelines developed by the American Society for Reproductive Medicine, the American College of Obstetrics and Gynecology, or the Society for Assisted Reproductive Technology may serve as a basis for these clinical guidelines. Making, issuing, circulating, or causing to be made, issued or circulated, any clinical guidelines that are based upon data that are not reasonably current or that do not cite with specificity any references relied upon shall constitute an unfair and deceptive act and practice in the business of insurance under RSA 417:4.

III. This chapter shall not be construed to provide benefits for:

(a) An experimental infertility procedure.

(b) Non-medical costs related to third party reproduction.

(c) Reversal of voluntary sterilization.

IV. In instances where an enrollee is utilizing a surrogate or gestational carrier due to a medical cause of infertility unrelated to voluntary sterilization or failed reversal, the enrollee's coverage shall not extend to medical costs relating to the preparation for reception or introduction of embryos, oocytes, or donor sperm into a surrogate or gestational carrier.


Source. 2019, 307:2, eff. Jan. 1, 2020.

    417-G:4 Rulemaking. 

The commissioner shall adopt necessary rules, under RSA 541-A, relative to the proper administration of this chapter. Until such rules are adopted, health carriers shall fulfill their obligations under this chapter by conforming to the standards of the American Society for Reproductive Medicine.


Source. 2019, 307:2, eff. Jan. 1, 2020.

    417-G:5 Severability. 

If any provision of this chapter or the application thereof to any person or circumstances 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 severable.


Source. 2019, 307:2, eff. Jan. 1, 2020.

    417:1 Purpose of Chapter. 

The purpose of this chapter is to regulate trade practices in the business of insurance, in accordance with the intent of Congress as expressed in the Act of Congress of March 9, 1945 (Public Law 15, 79th Congress),
 by defining or providing for the determination of all such practices which constitute in this state unfair methods of competition or unfair or deceptive acts or practices and by prohibiting the trade practices so defined or determined.


Source. 1947, 189:1, par. 1, eff. June 12, 1947.

    417:10 Orders and Penalty. 

I. If after hearing or at the expiration of the period set forth in a show cause order issued pursuant to this chapter, any person is found to have violated RSA 417:3, the commissioner may suspend, revoke, or refuse to renew the license of that person. The commissioner, in the commissioner's discretion, in addition to or in lieu of such suspension, revocation, or refusal to renew, may impose upon that person an administrative penalty of not more than $2,500 for each method of competition, act, or practice found to be in violation of RSA 417:3. The commissioner shall collect the amount so imposed and may bring an action in the name of the state to enforce collection.

II. In lieu of the monetary penalties provided for under paragraph I, the commissioner, after hearing, may order relief for actual economic losses to restore, in whole or in part, any individual consumer, as opposed to a group or class of consumers, in interest to the position that the consumer formerly occupied either by the return of that which the consumer formerly had or by receipt of its equivalent in money. Unless the parties agree, an order of relief under this paragraph shall not exceed $2,500 for each method of competition, act, or practice found to be in violation of RSA 417:3 and where a pattern of conduct or practice has been established. Relief may be ordered under this paragraph only when the consumer in interest has agreed that such relief shall constitute a waiver of any action for the same cause that might otherwise be filed before an administrative agency or any court. Relief ordered under this paragraph shall not apply to disputes regarding claims or losses.


Source. 1947, 189:1, par. 10. RSA 417:10. 1971, 519:5. 1996, 238:12. 2004, 210:3, eff. Aug. 10, 2004.

    417:11 Appeal. 

Any party to the proceedings aggrieved by any order or decision of the insurance commissioner pursuant to RSA 417:10 shall be entitled to an appeal to the supreme court in accordance with the provisions of RSA 541, except that in the case of a fine imposed by any order or decision, the party aggrieved shall be entitled to an appeal to the superior court in the county in which the party resides, if a resident, or, if a nonresident, in the Merrimack county superior court and a trial de novo in said court.


Source. 1947, 189:1, par. 11. RSA 417:11. 1971, 519:6; 561:12. 1996, 238:13, eff. Jan. 1, 1997.

    417:12 Procedure as to Undefined Unfair Acts and Practices. 

I. Whenever the commissioner shall have reason to believe that any person engaged in the business of insurance is engaging in this state in any method of competition or in any act or practice in the conduct of such business which is not defined in RSA 417:4 nor which has been determined pursuant to this section to be an unfair method of competition, or an unfair or deceptive act or practice in the business of insurance and that such method of competition is unfair or that such act or practice is unfair or deceptive, and that a proceeding by the commissioner in respect thereto would be in the public interest, the commissioner shall issue and serve upon such person a statement of the charges and a notice of hearing to be held at a time and place fixed in the notice, which shall not be less than 10 days after the date of the service of the notice. The notice of the hearing may be in the form of a notice to show cause, stating the proposed action to be taken unless such person shows cause at a hearing to be held as specified in the notice, why the proposed action should not be taken, and stating the basis of the proposed action.

II. At the expiration of the period set forth in the show cause order issued pursuant to paragraph I, or if after such hearing, the commissioner shall determine that the method of competition or the act or practice in question is in violation of this chapter and if such method of competition, act, or practice has not been discontinued, the commissioner shall reduce the findings to writing and shall issue and cause to be served on the person charged with the violation an order requiring such person to cease and desist from engaging in such method of competition, act or practice.

III. Upon showing by any person that such person has an interest likely to be affected adversely, the commissioner shall permit such person to intervene, appear and be heard at such hearing by counsel or in person.

IV. An order of the commissioner to cease and desist shall become final:

(a) Upon the expiration of the period set forth in the show cause order; or

(b) Upon receipt of the order by the person involved.

V. Any party aggrieved by any order or decision of the insurance commissioner pursuant to this section shall be entitled to an appeal in accordance with the provisions of RSA 541.


Source. 1947, 189:1, par. 12. RSA 417:12. 1971, 519:7. 1996, 238:14, eff. Jan. 1, 1997.

    417:13 Penalty. 

If any person violates a cease and desist order issued by the commissioner pursuant to RSA 417:12, the commissioner may suspend, revoke, or refuse to renew the license of that person. The commissioner in the commissioner's discretion, in addition to or in lieu of such suspension, revocation, or refusal to renew, may impose upon that person an administrative penalty of not more than $2,500 for each method of competition, act, or practice found to be in violation of this chapter pursuant to RSA 417:12. The commissioner shall collect the amount so imposed and may bring an action in the name of the state to enforce collection.


Source. 1947, 189:1, par. 13. RSA 417:13. 1971, 519:8. 1996, 238:15, eff. Jan. 1, 1997.

    417:14 Procedure Additional. 

The powers vested in the commissioner by this chapter shall be in addition to any other powers to enforce any penalties, fines or forfeitures authorized by law with respect to the methods, acts and practices hereby declared to be unfair or deceptive.


Source. 1947, 189:1, par. 14, eff. June 12, 1947.

    417:15 Failure to Obey Subpoena. 

In case of refusal of any person to comply with any subpoena issued under this chapter or to testify to any matter to which such person may be lawfully interrogated, the superior court of Merrimack county or the county where said party resides on application of the commissioner may issue an order requiring such person to comply with such subpoena and to testify. Any failure to obey such order of the court may be punished by the court as contempt of court.


Source. 1947, 189:1, par. 15. 1996, 238:16, eff. Jan. 1, 1997.

    417:16 Immunity From Prosecution. 

If any person shall ask to be excused from attending and testifying or from producing any books, papers, records, correspondence, or other documents at any hearing on the ground that the testimony or evidence required of such person may tend to be self-incriminating or subject such person to a penalty or forfeiture, and shall notwithstanding be directed to give such testimony or produce such evidence, the person must nonetheless comply with such direction, but shall not thereafter be prosecuted or subjected to any penalty or forfeiture for or on account of any transaction, matter or thing concerning which such person may testify or produce evidence pursuant thereto, and no testimony so given or evidence produced shall be received against the person upon any criminal action, investigation or proceeding; provided, however, that no such individual so testifying shall be exempt from prosecution or punishment for any perjury committed by such individual while so testifying and the testimony or evidence so given or produced shall be admissible against the individual upon any criminal action, investigation or proceeding concerning such perjury, nor shall the individual be exempt from the refusal, revocation, or suspension of any license, permission or authority conferred, or to be conferred, pursuant to the insurance law of this state. Any such individual may execute, acknowledge, and file in the office of the commissioner a statement expressly waiving such immunity or privilege in respect to any transaction, matter, or thing specified in such statement and thereupon the testimony of such person or such evidence in relation to such transaction, matter, or thing may be received or produced before any judge or justice, court, tribunal, grand jury or otherwise, and if so received or produced such individual shall not be entitled to any immunity or privilege on account of any testimony such individual may so give or evidence so produced.


Source. 1947, 189:1, par. 16. 1996, 238:17, eff. Jan. 1, 1997.

    417:17 Prohibitions. 

Any domestic insurance company may have as a director a person who is also a director of another insurance company, which may be a foreign or domestic company; provided, however, that if the effect is to substantially lessen competition generally in the insurance business or to tend to create a monopoly therein, it shall be deemed a violation of this chapter. In the administration and enforcement of this section the commissioner shall have the powers and duties conferred and imposed upon the commissioner by other applicable sections of this chapter with respect to violations of it.


Source. 1949, 47:1. 1996, 238:18, eff. Jan. 1, 1997.

    417:18 Definitions. 

As used in this subdivision the following words shall have the following meaning:

I. "Insurance unfair trade practices law" and similar phrases means those practices prohibited by RSA 417.

II. "Consumer" means any natural person who is offered or supplied goods or services for personal, family, or household purposes.

III. "Supplier" means any individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyd's insurer, fraternal benefit society, and any other legal entity engaged in the business of insurance, including agents, brokers, and adjusters.

IV. "State insurance supervisory authority" means the New Hampshire insurance commissioner, or other official charged with the responsibility of regulating the insurance business in the state in question.


Source. 1971, 519:9, eff. Sept. 5, 1971.

    417:19 Action Against Supplier. 

I. When a supplier, in any action or proceeding brought by the insurance commissioner, has been found to be in violation of this chapter or has been ordered to cease and desist, and said finding or order has become final, any consumer claiming to be adversely affected by the act or practice giving rise to such finding or order may bring suit against said supplier to recover any damages or loss suffered because of such action or practice.

II. For the sole purpose of providing the consumer with the procedural rights set forth under RSA 541 and RSA 541-A, failure of the commissioner to take action under RSA 417:6 or RSA 417:12 within 120 days from the date of the receipt of a complaint from an alleged injured person shall constitute a finding that the alleged act or practice is not in violation of this chapter. This finding may be appealed in accordance with RSA 541. If upon appeal the decision of the commissioner is not upheld, the petitioner may proceed under RSA 417:19, I. Nothing contained in this section shall be construed to limit the commissioner's authority to pursue any legal or regulatory action pursuant to this chapter or any provision in title XXXVII.


Source. 1971, 519:9. 2009, 178:5, eff. Sept. 11, 2009.

    417:2 Definitions. 

I. The term "person" shall mean any individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyd's insurers, fraternal benefit society and any other legal entity, engaged in the business of insurance, including agents, brokers, and adjusters.

II. "Commissioner" shall mean the commissioner of insurance of this state.

III. "Creditor or lender" shall include their successors or assigns.


Source. 1947, 189:1. RSA 417:2. 1986, 157:1, eff. May 28, 1986.

    417:20 Administration of Actions. 

I. Actions under this chapter shall be administered, so far as practicable, to avoid a multiplicity of actions seeking relief for or on behalf of the same consumers.

II. Actions under this chapter shall be administered, so far as practicable, to facilitate voluntary settlements.

III. Whenever a consumer shall prevail in an action brought under RSA 417:19, I, the consumer shall be allowed to recover, in addition to damages, the cost of the suit, including reasonable attorneys' fees. Upon the termination of all suits under this section, the court shall inquire into the reasonableness of attorneys' fees charged to the claimants and revise such fees where necessary to make them reasonable.


Source. 1971, 519:9. 1996, 238:19, eff. Jan. 1, 1997.

    417:21 Effect of Finding or Order. 

A final finding or order rendered in any proceeding before the insurance commissioner pursuant to RSA 417:10, to the effect that the defendant has engaged in an unfair insurance practice, shall be prima facie evidence against the defendant in any action or proceeding brought by any consumer against the defendant under the provisions of RSA 417:19, I. This section shall not apply to consent judgments. No consumer may recover more than once from the same supplier for the same act or practices.


Source. 1971, 519:9, eff. Sept. 5, 1971; 561:9, eff. Sept. 10, 1971.

    417:22 Venue. 

An action under this chapter may be brought in Merrimack county superior court or any district of the United States in which the claim arose or in which the defendant resides, is found, has an agent, is licensed to do business, or is doing business.


Source. 1971, 519:9, eff. Sept. 5, 1971.

    417:23 Insurance Fraud Investigation Unit Established. 

There is established in the department of insurance the insurance fraud investigation unit. The unit shall assist the commissioner, or any law enforcement agency, in investigating insurance fraud or other insurance-related criminal activity and in developing and implementing programs to prevent insurance fraud and abuse. The unit shall have the power to subpoena witnesses and administer oaths in any investigation it conducts, and to compel the production of any books, papers or other memoranda or documents by subpoena duces tecum. The unit shall promptly notify the attorney general of any insurance application, claim, or activity which involves criminal conduct. When required by the commissioner and the attorney general, the unit shall cooperate with the attorney general in the investigation and prosecution of criminal violations.


Source. 1993, 357:6. 2000, 260:1, eff. Aug. 11, 2000.

    417:24 Staff. 

The commissioner shall appoint full-time, classified persons who shall be qualified by training and experience to perform the duties of their positions.


Source. 1993, 357:6. 2003, 144:9, eff. Jan. 1, 2004.

    417:25 Attorney General. 

When requested by the commissioner, the attorney general may assign an assistant attorney general to assist the unit in the performance of its duties.


Source. 1993, 357:6, eff. July 1, 1993.

    417:26 Evidence Collection. 

If, by its own inquiries or as a result of complaints, the insurance department has any reason to believe that a person has engaged in, or is engaging in, any criminal activity or any violations involving title XXXVII, it may administer oaths, serve subpoenas ordering the attendance of witnesses or production of material, and collect evidence. Service of such subpoenas and subpoenas duces tecum may be made by:

I. Delivering a duly executed copy to the person to be served or an agent authorized by law to receive service of process;

II. Delivering a duly executed copy to the person's principal place of business or abode in this state, if any; or

III. Mailing a duly executed copy via registered mail, return receipt requested, to the person to be served, or an agent authorized by law to receive service of process.


Source. 1996, 285:1. 2000, 260:2. 2007, 37:1, eff. Jan. 1, 2008.

    417:27 Inspection. 

If material that the unit seeks to obtain by request is located outside the state, the person so requested may make such material available for examination by the unit or its representative at the place where it is located. The unit may designate representatives, including officials of the state in which the material is located, to inspect the material on its behalf, and it may respond to similar requests from officials of other states.


Source. 1996, 285:1, eff. Jan. 1, 1997.

    417:28 Reporting of Fraudulent Claims by Insurers. 

Any person or entity regulated under title XXXVII which has reason to believe that an insurance fraud or insurance-related criminal activity has been committed shall make a report to the unit within 60 days or within a shorter period under such circumstances as the commissioner may prescribe by rule. No waiver of any such regulated person's or entity's applicable privilege or claim of confidentiality in the documents, materials or information shall occur as a result of such disclosure to the unit. Such report shall be made on a form prescribed by the unit and shall contain the information requested and such additional information as the unit may require. The unit shall review such report and select such claims as, in its judgment, warrant further investigation. In the absence of fraud or malice, no public official or insurance company or person who furnishes information on behalf of the insurance company shall be liable for damages in a civil action or subject to criminal prosecution for any oral or written statement made or any other action taken that is necessary to supply information required pursuant to this section.


Source. 1996, 285:1. 1997, 284:18. 2007, 37:2, eff. Jan. 1, 2008.

    417:29 Fraud Unit Material Information Disclosure. 

The unit's papers, documents, reports, or evidence relative to the subject of investigation under this section shall remain confidential and shall not be subject to public inspection or disclosure. Further, such papers, documents, reports, or evidence relative to the subject of an investigation under this section shall be privileged and shall not be subject to subpoena, discovery, or disclosure in any proceeding other than the action initiated by the unit, except as specifically authorized in this subdivision. For the purposes of this section, investigative materials shall include the testimony of unit personnel concerning any matter of which they have knowledge pursuant to a pending insurance fraud investigation by the unit.


Source. 1996, 285:1, eff. Jan. 1, 1997.

    417:3 Unfair Methods Prohibited. 

No person shall engage in this state in any trade practice which is defined in this chapter or determined pursuant to this chapter as an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.


Source. 1947, 189:1, par. 3, eff. June 12, 1947.

    417:30 Insurer Antifraud Initiatives. 

I. Except for insurance companies writing only credit, home warranty, travel, or title insurance, every insurance company licensed to write direct business in this state shall have antifraud initiatives reasonably calculated to detect, prosecute, and prevent fraudulent insurance acts, including a written antifraud plan. This plan shall be furnished to the commissioner, upon request.

II. Antifraud plans submitted to the commissioner shall be privileged and confidential and shall not be a public record and shall not be subject to discovery or subpoena in a civil or criminal action.

III. The provisions of RSA 400-A:36, III shall apply to the furnishing of information by an insurer to the unit or to any other insurer involved in the prevention or detection of fraudulent insurance acts.

IV. If the commissioner finds that an insurer licensed to do business in New Hampshire has failed to execute an antifraud plan, the commissioner may issue a fine or suspend the right of the insurer to do business in this state until such time as that insurer comes into compliance with the provisions of this chapter.


Source. 1997, 284:19. 2000, 260:3, 4. 2007, 37:3, eff. Jan. 1, 2008. 2019, 189:1, 2, eff. July 10, 2019.

    417:31 Rulemaking. 

The commissioner may adopt rules, pursuant to RSA 400-A:15, I, as necessary for the implementation of this subdivision.


Source. 2007, 37:4, eff. Jan. 1, 2008.

    417:4 Unfair Methods, Acts, and Practices Defined. 

The following are hereby defined as unfair methods of competition and unfair and deceptive acts and practices in the business of insurance:

I. 
Misrepresentations. Misrepresenting, directly or indirectly, in the offer or sale of any insurance or in connection with any inducement or attempted inducement of any insured or person with ownership rights under an issued insurance policy to lapse, forfeit, surrender, assign, effect a loan against, retain, exchange, or convert the policy, by:

(a) Making, issuing, circulating, or causing to be made, issued or circulated any estimate, illustration, circular, or statement misrepresenting the terms of any policy issued or to be issued or the benefits or advantages therein or the dividends or share of surplus to be received thereon;

(b) Making any incomplete comparison of insurance policies;

(c) Making any false or misleading representation as to the dividends or share of surplus previously paid on similar policies;

(d) Making any false or misleading representation as to the financial condition of any insurer, or as to the legal reserve system upon which any life insurer operates;

(e) Using any name or title of any policy or class of policies misrepresenting the true nature thereof;

(f) Employing any device, scheme, or artifice to defraud;

(g) Obtaining money or property by means of any untrue statement of a material fact or any omission to state a material fact necessary in order to make the statement made, in light of the circumstances under which it was made, not misleading; the burden of establishing truthfulness or completeness shall be upon the party stating or omitting to state a material fact; or

(h) Engaging in any other transaction, practice, or course of business which operates as a fraud or deceit upon the purchaser, insured, or person with policy ownership rights.

II. 
Misrepresentation in Insurance Applications or Transactions. Making false or fraudulent statements or representations on or relative to an application for insurance, for the purpose of obtaining a fee, commission, money or benefit from an insurer, agent, or individual.

III. 
False Information and Advertising Generally.

(a) Making, publishing, disseminating, circulating, or placing before the public, or causing, directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in a newspaper, magazine, or other publication, or in the form of a notice, circular, pamphlet, letter, or poster, or over any radio or television station, or in any other way, an advertisement, announcement, or statement containing any assertion, representation, or statement with respect to any insurer, its financial condition, or the terms of any contracts issued or to be issued or the benefits or advantages promised thereby, or the dividends or share of the surplus to be received thereon or with respect to any person in the conduct of such person's insurance business, which is untrue, incomplete, deceptive, or misleading.

(b) The burden of establishing truth and completeness shall be on the person making, publishing, circulating or placing said advertisement, announcement, or statement before the public.

IV. 
Defamation. Making, publishing, disseminating, or circulating, directly or indirectly, or aiding, abetting, or encouraging the making, publishing, disseminating, or circulating of any oral or written statement or any pamphlet, circular, article or literature which is false or maliciously critical of or derogatory to the financial condition of an insurer, and which is calculated to injure any person engaged in the business of insurance.

V. 
Boycott; Coercion and Intimidation.

(a) Entering into any agreement to commit or by any concerted action committing any act of boycott or individually or by any concerted action entering into any agreement to commit or committing any act of coercion or intimidation resulting or tending to result in unreasonable restraint of, or a monopoly in, the business of insurance.

(b) Except as contained in the policy no insurer, corporation, partnership, or individual shall make any contract or agreement with any person insured or to be insured except as initiated by or agreed to by the person insured or to be insured that the whole or any part of the insurance which is subject to the provisions of this title, shall be placed by any particular corporation, partnership, or individual or be written by or in any particular company or insurer, or by or in any group of companies or insurers or by any agent or group of agents. Any contracts made in contravention of this section shall be null and void.

VI. 
False Financial Statements. Knowingly filing with any supervisory or other public official or knowingly making, publishing, disseminating, circulating, or delivering to any person; or knowingly placing before the public, or causing directly or indirectly, to be made, published, disseminated, circulated, delivered to any person, or placed before the public, any false statement of financial condition of an insurer; or knowingly making any false entry in any book, report, or statement of any insurer or knowingly misleading any public official to whom such insurer is required by law to report, or who has authority by law to examine into its condition or into any of its affairs or knowingly omitting to make a true entry of any material fact pertaining to the business of such insurer in any book, report or statement of such insurer.

VII. 
Stock Operations and Advisory Board Contracts. Issuing or delivering, or permitting agents, officers, or employees to issue or deliver, agency company stock or other capital stock, or benefit certificates or shares in any common-law corporation, or securities or any special or advisory board contracts or other contracts of any kind promising returns and profits as an inducement to insurance.

VIII. 
Unfair Discrimination.

(a) Making or permitting any unfair discrimination between individuals of the same class and equal expectation of life in the rates charged for any contract of life insurance or of life annuity or in the dividends or other benefits payable thereon, or in any other of the terms and conditions of such contract.

(b) Making or permitting any unfair discrimination between individuals of the same class and of essentially the same hazard in the amount of premium, policy fees, or rates charged for any policy or contract of health insurance or in the benefits payable thereunder, or in any of the terms or conditions of such contract, or in any other manner whatsoever. Discrimination on the basis of gender identity with respect to the availability of any covered services, medications, supplies, or durable medical equipment is specifically prohibited.

(c) Making any unreasonable distinction or discrimination between persons as to the policy, premiums, or rates charged for policies upon the lives or health of such persons, or in any other manner whatever; demanding or requiring by an insurer a greater premium from any person than is at that time required by such insurer from persons of the same age, sex, general condition of health and prospect of longevity; making, or requiring any rebate, diminution, or discount upon the amount to be paid on such policy in case of death of such person insured; inserting in the policy any condition, making any stipulation whereby such person insured shall bind oneself or one's heirs, executors, administrators and assigns to accept any sum less than the full amount of value of such policy in case of a claim accruing thereon by reason of the death or disability of such person insured, other than such as are imposed on persons in similar cases. Any such stipulations or conditions so made or inserted shall be void.

(d) Making or permitting any unfair distinction or discrimination in any contract of insurance or annuity contract.

(e) Refusing to insure risks solely because of age (except in the case of life, accident or health insurance), place or area or residence, race, color, creed, national origin, ancestry, marital status, lawful occupation including the military service (except in the case of life, accident or health insurance), of anyone who is or seeks to become insured or solely because another insurer has refused to write a policy, or has cancelled or has refused to renew an existing policy in which that person was the name insured or, except in the instance of excess coverages, solely because the insured does not insure collateral primary, personal types of insurance with the insurer. The exemption in this subparagraph shall not permit a mortgage life insurance policy or certificate to cease, cancel or terminate solely on the basis of the mortgagor's age, until the mortgagor has reached the age of 80.

(f) Refusing to insure or to continue to insure, or limiting the amount, extent or kind of coverage available solely because the applicant who is also the proposed insured has been or may become the victim of domestic abuse or violence. Nothing in this subparagraph shall prohibit an insurer from underwriting a risk on the basis of the physical or medical history or condition of the proposed insured, or other relevant factors relating to the proposed insured, at the time of application regardless of the underlying cause of the condition and in accordance with subparagraph (a) of this paragraph. No insurer shall be held criminally or civilly liable for any cause of action which may result from compliance with this subparagraph.

(g) Charging a higher premium for private passenger automobile or homeowner insurance solely on the basis of information obtained from a credit rating, a credit history, or a credit scoring model.

(h) For life coverage, annuity contracts, or disability coverage, refusing to insure or to continue to insure, or limiting the amount, extent, or kind of coverage based on the applicant who is also the proposed insured having filled a prescription for an opioid antagonist, when that prescription is not relevant to the applicant's health, but rather is designed to promote the health of someone else. For any such prescription, the carrier shall inquire with the applicant as to the reason for the prescription and may request documentation that verifies the applicant's response prior to issuing an underwriting decision.

IX. 
Rebates.

(a) Except as otherwise expressly provided by law, knowingly permitting or offering to make or making any contract of insurance or agreement as to such contract other than as plainly expressed in the contract issued thereon, or paying or allowing, or giving or offering to pay, allow, or give, directly or indirectly, as inducement to such insurance, or annuity, any rebate of premiums payable on the contract, or any special favor or advantage in the dividends or other benefits thereon, or any valuable consideration or inducement whatever not specified in the contract; or giving, or selling, or purchasing or offering to give, sell, or purchase as inducement to such insurance or annuity or in connection therewith any stocks, bonds, or other securities of any insurance company or other corporation, association, or partnership, or any dividends or profits accrued thereon, or anything of value whatsoever not specified in the contract.

(b) Nothing in paragraphs VIII or IX(a) shall be construed as including within the definition of discrimination or rebates any of the following practices:

(1) Paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from nonparticipating insurance, provided that any such bonuses or abatement of premiums shall be fair and equitable to policyholders and for the best interests of the company and its policyholders;

(2) In the case of life insurance policies issued on the industrial debit plan making allowance to policyholders who have continuously for a specified period made premium payments directly to an office of the insurer in an amount which fairly represents the saving in collection expenses;

(3) Readjustment of the rate of premium for a group insurance policy based on the loss or expense experience thereunder, at the end of the first or any subsequent policy year of insurance thereunder, which may be made retroactive only for such policy year;

(4) Issuing insurance policies covering bona fide employees of the insurer at a rate less than the rate charged other persons in the same class;

(5) Issuing policies on a salary saving, payroll deduction, preauthorized, postdated, automatic check or draft plans at a reduced rate commensurate with the savings made by the use of such plan;

(6) Paying commissions or other compensation to duly licensed agents or brokers, or allowing or returning to participating policyholders, members or subscribers, dividends, savings, or unabsorbed premium deposits;

(7) Paying by an insurance agent of part or all of commissions on public insurance to a nonprofit association of insurance agents, which is affiliated with a recognized state or national insurance agents' association, to be used in whole or in part for one or more civic enterprises;

(8) Reduction of premium rate for policies of large amounts, but not exceeding savings in issuance and administration expenses reasonably attributable to such policies as compared with policies of similar plan issued in smaller amounts;

(9) An insurance company paying to another insurance company or to any person who is a duly authorized producer, or an insurance company or such a person from receiving a commission in respect to any policy under which the entity or he or she is insured;

(10) An insurance company issuing non-participating life insurance paying bonuses to policyholders or otherwise abating their premiums in whole or in part out of surplus accumulated from non-participating insurance;

(11) Value added service, activity, or product offered or provided without a fee, or at a reduced fee, if the provision of such value added service, activity, or product does not violate any other applicable statute or rule, and is:

(A) Available to all insureds on an objective and fair basis; and

(B) Directly related to the firm's servicing of the insurance policy, annuity contract, or brokerage agreement, or offered or undertaken to provide risk control for the benefit of the client;

(12) For the purposes of subparagraph (11), "
value added service, activity, or product
" may include the following:

(A) Risk assessments or mitigation.

(B) Risk control tools.

(C) Claims assistance.

(D) Legislative updates.

(E) Administration consulting;

(13) The giving of a promotional item or items to a consumer in connection with marketing of contracts of insurance provided the item or items have a fair market value of $100 or less per consumer, per year;

(14) Contests, sweepstakes, raffles, or drawings, conducted in connection with the marketing or promotion of insurance products, if:

(A) There is no participation cost to entrants; and

(B) The contest, sweepstake, raffle, or drawing is open to consumers who are not policyholders and the consumer is not required to purchase a policy in order to be eligible to enter the contest, sweepstake, raffle, or drawing or receive a prize;

(15) The rebate of all or part of a producer's commission on the sale of commercial insurance as defined in RSA 412 provided the insurer expressly provides for such rebate in rate filings approved by the commissioner and the reduction of the commission is not disclosed to the insured either directly or indirectly;

(16) The payment or assignment of all or part of a producer's commission on the sale of insurance to an employee of the producer;

(17) In limited circumstances, activities that promote the public interest without harmfully affecting licensees, as determined by the commissioner. Such activities include, but are not limited to, the reduction of premium rate of an insurance policy based on the loss or expense thereunder, at the end of the first or any subsequent policy period, provided that there is no discrimination in favor of insured individuals within the same rate class and risk assessment.

(c) Knowingly receiving or accepting, directly or indirectly, any rebate of premium or part thereof, or agents, or brokers commission thereon payable on any policy of insurance or annuity contract or any favor or advantage, a share in the dividend, or other benefit to accrue thereon, or receiving anything of value as an inducement to such insurance or contract or in connection therewith which is not specified, promised, or provided for in the policy or contract, except as provided in paragraph IX(b).

(d) Nothing in this chapter shall be construed as including within the definition of securities as inducement to purchase insurance, the selling or offering for sale, contemporaneously with life insurance or annuities, of mutual fund shares or face amount certificates of regulated investment companies under offerings registered with the securities and exchange commission and the state of New Hampshire pursuant to RSA 421-B where such shares or such face amount certificates or such insurance or annuities may be purchased independently of and not contingent upon purchase of the other, at the same price and upon the same terms and conditions as were purchased independently.

X. 
Title Insurance Commissions, Rebates and Discounts. Paying, allowing, or permitting commissions, rebates, or discounts to any person having an interest in or lien upon real property, which is the subject of the title insurance involved, or to any person acting for or on behalf of a person with such an interest or lien.

XI. [Repealed.]

XII. 
Collecting Proper Premium. Knowingly collecting as premium or charge for insurance any sum in excess of or less than the premium or charge applicable to such insurance and as specified in the policy, in accordance with the applicable classifications and rates as filed with and approved by the commissioner, except a premium finance charge, consultant's fee, policy fee, and/or service fee as allowed by law or regulation; or, in cases where classifications, premiums, or rates are not required by this title to be so filed and approved, such premiums and charges shall not be in excess of or less than those specified in the policy and as fixed by the insurer. This provision shall not be deemed to prohibit the charging and collecting, by surplus line brokers of the amount of applicable state and federal taxes in addition to the premium required by the insurer. Nor shall it be deemed to prohibit the charging and collecting, by an insurer, of amounts actually to be expended for medical examination of an applicant for insurance or for reinstatement of an insurance policy. Nor shall it be deemed to prohibit the charging or collecting by an insurance agent or broker of a reasonable service charge or fee as may be determined by regulation.

XIII. 
Separate Charge for Insurance. Arranging or participating in any plan to offer or effect in this state as an inducement to the purchase or rental by the public of any property or services, any insurance for which there is no separate charge to the insured. This section does not apply to:

(a) Insurance offered as a guarantee of the performance of goods, and designed to protect the purchasers or users of such goods;

(b) Title insurance;

(c) Towing and labor services of motorist service clubs.

XIV. 
Coverage Reduction. Reduction by an insurance company authorized to do business in this state of liability limits or increasing premiums on any policy during its term, without the consent of the insured.

XV. 
Unfair Claim Settlement Practices by Insurers.

(a) Any of the following acts by an insurer, if committed without just cause and not merely inadvertently or accidentally, shall constitute unfair claim settlement practices:

(1) Knowingly misrepresenting to claimants or insureds pertinent facts or policy provisions relating to coverages at issue;

(2) Failing to acknowledge and act promptly upon communications with respect to claims arising under insurance policies;

(3) Failing to adopt and implement standards for the prompt and reasonable investigation of claims arising under insurance policies;

(4) Not attempting in good faith to effectuate prompt, fair and equitable settlements or compromises of claims in which liability has become reasonably clear;

(5) Compelling claimants to institute litigation to recover amounts due under insurance policies by offering substantially less than the amounts ultimately recovered in actions brought by them;

(6) Adopting or making known to insureds or claimants a policy of appealing from arbitration awards in favor of insureds or claimants for the purpose of compelling them to accept settlements or compromises less than the amount awarded in arbitration;

(7) Attempting settlement or compromise of a claim on the basis of an application which was altered without notice to, or knowledge or consent of the insured;

(8) Attempting to settle or compromise a claim for less than the amount which the insured had been led to believe the insured was entitled to by written or printed advertising material accompanying or made part of an application;

(9) Attempting to delay the investigation or payment of claims by requiring an insured and the insured's physician to submit a preliminary claim report and then requiring the subsequent submission of formal proof of loss forms, both of which submissions contain substantially the same information;

(10) Making any claim payment not accompanied by a statement setting forth the benefits included within the claim payment;

(11) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss forms have been submitted;

(12) Refusing payment of a claim solely on the basis of an insured's request to do so without making an independent evaluation of the insured's liability based upon all available information;

(13) Failure of an insurer to maintain a complete record of all complaints which it has received, whether or not they were deemed valid, the time it took to process the complaint, and the disposition thereof; or

(14) Knowingly underestimating the value of any claim by an insurer or by an adjuster representing the insurer.

(b) Evidence as to numbers and types of complaints to the insurance department against an insurer, and said department's complaint experience with other insurers writing similar lines of insurance, shall be admissible in evidence in an administrative or judicial proceeding brought under this title, provided that no insurer shall be deemed in violation of this section solely by reason of the numbers and types of such complaints.

XVI. 
Coercion in Requiring Insurance.

(a) No creditor or lender engaged in the business of financing the purchase of real or personal property or of lending money on the security of real or personal property may require, as a condition to such financing or lending, or as a condition to the renewal or extension of any such loan or to the performance of any other act in connection with such financing or lending, that the purchaser or borrower, or the purchaser's or borrower's successors shall negotiate through a particular insurance company or companies, insurance agent or agents, broker or brokers, type of company or types of companies, any policy of insurance or renewal of a policy insuring such property. This provision does not prevent the exercise by any mortgagee of the right to approve on a reasonable nondiscriminatory basis only insurance companies authorized to do business in this state, selected by the borrower.

(b) There shall be no interference either directly or indirectly with such borrower's, debtor's or purchaser's free choice of an agent and of an insurer which complies with the foregoing requirements, and the creditor or lender may not refuse the policy so tendered by the borrower, debtor or purchaser. Upon notice of any refusal of such tendered policy, the insurance commissioner shall order the creditor or lender to accept the tendered policy, if the commissioner determines that the refusal is not in accordance with the foregoing requirements of this subparagraph. Failure to comply with such an order of the insurance commissioner is a violation of this section.

(c) Whenever the instrument requires that the purchaser, mortgagor, or borrower furnish insurance of any kind on real or personal property which is being conveyed or which is collateral security to a loan, the mortgagee or lender shall refrain from disclosing or using any and all such insurance information to its own advantage and to the detriment of either the borrower, purchaser, mortgagor, insurer, or company or agency complying with the requirements relating to insurance.

(d) Notwithstanding any other law to the contrary, a creditor or lender of a loan secured by an interest in real property shall not require the borrower to keep the mortgaged property insured under a property insurance policy in a sum in excess of the value of the buildings on the real property.

(e) Notwithstanding any other law to the contrary, no creditor or lender shall require as a condition to closing a loan that the borrower provide an original insurance policy at said closing; provided, however, that the creditor or lender may require the borrower to produce at closing a binder showing the borrower as a named insured and creditor or lender as mortgagee, and confirming that insurance has been issued, is in force, and will remain in full force until a copy of the final policy is delivered to the creditor or lender or until the creditor or lender has received notice of cancellation in accordance with the policy conditions.

(f) No insurer may automatically write insurance on a debtor who has contracted credit based on the principle that the insurance is applicable unless specifically rejected by the debtor, unless the premium or such other identifiable charge as may be applicable is paid in full by the creditor.

XVII. 
Complaint Handling Procedures Applicable to Insurance Companies.

(a) Failing to maintain a procedural means within the company, headed by a responsible officer, to process and respond adequately to policyholders' and certificate holders' complaints.

(b) Failing to record and assemble all records of policyholders' and certificate holders' complaints in a central location to facilitate periodic review by insurance departments.

(c) Failing to record, maintain and produce, when requested by appropriate authority, a summary of all complaints received, whether or not they were deemed valid, the time it took to process the complaints, and the disposition thereof.

(d) Failing to provide within this state reasonable means whereby any person aggrieved by the application of an insurer's rating system, claims practices, sales practices or underwriting procedures may be heard, in person or by an authorized representative, upon the person's written request to review the manner in which such procedures were applied in connection with insurance afforded or tendered to the person.

XVIII. 
Conflict of Interest. Failing to establish a reasonable procedure whereby insurance company officers, directors, trustees or responsible employees can disclose to the company board of directors or trustees any material interest or affiliation likely to conflict with their official duties.

XIX. 
Human Immunodeficiency Virus. No person engaged in the business of insurance in this state shall test for the presence of an antibody or antigen to a human immunodeficiency virus other than in accordance with the provisions of this paragraph. Such persons shall not be subject to any provision of RSA 141-F.

(a) No person may test any individual in connection with an application for insurance for the presence of an antibody or antigen to a human immunodeficiency virus unless such individual gives written consent on a form designed by the commissioner of the department of health and human services with consultation and approval by the commissioner of insurance. The form shall contain information about the medical interpretations of positive and negative test findings, disclosure of test results, and the purpose for which the test results may be used.

(b) If the laboratory analysis is performed within this state, only laboratories certified by the department of health and human services shall be used to test for the presence of an antibody or antigen to a human immunodeficiency virus. If the laboratory analysis is conducted without this state, only laboratories licensed by the United States Department of Health and Human Services under the Clinical Laboratory Improvement Amendments of 1988
, as amended, shall be used to perform such tests.

(c) In the event of a positive test result on a blood, urine, or oral specimen, or a positive test result on an FDA approved test, a person who tests for the presence of an antibody or antigen to a human immunodeficiency virus shall disclose the test results, but only to:

(1) The individual tested;

(2) Such other person or entity as the individual tested may authorize by written consent to receive the test results, which consent shall be clearly identifiable as part of the form described in subparagraph (a) of this paragraph.

(d) Notwithstanding the provisions of subparagraph (c), if the test results are positive or indeterminate and the individual tested has not given written consent authorizing a physician to receive the test results, such individual shall be urged, at the time the individual is informed of the positive or indeterminate test results, to contact the commissioner of the department of health and human services for appropriate counseling.

(e) A person who requires the test for the presence of an antibody or antigen to a human immunodeficiency virus shall maintain all test results and records pertaining to test results as confidential and protected against inadvertent or unwarranted intrusion. Such test results obtained by subpoena or any other method of discovery shall not be released or made public outside the proceedings.

(f) The commissioner of insurance shall adopt rules, under RSA 541-A, relative to:

(1) Recordkeeping designed to maintain the confidentiality of an individual tested under this paragraph.

(2) Who may have access to such records and the conditions of such access.

XX. 
Coercion in Requiring Certain Automobile or Glass Repair.

(a) No insurance company, and no agent or adjuster for such insurance company, that issues or renews in this state any policy of insurance covering, in whole or in part, motor vehicles shall require any insured person or entity under that policy to use a particular company or location for the providing of automobile glass replacement or automobile repair services or products insured in whole or in part by that policy.

(b) No such insurance company, agent or adjuster shall engage in any act or practice of intimidation, coercion, threat, for or against any such insured person or entity to use such a particular company or location to provide such services or products.

(c) Nothing shall prohibit any insurance company, agent or adjuster from providing to such insured person or entity the name of an automobile glass company or automobile repair company with which arrangements may have been made with respect to automobile glass or repair prices or services. If a name is provided, there must be disclosure by the insurance company, agent or adjuster to the insured person or entity that any other automobile glass company or automobile repair company or location may be used at the discretion of the insured person or entity. However, the insurer may limit payment for such work based on the fair and reasonable price in the area by repair shops or facilities providing similar services with the usual and customary guarantees as to materials and workmanship. If an independent repair shop or facility and an insurer are unable to agree on a price, then for the purposes of this section "fair and reasonable price" shall mean the price available from a recognized, competent and conveniently located, independent repair shop or facility which is willing and able to repair the damaged automobile within a reasonable time.

XXI. 
"Most Favored Nation" or "Equally Favored Nation" Provisions. Using or enforcing any "most favored nation" or "equally favored nation" provision in any contract for medical care provider services. For the purposes of this paragraph "
most favored nation
" or "
equally favored nation
" provisions mean a requirement that a provider give the insurer the benefit of any lower fee schedules or charges for services which the provider may subsequently agree to with other persons or entities.

XXII. [Repealed.]

XXIII. 
Medicare Products and Medicare Supplemental Health Insurance.

(a)(1) Selling, soliciting or negotiating the purchase of Medicare products (Part C and Part D) or Medicare supplemental (Medigap) health insurance in this state through the use of cold lead advertising.

(2) Using an appointment that was made to discuss Medicare products or to solicit the sale of Medicare products in order to solicit sales of life insurance or annuity products.

(3) Soliciting the sale of Medicare products door-to-door prior to receiving an invitation from a consumer.

(b) In this paragraph:

(1) "
Cold lead advertising
" means making use directly or indirectly of a method of marketing that fails to disclose in a conspicuous manner that a purpose of the marketing is insurance sales solicitation and that a contact will be made by an insurance producer or insurance company.

(2) "
Medicare products
" means Medicare Part C (Medicare Advantage) and Medicare Part D (prescription drugs).

(3) "
Medicare supplemental health insurance
" means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations, other than a policy issued pursuant to a contract under section 1876 of the federal Social Security Act 42 U.S.C. section 1395 et seq. or an issued policy under a demonstration project specified in 42 U.S.C. section 1395 ss (g)(1), which is advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical expenses of persons eligible for Medicare. "Medicare supplemental health insurance" does not include Medicare Advantage plans established under Medicare Part C, Outpatient Prescription Drug plans established under Medicare Part D, or any Health Care Prepayment Plan (HCPP) that provides benefits pursuant to an agreement under section 1833(a)(1)(A)
 of the Social Security Act.


Source. 1947, 189:1, par. 4. RSA 417:4. 1965, 122:1. 1971, 519:1; 561:7, 8. 1986, 157:2. 1988, 262:10. 1991, 26:1. 1993, 160:1. 1994, 320:1. 1995, 310:181, 182. 1996, 40:1; 238:1-8. 1997, 158:11; 174:1; 282:4. 2000, 206:1. 2003, 144:8. 2004, 245:5, 6. 2006, 196:11. 2007, 30:1. 2009, 96:1, II. 2010, 258:1, eff. Jan. 1, 2011. 2018, 132:4-6, eff. July 29, 2018. 2019, 127:1, eff. Aug. 24, 2019; 314:2, eff. July 1, 2019; 332:20, eff. Jan. 1, 2020. 2020, 37:51, eff. Sept. 27, 2020. 2021, 56:7, eff. July 24, 2021; 171:1, eff. Sept. 28, 2021. 2022, 42:12, eff. July 2, 2022.

    417:5-a Cumulative Authority. 

The enumeration in this chapter of powers vested in the commissioner and of specific unfair methods of competition and unfair or deceptive acts and practices in the business of insurance is not exclusive or restrictive or intended to limit the powers of the commissioner or any court of review but the provisions of such chapter are in all respects cumulative of and supplemental to the insurance code and all other applicable New Hampshire statutes and common law.


Source. 1971, 519:2, eff. Sept. 5, 1971.

    417:5 Power of Commissioner. 

The commissioner shall have power to examine and investigate into the affairs of every person engaged in the business of insurance in this state in order to determine whether such person has been or is engaged in any unfair method of competition or any unfair or deceptive act or practice.


Source. 1947, 189:1, par. 5, eff. June 12, 1947.

    417:6 Notice of Hearing. 

Whenever the commissioner shall have reason to believe that any such person has been engaged or is engaging in any unfair method of competition or any unfair or deceptive act or practice defined in RSA 417:4, and that a proceeding by the commissioner in respect thereto would be to the public interest, the commissioner shall issue and serve upon such person a statement of the charges and a notice of a hearing to be held at a time and place fixed in the notice, which shall not be less than 10 days after the date of the service of the notice. The notice of the hearing may be in the form of a notice to show cause, stating the proposed action to be taken unless such person shows cause at a hearing to be held as specified in the notice, why the proposed action should not be taken, and stating the basis of the proposed action.


Source. 1947, 189:1, par. 6. RSA 417:6. 1971, 519:3. 1996, 238:9, eff. Jan. 1, 1997.

    417:7 Hearing;  Witnesses;  Production of Books. 

At the time and place fixed for such hearing, such person shall have an opportunity to be heard. The commissioner upon such hearing may administer oaths, examine and cross-examine witnesses, receive oral and documentary evidence, and shall have the power to subpoena witnesses, compel their attendance, and require the production of books, papers, records, correspondence, or other documents which the commissioner deems relevant to the inquiry. The commissioner, upon such hearing may, and upon the request of any party shall, cause to be made a written or electronic record of all the evidence offered or introduced and all proceedings had at such hearing. Nothing contained in this chapter shall require the observance at such hearing of formal rules of pleading or evidence.


Source. 1947, 189:1, par. 7. RSA 417:7. 1971, 519:4. 1996, 238:10, eff. Jan. 1, 1997.

    417:8 Appearances. 

Upon good cause shown, the commissioner may permit any person to intervene, appear and be heard at such hearing.


Source. 1947, 189:1, par. 8, eff. June 12, 1947.

    417:9 Service of Charges, Etc. 

Statements of charges, notices, orders, and other processes of the commissioner under this chapter may be served by anyone duly authorized by the commissioner, either in the manner provided by law for service of process in civil actions, or by registering and mailing a copy thereof to the person affected by such statement, notice, order, or other process at such person's or its residence or principal office or place of business. The verified return by the person so serving such statement, notice, order, or other process, setting forth the manner of such service, shall be proof of the same, and the return postcard receipt for such statement, notice, order, or other process, registered and mailed as provided in this section, shall be proof of the service of the same.


Source. 1947, 189:1, par. 9. 1996, 238:11, eff. Jan. 1, 1997.

    418:1 Fraternal Benefit Societies Defined. 

Any incorporated society, order or supreme lodge, without capital stock, including one exempted under RSA 418:36, I(b), whether incorporated or not, conducted solely for the benefit of its members and their beneficiaries and not for profit, operated on a lodge system with ritualistic form of work, having a representative form of government, and which provides benefits in accordance with this chapter, is hereby declared to be a fraternal benefit society.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:10 Amendments to Laws. 

I. A domestic society may amend its articles of incorporation or bylaws in accordance with the provisions thereof by action of its supreme governing body at any regular or special meeting thereof or, if its laws so provide, by referendum. Such referendum may be held in accordance with the provisions of its laws by the vote of the voting members of the society, by the vote of delegates or representatives of voting members or by the vote of local lodges. A society may provide for voting by mail. No amendment submitted for adoption by referendum shall be adopted unless, within 6 months from the date of submission thereof, a majority of the members voting shall have signified their consent to such amendment by one of the methods under this section.

II. No amendment to the articles of incorporation or bylaws of any domestic society shall take effect unless approved by the commissioner who shall approve such amendment if the commissioner finds that it has been duly adopted and is not inconsistent with any requirement of the laws of this state or with the character, objects and purposes of the society. Unless the commissioner shall disapprove any such amendment within 60 days after the filing of the same, such amendment shall be considered approved. The approval or disapproval of the commissioner shall be in writing and mailed to the secretary or corresponding officer of the society at its principal office. In case the commissioner disapproves such amendment, the reasons for such disapproval shall be stated in such written notice.

III. Within 90 days from the approval thereof by the commissioner, all such amendments, or a synopsis thereof, shall be furnished to all members of the society either by mail or by publication in full in the official publication of the society. The affidavit of any officer of the society or of anyone authorized by it to mail any amendments or synopsis thereof, stating facts which show that same have been duly addressed and mailed, shall be prima facie evidence that such amendments or a synopsis thereof, have been furnished the addressee.

IV. Every foreign or alien society authorized to do business in this state shall file with the commissioner a duly certified copy of all amendments of, or additions to, its laws within 90 days after the enactment of same.

V. Printed copies of the laws as amended, certified by the secretary or corresponding officer of the society shall be prima facie evidence of the legal adoption thereof.

VI. Every society transacting business under this chapter shall file with the commissioner of insurance a duly certified copy of all amendments of or additions to its constitution and laws within 90 days after the enactment of the same. Printed copies of the constitution and laws as amended, changed or added to, certified by the secretary, or corresponding officer, of the society, shall be prima facie evidence of the legal adoption thereof.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:11 Institutions. 

A society may create, maintain, and operate, or may establish organizations to operate, not-for-profit institutions to further the purposes permitted in RSA 418:4, I(b). Such institutions may furnish services free or at a reasonable charge. Any real or personal property owned, held or leased by the society for this purpose shall be reported in every annual statement.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:12 Reinsurance. 

I. A domestic society may, by a reinsurance agreement, cede any individual risk or risks in whole or in part to an insurer, other than another fraternal benefit society, having the power to make such reinsurance and authorized to do business in this state, or if not so authorized, one which is approved by the commissioner, but no such society may reinsure substantially all of its insurance in force without the written permission of the commissioner.

II. Notwithstanding the limitation in paragraph I, a society may reinsure the risks of another society in a consolidation or merger approved by the commissioner under RSA 418:13, or as part of an assumption reinsurance agreement approved by the commissioner for the purpose of consolidating risks in a particular geographic region or facilitating the transformation of a fraternal benefit society to another form of organization.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:13 Consolidations and Mergers. 

I. A domestic society may consolidate or merge with any other society by complying with the provisions of this section. It shall file with the commissioner:

(a) A certified copy of the written contract containing in full the terms and conditions of the consolidation or merger;

(b) A sworn statement by the president and secretary or corresponding officers of each society showing the financial condition thereof on a date fixed by the commissioner but not earlier than December 31, next preceding the date of the contract;

(c) A certificate of such officers, duly verified by their respective oaths, that the consolidation or merger has been approved by a 
2/3 vote of the supreme governing body of each society, such vote being conducted at a regular or special meeting of each such body, or, if the society's laws so permit, by mail; and

(d) Evidence that at least 60 days prior to the action of the supreme governing body of each society, the text of the contract has been furnished to all members of each society either by mail or by publication in full in the official publication of each society.

II. If the commissioner finds that the contract is in conformity with the provisions of this section, that the financial statements are correct, and that the consolidation or merger is just and equitable to the members of each society, the commissioner shall approve the contract and issue a certificate to such effect. Upon such approval, the contract shall be in full force and effect unless any society which is a party to the contract is incorporated under the laws of any other state or territory. In such event the consolidation or merger shall not become effective unless and until it has been approved as provided by the laws of such state or territory and a certificate of such approval filed with the commissioner of this state or, if the laws of such state or territory contain no such provision, then the consolidation or merger shall not become effective unless and until it has been approved by the commissioner of insurance of such state or territory and a certificate of such approval filed with the commissioner of this state. In case such contract is not approved it shall be inoperative, and the fact of submission and its contents shall not be disclosed by the commissioner of this state.

III. Upon the consolidation or merger becoming effective as provided under this section, all the rights, franchises and interests of the consolidated or merged societies in and to every species of property, real, personal or mixed, and things in action thereunto belonging shall be vested in the society resulting from or remaining after the consolidation or merger without any other instrument, except that conveyances of real property may be evidenced by proper deeds, and the title to any real estate or interest therein, vested under the laws of this state in any of the societies consolidated or merged, shall not revert or be in any way impaired by reason of the consolidation or merger, but shall vest absolutely in the society resulting from or remaining after such consolidation or merger.

IV. The affidavit of any officer of the society or of anyone authorized by it to mail any notice or document, stating that such notice or document has been duly addressed and mailed, shall be prima facie evidence that such notice or document has been furnished the addressees.

V. Where such merger or consolidation is between a fraternal society and a beneficiary association having no lodge system or representative form of government, it may be authorized by the commissioner upon proof that it has been approved by a majority vote of the membership of the beneficiary association and of the general board of directors of the fraternal society.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:14 Conversion of Fraternal Benefit Society Into a Mutual Life Company. 

Any domestic fraternal benefit society may be converted and licensed as a mutual life insurance company by compliance with all the requirements of the general insurance laws for mutual life insurance companies. A plan of conversion shall be prepared in writing by the board of directors setting forth in full the terms and conditions of conversion. The affirmative vote of 
2/3 of all members of the supreme governing body at a regular or special meeting shall be necessary for the approval of such plan. No such conversion shall take effect unless and until approved by the commissioner who may give such approval if the commissioner finds that the proposed change is in conformity with the requirements of law and not prejudicial to the certificate holders of the society.


Source. 2003, 182:1, eff. Jan. 1, 2003.

    418:15 Benefits. 

I. A society may provide the following contractual benefits in any form:

(a) Death benefits;

(b) Endowment benefits;

(c) Annuity benefits;

(d) Temporary or permanent disability benefits;

(e) Hospital, medical or nursing benefits;

(f) Monument or tombstone benefits to the memory of deceased members; and

(g) Such other benefits as authorized for life insurers and which are not inconsistent with this chapter.

II. A society shall specify in its rules those persons who may be issued, or covered by, the contractual benefits in paragraph I, consistent with providing benefits to members and their dependents. A society may provide benefits on the lives of children under the minimum age for adult membership upon application of an adult person.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:16 Beneficiaries. 

I. The owner of a benefit contract shall have the right at all times to change the beneficiary or beneficiaries in accordance with the laws or rules of the society unless the owner waives this right by specifically requesting in writing that the beneficiary designation be irrevocable. A society may, through its laws or rules, limit the scope of beneficiary designations and shall provide that no revocable beneficiary shall have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the benefit contract.

II. A society may make provision for the payment of funeral benefits to the extent of such portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of the member.

III. If, at the death of any person insured under a benefit contract, there is no lawful beneficiary to whom the proceeds shall be payable, the amount of such benefit, except to the extent that funeral benefits may be paid as under paragraph II, shall be payable to the personal representative of the deceased insured, provided that if the owner of the certificate is other than the insured, such proceeds shall be payable to such owner.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:17 Benefits Not Attachable. 

No money or other benefit, charity, relief or aid to be paid, provided or rendered by any society, shall be liable to attachment, garnishment or other process, or to be seized, taken, appropriated or applied by any legal or equitable process or operation of law to pay any debt or liability of a member or beneficiary, or any other person who may have a right thereunder, either before or after payment by the society; provided, however, that this section shall not apply to loans or other obligations owing to the society from the member or his or her benefactory.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:18 The Benefit Contract. 

I. Every society authorized to do business in this state shall issue to each owner of a benefit contract a certificate specifying the amount of benefits provided in such contract. The certificate, together with any riders or endorsements, the laws of the society, the application for membership, the application for insurance and declaration of insurability, if any, signed by the applicant, and all amendments to each thereof, shall constitute the benefit contract, as of the date of issuance, between the society and the owner, and the certificate shall so state. A copy of the application for insurance and declaration of insurability, if any, shall be endorsed upon or attached to the certificate. All statements on the application shall be representations and not warranties. Any waiver of this provision shall be void.

II. Any changes, additions or amendments to the laws of the society duly made or enacted subsequent to the issuance of the certificate, shall bind the owner and the beneficiaries, and shall govern and control the benefit contract in all respects the same as though such changes, additions or amendments had been made prior to and were in force at the time of the application for insurance, except that no change, addition or amendment shall destroy or diminish benefits which the society contracted to give the owner as of the date of issuance.

III. Any person upon whose life a benefit contract is issued prior to attaining the age of majority shall be bound by the terms of the application and certificate and by all the laws and rules of the society to the same extent as though the age of majority had been attained at the time of application.

IV. A society shall provide in its laws that if its reserves as to all or any class of certificates become impaired its board of directors or corresponding body may require that there shall be paid by the owner to the society the amount of the owner's equitable proportion of such deficiency as ascertained by its board, and that if the payment is not made either:

(a) It shall stand as an indebtedness against the certificate and draw interest not to exceed the rate specified for certificate loans under the certificates; or

(b) In lieu of or in combination with subparagraph (a), the owner may accept a proportionate reduction in benefits under the certificate. The society may specify the manner of the election and which alternative is to be presumed if no election is made.

V. Copies of any of the documents mentioned in this section, certified by the secretary or corresponding officer of the society, shall be received in evidence of the terms and conditions thereof.

VI. No certificate shall be delivered or issued for delivery in this state unless a copy of the form has been filed with the commissioner in the manner provided for like policies issued by life insurers in this state. Every life, accident, health, or disability insurance certificate and every annuity certificate issued on or after one year from the effective date of this chapter shall meet the standard contract provision requirements not inconsistent with this chapter for like policies issued by life insurers in this state, except that a society may provide for a grace period for payment of premiums of one full month in its certificates.

VII. The certificate shall also contain a provision stating the amount of premiums which are payable under the certificate and a provision reciting or setting forth the substance of any sections of the society's laws or rules in force at the time of issuance of the certificate which, if violated, will result in the termination or reduction of benefits payable under the certificate.

VIII. If the laws of the society provide for expulsion or suspension of a member, the certificate shall also contain a provision that any member so expelled or suspended, except for nonpayment of a premium or within the contestable period for material misrepresentation in the application for membership or insurance, shall have the privilege of maintaining the certificate in force by continuing payment of the required premium.

IX. Benefit contracts issued on the lives of persons below the society's minimum age for adult membership may provide for transfer of control of ownership to the insured at an age specified in the certificate. A society may require approval of an application for membership in order to effect this transfer, and may provide in all other respects for the regulation, government and control of such certificates and all rights, obligations and liabilities incident thereto and connected therewith. Ownership rights prior to such transfer shall be specified in the certificate.

X. A society may specify the terms and conditions on which benefit contracts may be assigned.

XI. No action at law or in equity shall be had or maintained on any certificate or contract issued by a fraternal benefit society unless commenced within 18 months after the cause of action shall accrue.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:19 Nonforfeiture Benefits, Cash Surrender Values, Certificate Loans and Other Options. 

I. For certificates issued prior to one year after the effective date of this act, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall comply with the provisions of law applicable immediately prior to the effective date of this chapter.

II. For certificates issued on or after one year from the effective date of this chapter for which reserves are computed on the Commissioner's 1941 Standard Ordinary Mortality Table, the Commissioner's 1941 Standard Industrial Table or the Commissioner's 1958 Standard Ordinary Mortality Table, or the Commissioner's 1980 Standard Mortality Table, or any more recent table made applicable to life insurers, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall not be less than the corresponding amount ascertained in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits based upon such tables.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:2 Lodge System Defined. 

I. A society is operating on the lodge system if it has a supreme governing body and subordinate lodges into which members are elected, initiated or admitted in accordance with its laws, rules, and ritual. Subordinate lodges shall be required by the laws of the society to hold regular meetings at least once each month in furtherance of the purposes of the society.

II. A society may, at its option, organize and operate lodges for children under the minimum age for adult membership. Membership and initiation in local lodges shall not be required of such children, nor shall they have a voice or vote in the management of the society.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:20 Investments. 

A society shall invest its funds only in such investments as are authorized by the laws of this state for the investment of assets of life insurers as provided in RSA 411-A. Provided, that any foreign society permitted or seeking to do business in this state, which invests its funds in accordance with the laws of the state in which it is incorporated, shall be held to meet the requirements of this section for the investment of funds.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:21 Funds. 

I. All assets shall be held, invested, and disbursed for the use and benefit of the society and no member or beneficiary shall have or acquire individual rights therein or become entitled to any apportionment on the surrender of any part thereof, except as provided in the benefit contract.

II. A society may create, maintain, invest, disburse and apply any special fund or funds necessary to carry out any purpose permitted by the laws of such society.

III. A society may, pursuant to resolution of its supreme governing body, establish and operate one or more separate accounts and issue contracts on a variable basis, subject to the provisions of RSA 408 regulating life insurers establishing such accounts and issuing such contracts. To the extent the society deems it necessary in order to comply with any applicable federal or state laws, or any rules issued thereunder, the society may adopt special procedures for the conduct of the business and affairs of a separate account, may, for persons having beneficial interests therein, provide special voting and other rights, including without limitation special rights and procedures relating to investment policy, investment advisory services, selection of certified public accountants, and selection of a committee to manage the business and affairs of the account, and may issue contracts on a variable basis to which RSA 418:18, II and IV shall not apply.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:22 Exemptions. 

Except as provided in this chapter, and except for RSA 405:53 through 405:60, inclusive, which are herein incorporated and made applicable hereto, societies shall be governed by this chapter and shall be exempt from all provisions of the insurance laws of this state not only in governmental relations with the state, but for every other purpose, and no law hereafter enacted shall apply to them unless they be expressly designated therein.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:23 Taxation. 

Every society organized or licensed under this chapter is hereby declared to be a charitable and benevolent institution, and all of its funds shall be exempt from all and every state, county, and municipal tax, other than taxes on real estate and office equipment.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:24 Valuation. 

I. Standards of valuation for certificates issued prior to one year after the effective date of this chapter shall be those provided by the laws applicable immediately prior to the effective date of this chapter.

II. The minimum standards of valuation for certificates issued on or after one year from the effective date of this chapter shall be based on the following tables:

(a) For certificates of life insurance, the Commissioner's 1941 Standard Ordinary Mortality Table, the Commissioner's 1941 Standard Industrial Mortality Table, the Commissioner's 1958 Standard Ordinary Mortality Table, the Commissioner's 1980 Standard Ordinary Mortality Table or any more recent table made applicable to life insurers.

(b) For annuity and pure endowment certificates, for total and permanent disability benefits, for accidental death benefits, and for non-cancellable accident and health benefits, such tables as are authorized for use by life insurers in this state.

(c) All of the above shall be under valuation methods and standards (including interest assumptions) in accordance with the laws of this state applicable to life insurers issuing policies containing like benefits.

III. The commissioner may, in his or her discretion, accept other standards for valuation if the commissioner finds that the reserves produced thereby will not be less in the aggregate than reserves computed in accordance with the minimum valuation standard herein prescribed. The commissioner may, in his or her discretion, vary the standards of mortality applicable to all benefit contracts on substandard lives or other extra hazardous lives by any society authorized to do business in this state.

IV. Any society, with the consent of the commissioner of the state of domicile of the society and under such conditions, if any, which the commissioner may impose, may establish and maintain reserves on its certificates in excess of the reserves required thereunder, but the contractual rights of any benefit member shall not be affected thereby.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:25 Reports. 

Reports shall be filed in accordance with the provisions of this section:

I. Every society transacting business in this state shall annually, on or before March 1, unless for cause shown such time has been extended by the commissioner, file with the commissioner of insurance a true statement of its financial condition, transactions and affairs for the preceding calendar year. The statement shall be in general form and context as approved by the National Association of Insurance Commissioners for fraternal benefit societies and as supplemented by additional information required by the commissioner.

II. As part of the annual statement herein required, each society shall, on or before March 1, file with the commissioner a valuation of its certificates in force on December 31 last preceding, provided the commissioner may, in his or her discretion for cause shown, extend the time for filing such valuation for not more than 2 calendar months. Such valuation shall be done in accordance with the standards specified in RSA 418:24. Such valuation and underlying data shall be certified by a qualified actuary or, at the expense of the society, verified by the actuary of the department of insurance of the state of domicile of the society.

III. A society neglecting to file the annual statement in the form and within the time provided by this section shall forfeit $100 for each day during which such neglect continues, and, upon notice by the commissioner to that effect, its authority to do business in this state shall cease while such default continues.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:26 Annual License. 

On compliance with the foregoing conditions and if the society is found upon examination made by or under the direction of the commissioner to have complied with the laws of the state applicable to it, a license to transact business in this state shall be issued until June 14 thereafter. Annually thereafter, on June 15, such license may be renewed so long as the society shall comply with the requirements of the law and the commissioner shall regard it as safe, reliable, and entitled to confidence; provided, however, a license so issued shall continue in full force and effect until the new license be issued or specifically refused. No unincorporated or voluntary society shall be permitted to transact business in this state. A duly certified copy or duplicate of such license shall be prima facie evidence that the licensee is a fraternal benefit society within the meaning of this chapter.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:27 Examination of Domestic Societies;  No Adverse Publications. 

I. The commissioner, or any person he or she may appoint, may examine any domestic, foreign or alien society transacting or applying for admission to transact business in this state in the same manner as provided in RSA 400-A:37 and RSA 400-A:38 for examination of domestic, foreign or alien insurers. Requirements of notice and an opportunity to respond before findings are made public as provided in the laws regulating insurers shall also be applicable to the examination of societies.

II. The expense of each examination and of each valuation, including compensation and actual expense of examiners, shall be paid by the society examined or whose certificates are valued, upon statements furnished by the commissioner.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:28 Foreign or Alien Society Admission. 

I. No foreign or alien society shall transact business in this state without a license issued by the commissioner. Any such society desiring admission to this state shall comply substantially with the requirements and limitations of this chapter applicable to domestic societies. Any such society may be licensed to transact business in this state upon filing with the commissioner:

(a) A duly certified copy of its articles of incorporation;

(b) A copy of its bylaws, certified by its secretary or corresponding officer;

(c) A power of attorney to the commissioner as prescribed in RSA 418:33;

(d) A statement of its business under oath of its president and secretary or corresponding officers in a form prescribed by the commissioner, duly verified by an examination made by the supervising insurance official of its home state or other state, territory, province or country, satisfactory to the commissioner of insurance of this state;

(e) Certification from the proper official of its home state, territory, province or country that the society is legally incorporated and licensed to transact business therein;

(f) Copies of its certificate forms; and

(g) Such other information as the commissioner may deem necessary; and upon a showing that its assets are invested in accordance with the provisions of this chapter.

II. For each such license or renewal, the society shall pay the commissioner $100.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:29 Suspension or Revocation of License. 

I. When the commissioner upon investigation finds that a domestic, foreign or alien society has exceeded its powers; has failed to comply with any provision of this chapter; is not fulfilling its contracts in good faith; has a membership of less than 400 after an existence of one year or more; or is conducting business fraudulently or in a manner hazardous to its members, creditors, the public or the business; the commissioner shall notify the society of such deficiency or deficiencies and state in writing the reasons for his or her dissatisfaction.

II. The commissioner shall at once issue a written notice to the society requiring that the deficiency or deficiencies which exist are corrected. After such notice the society shall have a 30-day period in which to comply with the commissioner's request for correction, and if the society fails to comply the commissioner shall notify the society of such findings of noncompliance and require the society to show cause, on a date named, why its license should not be suspended or revoked until the violation complained of shall have been corrected.

III. If on the date named in the notice such objections have not been removed to the satisfaction of the commissioner, or the society does not present good and sufficient reason why its authority to transact business in this state should not at that time be suspended or revoked, the commissioner may either suspend or revoke the authority of the society to continue business in this state.

IV. Nothing contained in this section shall be taken or construed as preventing any such society from continuing in good faith all contracts made in this state during the time such society was legally authorized to transact business herein.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:3 Representative Form of Government Defined. 

I. A society has a representative form of government when the supreme governing body is an assembly composed of delegates elected directly by the members or at intermediate assemblies or conventions of members or their representatives, together with other delegates as may be prescribed in the society's laws.

(a) The assembly shall be elected and shall meet at least once every 4 years and shall elect a board of directors to conduct the business of the society between meetings of the assembly. Vacancies on the board of directors between elections may be filled in the manner prescribed by the society's laws.

(b) The elected delegates shall constitute a majority in number and shall not have less than 
2/3 of the votes and not less than the number of votes required to amend the society's laws.

(c) A society may provide for election of delegates by mail.

II. A society has a representative form of government when:

(a) The supreme governing body is a board composed of persons elected by the members, either directly or by their representatives in intermediate assemblies, and any other persons prescribed in the society's laws. A society may provide for election of the board by mail. Each term of a board member may not exceed 4 years. Vacancies on the board between elections may be filled in the manner prescribed by the society's laws. Those persons elected to the board shall constitute a majority in number and not less than the number of votes required to amend the society's laws. A person filling the unexpired term of an elected board member shall be considered to be an elected member. The board shall meet at least quarterly to conduct the business of the society;

(b) The officers of the society are elected either by the supreme governing body or by the board of directors;

(c) Only benefit members are eligible for election to the supreme governing body, the board of directors or any intermediate assembly; and

(d) Each voting member shall have one vote; no vote may be cast by proxy.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:30 Injunction. 

No application or petition for injunction against any domestic, foreign or alien society, or lodge thereof, shall be recognized in any court of this state unless made by the attorney general upon request of the commissioner.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:31 Licensing of Agents. 

I. Agents of societies shall be licensed in accordance with the provisions of RSA 402-J regulating the licensing, revocation, suspension or termination of license of resident and nonresident agents.


[Paragraph II effective until January 1, 2023; see also paragraph II set out below.]



II. Any person who acts in violation of this section shall, in addition to any penalties or forfeiture with the power of the commissioner, be subject to the provisions of RSA 402-J and RSA 408:8.


[Paragraph II effective January 1, 2023; see also paragraph II set out above.]



II. Any person who acts in violation of this section shall, in addition to any penalties or forfeiture with the power of the commissioner, be subject to the provisions of RSA 402-J.


Source. 2003, 182:1, eff. Jan. 1, 2004. 2022, 144:3, eff. Jan. 1, 2023.

    418:32 Unfair Methods of Competition and Unfair and Deceptive Acts and Practices. 

Every society authorized to do business in this state shall be subject to the provisions of RSA 417, relating to unfair insurance trade practices; provided, however, that nothing in such provisions shall be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership, or be construed as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:33 Service of Process. 

I. Every society authorized to do business in this state shall appoint in writing the commissioner and each successor in office to be its true and lawful attorney upon whom all lawful process in any action or proceeding against it shall be served, and shall agree in such writing that any lawful process against it which is served on said attorney shall be of the same legal force and validity as if served upon the society, and that the authority shall continue in force so long as any liability remains outstanding in this state. Copies of such appointment, certified by the commissioner, shall be deemed sufficient evidence thereof and shall be admitted in evidence with the same force and effect as the original thereof might be admitted.

II. Service shall only be made upon the commissioner, or if absent, upon the person in charge of the commissioner's office. It shall be made in duplicate and shall constitute sufficient service upon the society. When legal process against a society is served upon the commissioner, the commissioner shall forthwith forward one of the duplicate copies by registered mail, prepaid, directed to the secretary or corresponding officer. No such service shall require a society to file its answer, pleading or defense in less than 14 days from the date of mailing the copy of the service to a society. Legal process shall not be served upon a society except in the manner under this section.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:34 Review. 

All decisions and findings of the commissioner made under the provisions of this chapter shall be subject to review by proper proceedings in any court of competent jurisdiction in this state.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:35 Penalties. 

I. Any person, officer, member or examining physician of any society authorized to do business under this chapter, who shall knowingly or willfully make any false or fraudulent statement or representation in or with reference to any application for membership, or for the purpose of obtaining money from, or benefit in, any society transacting business under this chapter, shall, if a natural person, be guilty of a misdemeanor, and if any other person, be guilty of a felony.

II. Any person who willfully makes a false statement of any material fact or thing in a sworn statement as to the death or disability of a certificate holder, in any such society for the purpose of procuring payment of a benefit named in the certificate of such holder and any person who shall willfully make any false statement in any verified report or declaration under oath required or authorized by this chapter shall be guilty of perjury, and shall be proceeded against and punished as provided by the statutes of this state in relation to the crime of perjury.

III. Any person who shall solicit membership for, or in any manner assists in procuring membership in, any fraternal benefit society not licensed to do business in this state, or who shall solicit membership for, or in any manner assist in procuring membership in any such society not authorized, as herein provided, to do business, as herein defined, in this state, shall be guilty of a misdemeanor.

IV. Any society, or any officer, agent, or employee thereof, neglecting or refusing to comply with, or violating, any of the provisions of this chapter, the penalty for which neglect, refusal, or violation is not specified in this section, shall be guilty of a misdemeanor.

V. Any society refusing or neglecting to make the report, as provided in this chapter, or to appoint the commissioner as its true and lawful attorney for the purpose of this chapter, shall be excluded from doing business in this state. The commissioner shall, within 60 days after failure to make such report, or in case any such society shall exceed its powers, or shall conduct its business fraudulently, or shall fail to comply with any of the provisions of this chapter, give notice, in writing, to the attorney general, who shall immediately commence an action against any such society to enjoin the same from carrying on any business. No society so enjoined shall have authority to continue business until such report shall be made or overt act or violation complained of shall have been corrected, nor until the costs of such action be paid by it, provided the court shall find that such society was in default as charged. Whereupon, the commissioner shall reinstate such society, and not until then shall such society be allowed to again do business in this state. Any officer, agent or person acting for any society, or subordinate body thereof, in this state, while such society shall be so enjoined or prohibited from doing business pursuant to RSA 418, shall be deemed guilty of a misdemeanor.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:36 Exemption of Certain Societies. 

I. Nothing contained in this chapter shall be so construed as to affect or apply to:

(a) Grand or subordinate lodges of societies, orders or associations now doing business in this state which provide benefits exclusively through local or subordinate lodges;

(b) Orders, societies or associations which admit to membership only persons engaged in one or more crafts or hazardous occupations, in the same or similar lines of business, insuring only their own members and their families, and the ladies' societies or ladies' auxiliaries to such orders, societies or associations;

(c) Domestic societies which limit their membership to employees of a particular city or town, designated firm, business house or corporation or which provide for a death benefit of not more than $400 or disability benefits of not more than $350 to any person in any one year, or both; or

(d) Domestic societies or associations of a purely religious, charitable or benevolent description, which provide for a death benefit of not more than $400 or for disability benefits of not more than $350 to any one person in any one year, or both.

II. Any such society or association described in subparagraph I(c) or (d) which provides for death or disability benefits for which benefit certificates are issued, and any such society or association included in subparagraph I(d) which has more than 1,000 members, shall not be exempted from the provisions of this chapter but shall comply with all requirements of this chapter.

III. No society which is exempt from the requirements of this chapter, except any society described in subparagraphs I(a) and (b), shall give or allow, or promise to give or allow to any person any compensation for procuring new members.

IV. Every society heretofore organized and incorporated, and which provides for benefits in case of death or disability resulting solely from accident, and which does not obligate itself to pay natural death or sick benefits shall have all of the privileges and be subject to all the applicable provisions and regulations of this chapter except that the provisions thereof relating to medical examination, valuations of benefit certificates, and incontestability, shall not apply to such society.

V. The commissioner may require from any society or association, by examination or otherwise, such information as will enable the commissioner to determine whether such society or association is exempt from the provisions of this chapter.

VI. Societies exempted under the provisions of this section shall also be exempt from all other provisions of the insurance laws of this state.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:37 Severability. 

If any provision of this chapter or the application thereof to any person or circumstance is held to be invalid, the invalidity shall not affect any other provision or the application of such provision to other persons or circumstances, and to this end the provisions of this chapter are severable.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:4 Purposes and Powers. 

I. A society shall operate for the benefit of members and their beneficiaries by:

(a) Providing benefits as specified in RSA 418:15; and

(b) Operating for one or more social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic or religious purposes for the benefit of its members, which may also be extended to others. Such purposes may be carried out directly by the society, or indirectly through subsidiary corporations or affiliated organizations.

II. Every society shall have the power to adopt laws and rules for the government of the society, the admission of its members, and the management of its affairs. It shall have the power to change, alter, add to or amend such laws and rules and shall have such other powers as are necessary and incidental to carrying into effect the objects and purposes of the society.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:5 Qualifications for Membership. 

I. A society shall specify in its laws or rules:

(a) Eligibility standards for each and every class of membership, provided, that if benefits are provided on the lives of children, the minimum age for adult membership shall be set at not less than age 15 and not greater than age 21;

(b) The process for admission to membership for each membership class; and

(c) The rights and privileges of each membership class, provided that only benefit members shall have the right to vote on the management of the insurance affairs of the society.

II. A society may also admit social members who shall have no voice or vote in the management of the insurance affairs of the society.

III. Membership rights in the society are personal to the member and are not assignable.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:6 Location of Office, Meetings, Communications to Members. 

I. The principal office of any domestic society shall be located in this state. The meetings of its supreme governing body may be held in any state, district, province or territory wherein such society has at least one subordinate lodge, or in such other location as determined by the supreme governing body, and all business transacted at such meetings shall be as valid in all respects as if such meetings were held in this state. The minutes of the proceedings of the supreme governing body and of the board of directors shall be in the English language.

II. A society may provide in its laws for an official publication in which any notice, report, or statement required by law to be given to members, including notice of election, may be published. Such required reports, notices, and statements shall be printed conspicuously in the publication. If the records of a society show that 2 or more members have the same mailing address, an official publication mailed to one member is deemed to be mailed to all members at the same address unless a member requests a separate copy.

III. Not later than June 1 of each year, a synopsis of the society's annual statement providing an explanation of the facts concerning the condition of the society thereby disclosed shall be printed and mailed to each benefit member of the society or, in lieu thereof, such synopsis may be published in the society's official publication.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:7 No Personal Liability. 

Officers and members of the supreme, grand or any subordinate body of any such incorporated society shall not be individually liable for the payment of any disability, death or other benefit provided for in the laws and agreements of such society, but the same shall be payable only out of the funds of such society and in the manner provided by its laws.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:8 Waiver. 

The laws of the society may provide that no subordinate body, nor any of its subordinate officers or members shall have the power or authority to waive any of the provisions of the laws of the society. Such provision shall be binding on the society and every member and beneficiary of a member.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    418:9 Organization. 

A domestic society organized on or after the effective date of this chapter shall be formed as follows:

I. Ten or more citizens of the United States, a majority of whom are citizens of this state, who desire to form a fraternal benefit society, may make, sign and acknowledge before some officer competent to take acknowledgment of deeds, articles of incorporation, in which shall be stated:

(a) The proposed corporate name of the society, which shall not so closely resemble the name of any society or insurance company as to be misleading or confusing.

(b) The purposes for which it is being formed and the mode in which its corporate powers are to be exercised. Such purposes shall not include more liberal powers than are granted by this chapter.

(c) The names and residences of the incorporators and the names, residences and official titles of all the officers, trustees, directors, or other persons who are to have and exercise the general control of the management of the affairs and funds of the society for the first year or until the ensuing election at which all such officers shall be elected by the supreme governing body, which election shall be held not later than one year from the date of issuance of the permanent certificate of authority.

II. Such articles of incorporation, duly certified copies of the society's bylaws and rules, copies of all proposed forms of certificates, applications therefor, and circulars to be issued by the society and a bond conditioned upon the return to applicants of the advanced payments if the organization is not completed within one year shall be filed with the commissioner, who may require such further information as the commissioner deems necessary. The bond with sureties approved by the commissioner shall be in such amount, not less than $300,000 nor more than $1,500,000, as required by the commissioner. All documents filed are to be in the English language. If the purposes of the society conform to the requirements of this chapter and all provisions of the law have been complied with, the commissioner shall so certify, retain and file the articles of incorporation and furnish the incorporators a preliminary certificate of authority authorizing the society to solicit members pursuant to paragraph IV.

III. No preliminary certificate of authority granted under the provisions of this section shall be valid after one year from its date or after such further period, not exceeding one year, as may be authorized by the commissioner upon cause shown, unless the 500 applicants hereinafter required have been secured and the organization has been completed as herein provided. The articles of incorporation and all other proceedings thereunder shall become null and void in one year from the date of the preliminary certificate of authority, or at the expiration of the extended period, unless the society shall have completed its organization and received a certificate of authority to do business pursuant to paragraph V.

IV. Upon receipt of a preliminary certificate of authority from the commissioner, the society may solicit members for the purpose of completing its organization, shall collect from each applicant the amount of not less than one regular monthly premium in accordance with its table of rates, and shall issue to each such applicant a receipt for the amount so collected. No society shall incur any liability other than for the return of such advance premium, nor issue any certificate, nor pay, allow, or offer or promise to pay or allow, any benefit to any person until:

(a) Actual bona fide applications for benefits have been secured on not less than 500 applicants, and any necessary evidence of insurability has been furnished to and approved by the society;

(b) At least 10 subordinate lodges have been established into which the 500 applicants have been admitted;

(c) There has been submitted to the commissioner, under oath of the president or secretary, or corresponding officer of the society, a list of such applicants, giving their names, addresses, date each was admitted, name and number of the subordinate lodge of which each applicant is a member, amount of benefits to be granted and premiums therefor; and

(d) It shall have been shown to the commissioner, by sworn statement of the treasurer, or corresponding officer of such society, that at least 500 applicants have each paid in cash at least one regular monthly premium as herein provided, which premiums in the aggregate shall amount to at least $150,000. The advance premiums shall be held in trust during the period of organization and if the society has not qualified for a certificate of authority within one year, such premiums shall be returned to the applicants.

V. The commissioner may make such examination and require such further information as the commissioner deems advisable. Upon presentation of satisfactory evidence that the society has complied with all the provisions of law, the commissioner shall issue to the society a certificate of authority to that effect and that the society is authorized to transact business pursuant to the provisions of this chapter. The certificate of authority shall be prima facie evidence of the existence of the society at the date of such certificate. The commissioner shall cause a record of such certificate of authority to be made. A certified copy of such record may be given in evidence with like effect as the original certificate of authority.

VI. Any incorporated society authorized to transact business in this state at the time this chapter becomes effective shall not be required to reincorporate.


Source. 2003, 182:1, eff. Jan. 1, 2004.

    420-A:1 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Covered dependent" means the spouse, an adult dependent, or a child or an adopted child of the subscriber who is named in the subscription certificate issued to the subscriber and with respect to whom appropriate premium is specified in the certificate.

II-a. "
Date of enrollment
" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

III. "Health service corporation" means a nonprofit sharing corporation without capital stock organized under the laws of the state for the purpose of establishing, maintaining, and operating a health service plan or plans whereby the expense of health-related care may be partially or wholly provided to its subscribers by the payment of benefits for facilities, professional services, appliances, medicines, or supplies furnished directly or indirectly by the health service corporation to its subscribers.

IV. "Provider" means any physician, hospital, or other institution, organization, or other person who furnishes health care services.

V. "Subscriber" means a person to whom a subscription certificate is issued by the health service corporation and which sets forth the kinds and extent of health services for which the health service corporation is liable to make payment and which constitutes the contract between the subscriber and the health service corporation.


Source. 1997, 190:1. 2007, 289:12, eff. Jan. 1, 2008.

    420-A:10-a Dependent Coverage. 

I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

II. Nothing in this section shall be construed to require:

(a) Coverage for services provided to a dependent before the effective date of this section; or

(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.

III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.

IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:

(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or

(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).

VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days following the effective date of this section.

(b) Such notice shall include information regarding the required special open enrollment period.


Source. 2007, 352:2. 2009, 235:9. 2010, 243:9, eff. Sept. 23, 2010.

    420-A:10 Part-Time Employees. 

A health service corporation shall not exclude part-time employees and shall offer the same insurance benefits to part-time employees as it offers to the employee groups of which the part-time employees would be members if they were full-time employees. The insurer shall offer to include the part-time employees as part of the employer's employee group, at the full rate to be paid by the employer, at a rate prorated between the employer and the employee, or at the employee's expense. A part-time employee shall be any employee who regularly works at least half of the weekly hours of the full-time employee in the employee group of which the part-time employee would be a member if such employee were a full-time employee, but who works a minimum of at least 15 hours per week.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:11 Cancellation or Nonrenewal of Group Insurance Contracts. 

No group accident or health insurance contract, authorized under this chapter, may be cancelled or nonrenewed by the health service corporation, except for nonpayment of premium, unless the group contract holder receives either a notice of cancellation or nonrenewal or an offer of renewal in accordance with this section. The notice of cancellation or nonrenewal or offer of renewal shall be delivered to the group contract holder or mailed to the group contract holder's last address as shown in the records of the health service corporation at least 45 days prior to the renewal date of the contract. Notice of cancellation for lack of participation, if permitted by the terms of the contract, shall be delivered to the group contract holder or mailed to the group contract holder's last address as shown in the records of the health service corporation, at least 30 days prior to the effective date of the cancellation.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:12 Cancellation or Nonrenewal of Non-Group Insurance Contracts. 

No non-group accident or health insurance contract, authorized under this chapter, may be cancelled or nonrenewed by the health service corporation except for nonpayment of premium, unless the insured receives either a notice of cancellation or nonrenewal or an offer of renewal in accordance with this section. The notice of cancellation or nonrenewal or offer of renewal shall be delivered to the insured or mailed to the insured's last address as shown in the records of the health service corporation at least 30 days prior to the renewal date of the contract.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:13 Repealed by 2010, 61:3, II, eff. May 18, 2010. 

    420-A:14 Coverage for Scalp Hair Prostheses. 

I. Every health service corporation and every other similar corporation licensed under the laws of another state, which provides coverage for other prostheses, shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state and whose principal place of employment is in this state, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of alopecia areata, alopecia totalis, alopecia medicamentosa resulting from the treatment from any form of cancer or leukemia, or permanent loss of scalp hair due to injury. Such coverage, however, shall be subject to a written recommendation by the treating physician stating that the hair prosthesis is a medical necessity. Such coverage shall be subject to the same limitations and guidelines as other prostheses, provided, that such coverage for alopecia medicamentosa shall not exceed $350 per year.

II. For the purposes of this section:

(a) "Prostheses" means artificial appliances used to replace lost natural structures. Prostheses include, but are not limited to, artificial arms, legs, breasts, or glass eyes.

(b) "Scalp hair prostheses" means artificial substitutes for scalp hair that are made specifically for a specific individual.


Source. 1997, 190:1. 2001, 276:4, eff. Sept. 14, 2001.

    420-A:15-a Third-Party Payment of Covered, Court-Ordered Services. 

The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such services shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to the terms and conditions of the policy or certificate, including any managed care provisions. However, the claimant or claimant's representative shall have 48 hours from the commencement of a court-ordered service, placement, or program to seek any pre-authorization, pre-certification, or referral required under the terms of the policy. The determination of these preservice claims for court-ordered services for a minor shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 48 hours after receipt of the request and sufficient information, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the insurer shall notify the claimant or claimant's representative within 24 hours of receipt of the request and shall advise the claimant or claimant's representative of the specific information necessary to determine to what extent benefits are covered or payable. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the claim determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of:

I. The insurer's receipt of the specified additional information; or

II. The end of the period afforded the claimant or claimant's representative to provide the specified additional information.


Source. 2004, 117:2, eff. Aug. 15, 2004.

    420-A:15-b Coverage for Dependents. 

If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this section. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this section. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this section commences.


Source. 2007, 289:13, eff. Jan. 1, 2008.

    420-A:15 Coverage During Adoption Proceedings. 

All contracts issued by a health service corporation which provide coverage for a family member of the subscriber shall, as to such family member's coverage, also provide that health insurance benefits applicable for children are payable with respect to any minor from the date such minor is placed in the custody of the subscriber pursuant to an adoption proceeding under the provisions of RSA 170-B. Such health insurance benefits shall terminate upon dismissal or withdrawal of the petition for adoption.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:16-a Patients' Bill of Rights. 

Every health service corporation and every other similar corporation licensed under the laws of another state shall provide to each new subscriber who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.


Source. 1997, 331:19, eff. Jan. 1, 1998 at 12:01 a.m.

    420-A:16 Notification of Allowable Benefit. 

All health service corporations and every other similar corporation licensed under the laws of another state shall provide to each subscriber, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:17-a Coverage for Diabetes Services and Supplies. 

Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each health service corporation that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy. Each health service corporation that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. Each health service corporation that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides for durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy.


Source. 1997, 258:7. 2010, 188:13, eff. Aug. 20, 2010. 2020, 13:3, eff. Sept. 14, 2020.

    420-A:17-b Coverage for Dental Procedures. 

I. Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certificate holder who is a resident of New Hampshire coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:

(a) Is a child under the age of 13 who is determined by a licensed dentist in conjunction with a licensed primary care physician to have a dental condition of significant dental complexity which requires certain dental procedures to be performed in a surgical day care facility or hospital setting; or

(b) Is a person who has exceptional medical circumstances or a developmental disability as determined by a licensed primary care physician which place the person at serious risk.

II. All of the terms and conditions of the covered person's policy shall apply to these services.


Source. 1998, 280:3. 2003, 278:4. 2010, 188:8, eff. Aug. 20, 2010. 2018, 188:7, eff. Aug. 7, 2018.

    420-A:17-c Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. 

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "
Outpatient contraceptive services
" means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which have been approved by the U.S. Food and Drug Administration. Each health service corporation and every other similar corporation licensed under the laws of a different state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration. Coverage shall include contraceptives dispensed in a quantity intended to last for a 12-month period, if prescribed in that quantity. An insurer shall not impose utilization review requirements or other limitations to control the prescribing or dispensing of contraceptives to an amount that is less than a 12-month supply, if that quantity is prescribed. An insurer shall not be required to cover more than one 12-month contraceptive prescription in a single dispensing per plan year. A deductible, copayment, coinsurance, or other cost-sharing requirement shall not be imposed on the coverage of prescription contraceptive drugs and contraceptive devices approved by the FDA under this section. Notwithstanding any other provision of law, if there is a therapeutic equivalent of a drug or device for an FDA-approved contraceptive method, an insurer may impose cost-sharing requirements as long as at least one drug or device for that method is available without cost-sharing; provided that if an individual's provider recommends a particular FDA-approved contraceptive drug or device based on a medical determination, the insurer shall provide coverage for the prescribed contraceptive drug or device without cost-sharing. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 1999, 252:2. 2010, 188:13, eff. Aug. 20, 2010. 2018, 205:5, eff. Jan. 1, 2019; 361:10, eff. Jan. 1, 2019 at 12:01 a.m.

    420-A:17-d Prompt Payment Required. 

I. (a) Every health service corporation, and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered by New Hampshire health care providers within 30 calendar days upon receipt of a clean non-electronic claim or 15 calendar days upon receipt of a clean electronic claim.

(b) When the health service corporation is denying or pending the claim, the corporation shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or subscriber of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the health service corporation's receipt of the requested additional information, the health service corporation shall adjudicate the claim within 45 calendar days. If the required notice is not provided, the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a).

(c) Payment of a claim shall be considered to be made on the date a check was issued or electronically transferred. The health services corporation shall mail checks no later than 5 business days after the date a check was issued. Failure to mail a check within 5 business days shall constitute a violation subject to enforcement under RSA 415:20.

(d) The corporation's failure to comply with the time limits in this section shall not have the effect of requiring coverage for an otherwise non-covered claim. This section shall only apply to payments made on a claims basis and shall not apply to capitation or other forms of periodic payment.

II. In this section:

(a) "
Clean claim
" means a claim for payment of covered health care expenses that is submitted to a health service corporation on the corporation's standard claim form using the most current published procedural codes, with all the required fields completed with correct and complete information in accordance with the corporation's published filing requirements.

(b) "
Electronic claim
" means the transmission of data for purposes of payment of covered health care services in an electronic data format specified by the corporation and, if covered by the Health Insurance Portability and Accountability Act (HIPAA),
 is in such form and substance as to be in compliance with such act.

III. Any initial clean claim submission not paid within the time periods specified in subparagraph I(a) shall be deemed overdue. In that case:

(a) The health service corporation shall pay the health care provider or the insured person the amount of the overdue claim plus an interest payment of 1.5 percent per month beginning from the date the payment was due; and

(b) The health care provider may recover from the health service corporation, upon a judicial finding of bad faith, reasonable attorney's fees for advising and representing a health care provider in a successful action against an health service corporation for payment of the claim.

IV. Exceptions to the requirements of this section are as follows:

(a) No health service corporation shall be in violation of this section for a claim submitted by a health care provider if:

(1) Failure to comply is caused by a directive from a court or a federal or state agency;

(2) The corporation is in liquidation or rehabilitation or is operating in compliance with a court-ordered plan of rehabilitation; or

(3) The corporation's compliance is rendered impossible due to matters beyond the corporation's control which are not caused by such corporation.

(b) No health service corporation shall be in violation of this section for any claim submitted more than 90 days after the service was rendered.

(c) No health service corporation shall be in violation of this section while the claim is pending due to a fraud investigation that has been reported to a state or federal agency, or an internal or external review process.

V. The commissioner may assess an administrative fine against any health service corporation or may suspend or revoke the license or certificate of authority of any health service corporation after determining that the health service corporation has established a pattern of overdue payments and that the contemplated enforcement action would not promote the deterioration of the financial condition of an at-risk insurer. Such fine shall not exceed $300,000 per calendar year examined. Nothing in this paragraph shall be construed to alter the commissioner's authority to investigate or take action, including, but not limited to, action pursuant to RSA 415:20, in response to individual instances of noncompliance.


Source. 2000, 274:4; 314:4. 2005, 162:3. 2010, 188:9. 2012, 99:3, eff. July 28, 2012.

    420-A:17-e Retroactive Denials Prohibited;  Exceptions. 

I. In this section "
retroactive denial of a previously paid claim
" means any attempt by a health service corporation to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments currently owed to the provider, withholding or setting off against future payments, reducing or affecting the future claim payments to the provider in any other manner.

II. No health service corporation shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:

(a) The corporation has provided the reason for the retroactive denial in writing to the health care provider; and

(b) The time which has lapsed since the date of payment of the challenged claim does not exceed 18 months. The retroactive denial of a previously paid claim may be permitted beyond 18 months from the date of payment only for the following reasons:

(1) The claim was submitted fraudulently;

(2) The claim payment was incorrect because the physician/provider or the insured was already paid for the health care services identified in the claim;

(3) The health care services identified in the claim were not delivered by the physician/provider;

(4) The claim payment was for services covered by Title XVIII, Title XIX, or Title XXI of the Social Security Act;

(5) The claim payment is the subject of an adjustment with a different insurer, administrator, or payor and such adjustment is not affected by a contractual relationship, association, or affiliation involving claims payment, processing, or pricing; or

(6) The claim payment is the subject of legal action.

III. A health service corporation shall notify a health care provider at least 15 days in advance of the imposition of any retroactive denials of previously paid claims. The health care provider shall have 6 months from the date of notification under this paragraph to determine whether the insured has other appropriate insurance, which was in effect on the date of service. Notwithstanding the contractual terms between the health service corporation and provider, the health service corporation shall allow for the submission of a claim that was previously denied by another insurer due to the insured's transfer or termination of coverage.


Source. 2002, 143:3. 2006, 104:3, eff. Aug. 7, 2006.

    420-A:17-f Coverage for Certified Midwives. 

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing maternity benefits shall also provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage consistent with the terms and conditions of the policy for services rendered by a midwife certified under RSA 326-D. Such coverage shall be subject to each insurer's standards and mechanisms for credentialing and contracting pursuant to RSA 420-J:4 and RSA 420-J:8 respectively, where applicable, and contingent upon services being provided in a licensed health care facility or at home and within the scope of practice of a certified midwife. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2006, 8:3. 2008, 298:3. 2010, 188:13, eff. Aug. 20, 2010.

    420-A:17-g Coverage for Children's Early Intervention Services. 

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for expenses arising from the services of licensed and credentialed occupational therapists, physical therapists, speech-language pathologists, and clinical social workers working with children from birth to 36 months of age with an identified developmental disability and/or delay as specified in rules adopted pursuant to RSA 171-A:18, IV as long as the providing therapist receives a referral from the child's primary care provider if applicable. The benefits in this section shall not be subject to deductibles, copayments, or coinsurance; provided that the benefits included in this section may have a cap of $3,200 per child per year not to exceed $9,600 by the child's third birthday. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2) or a catastrophic health plan, as defined under the Patient Protection and Affordable Care Act of 2009, a carrier shall be exempt from the deductible provisions of this section and may apply a deductible to children's early intervention therapy services until an enrollee's deductible has been satisfied for the year. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 2007, 338:3. 2010, 188:13, eff. Aug. 20, 2010. 2020, 26:41, eff. Sept. 18, 2020. 2021, 56:10, eff. July 24, 2021.

    420-A:17 Coverage for Nonprescription Enteral Formulas. 

I. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.

II. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.

III. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the service provided.


Source. 1997, 190:1. 2010, 188:7, eff. Aug. 20, 2010.

    420-A:18 Investments. 

No health service corporation shall invest its funds otherwise than as provided in RSA 411-A relating to the investments and holding of real estate by domestic life insurance companies; provided that not exceeding 10 percent of a health service corporation's total admitted assets may be invested in such investments as are prudent for a domestic life insurance company to make, and provided further that, notwithstanding RSA 411-A:12, no such health service corporation may acquire and hold directly or indirectly through its subsidiaries or affiliates more than 10 percent of the outstanding voting stock of any life insurance company formed under the laws of this or another state or any corporation owning or holding the stock of such life insurance company.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:19 Prohibiting Limitations on Liability;  Disclosure of Information. 

I. No contract between a health service corporation and a physician, for the purpose of delineating the rights and obligations of the parties within the provider network, shall limit the liability of the health service corporation for any actions of the physician for which the health service corporation might otherwise be liable.

II. No contract between a health service corporation and a health care provider shall limit what information such health care provider may disclose to patients or to prospective patients regarding the provisions, terms, or requirements of the health service corporation's products as they relate to the needs of such provider's patients except for trade secrets of significant competitive value.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:2 Applicable Statutes. 

Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:6-z, RSA 415:6-a1, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:18-dd, RSA 415:18-ee, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.


Source. 1997, 190:1; 345:9. 1999, 323:7. 2000, 207:6. 2003, 286:4. 2006, 187:3. 2007, 289:35. 2008, 389:3. 2010, 362:3. 2011, 133:3; 189:8, 10. 2012, 278:3. 2014, 299:3, eff. Sept. 30, 2014; 299:6, eff. Oct. 1, 2017. 2015, 263:8, eff. Jan. 1, 2017; 263:9, eff. Oct. 1, 2017 at 12:01 a.m.; 263:12, eff. Jan. 1, 2021. 2016, 326:3, eff. Aug. 23, 2016; 326:4, eff. Oct. 1, 2017 at 12:02 a.m.; 326:5, eff. Jan. 1, 2021 at 12:01 a.m.; 326:9, eff. Jan. 1, 2017 at 12:01 a.m. 2018, 4:13, eff. Feb. 8, 2018; 4:14, eff. Jan. 1, 2021 at 12:02 a.m.; 361:4, eff. Jan. 1, 2019; 361:5, eff. Jan. 1, 2021 at 12:02 a.m. 2019, 113:4, eff. Aug. 20, 2019; 113:5, eff. Jan. 1, 2021 at 12:03 a.m. 2020, 13:11, eff. Jan. 1, 2021; 13:12, eff. Jan. 1, 2021 at 12:04 a.m.; 30:11, eff. Sept. 21, 2020; 30:12, eff. Jan. 1, 2021 at 12:04 p.m.; 39:7, eff. Jan. 1, 2021 at 12:04 a.m.; 39:22, eff. June 30, 2021; 39:23, eff. Jan. 1, 2021 at 12:05 p.m.

    420-A:20 Reports and Examinations. 

Every health service corporation shall annually, on or before March 1, file in the office of the commissioner a statement, verified by at least 2 of its principal officers, showing its condition on the preceding December 31, which shall be in such form and contain such matters as the commissioner may prescribe. Examination of the financial condition of each health service corporation by the commissioner shall be made as often as the commissioner deems necessary. The commissioner or designee shall have the power of visitation and examination into the affairs of any health service corporation and free access to all of the books, papers, and documents that relate to the business of the corporation, and may summon and qualify witnesses under oath and examine its officers, agents, or employees or other persons in relation to the affairs, transactions, and condition of the corporation. All costs of such examination shall be paid by the health service corporation.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:21 Reserves. 

Every health service corporation shall collect reasonable rates as described in RSA 420-A:22, designed to permit it to accumulate and maintain a contingency reserve fund.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:22 Annual Review. 

Annually, in the month of April, the commissioner may review the rates of every health service corporation, and shall, not later than 60 days after April 1 of each year, provided that the corporation has filed all pertinent data, make adjustments thereto, if any, as are just and reasonable. Whenever the contingency reserve fund of a health service corporation shall be less than 8 percent of its annual premium income, the commissioner shall permit the corporation to charge rates designed to enable it to increase its contingency reserve fund by an amount equal to at least 2 percent of the annual premium income of the corporation. If the liabilities of a health service corporation exceed its assets, however, the commissioner shall permit the corporation to charge rates designed to enable the corporation to accumulate such a reserve fund by an amount equal to at least 5 percent of the annual premium income of the corporation until such time as the assets of the corporation equal its liabilities. In no event shall the commissioner permit a health service corporation to charge rates which would result in a reserve fund in excess of 20 percent of the annual premium volume of the corporation. This section shall not preclude the granting of appropriate rate changes at any other times. In connection with a rate decision, the commissioner may also make reasonable supplemental orders to the health service corporation and may attach reasonable conditions and limitations to such orders as the commissioner finds, on the basis of competent and substantial evidence, necessary to insure that benefits and services are provided at minimum cost under efficient and economical management of the corporation.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:23 Appeals. 

All orders and decisions of the commissioner concerning matters within the commissioner's jurisdiction under this chapter shall be subject to rehearing and appeal as provided in RSA 541. RSA 541:18 and RSA 541:19 shall apply to orders and decisions of the insurance commissioner affecting the rates of health service corporations.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:24 Agreements With Providers. 

Any health service corporation may enter into agreements with eligible persons whereby such persons become providers of a plan operated by the corporation. Any health service corporation may enter into contracts for the payment of health services to the subscribers or members of similar nonprofit health service corporations of other states subject to the supervision of such other states, or of counties of this state in which the corporation does not transact business. The corporation shall maintain in its office complete records of all health services rendered to subscribers and covered dependents in such form as will include the kind of services rendered, the amounts claimed for such services by the providers and the amount paid by the corporation.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:25 Administrative Services. 

Any health service corporation may contract to furnish administrative services to any health-related organization, agency, entity, or plan.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:26 Nonliability of Corporation. 

No health service corporation holding a license under this chapter shall be liable for injuries resulting from negligence, malfeasance, nonfeasance, or malpractice on the part of any officer or employee or on the part of any provider in the course of rendering health care service or supplies to subscribers.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:27 Taxation. 

Except as otherwise expressly provided for by law, every health service corporation doing business pursuant to this chapter is hereby declared to be a nonprofit and benevolent organization and to be exempt from all taxes, other than taxes on real property situated within this state, fees on motor vehicles registered in this state, fees prescribed by this chapter, and the premium tax under RSA 400-A: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 political subdivisions of the state of New Hampshire, or from employees or retirees of such political subdivisions, either directly or indirectly. Nor shall any tax be levied on any revenues of such a health service corporation that are derived from any business of the corporation where the corporation has assumed no insurance risk and is providing administrative services only.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:28 Relationship of Provider and Patient. 

Nothing in this chapter shall be deemed to alter the relationship of physician and patient. No health service corporation shall in any way influence the subscriber in the free choice of hospital or physician or other provider. Nothing in this chapter shall be deemed to abridge the right of any hospital, physician or other provider to decline patients in accordance with lawful standards and practices of such provider.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:29 Foreign Corporations;  Reciprocity. 

Any corporation organized under the laws of another state or country which except as to state of organization is a health service corporation and which the commissioner finds has fully complied with the laws of such other state or country, shall be entitled to do business within this state subject to this chapter after obtaining a license as provided in RSA 420-A:4; provided, however, that no such corporation organized under the laws of another state or country shall be entitled to such license, or to do business in this state, unless such other state or country grants substantially similar rights and privileges to health service corporations organized under the laws of this state. The commissioner shall determine whether rights and privileges granted by other states or countries are substantially similar to those granted by this state, and the commissioner's determination shall be final.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:3 Incorporation. 

Persons desiring to form a health service corporation may incorporate under RSA 292, but subject to the following provisions:

I. The certificate of incorporation of each health service corporation shall have endorsed upon it or attached to it the approval of the commissioner, if the commissioner finds the same to be in accordance with this chapter.

II. The certificate shall include a statement of the territory in which the health service corporation will operate and a statement of the purposes of such corporation.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:30 Exceptions. 

Fraternal benefit societies and life or accident insurance companies are not affected by this chapter.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:31 Rules. 

The commissioner is authorized and empowered to adopt such rules in accordance with RSA 541-A which are reasonable and necessary to administer and enforce the provisions of this chapter.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:32 Workers' Compensation Law Not Affected. 

No provision of this chapter or any contract for hospital service by such health service corporation shall in any way affect the operation of workers' compensation laws of the state.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:4 License to Health Service Corporation. 

I. No health service corporation organized under the laws of this state shall do business unless it has obtained a license from the commissioner.

II. No health service corporation organized under the laws of any other state or country shall be licensed to do business in this state except as provided in RSA 420-A:29.

III. Application for such license shall be made in the form required by the commissioner and shall contain the information the commissioner deems necessary. The application shall be accompanied by a copy of each of the following documents:

(a) Articles of incorporation.

(b) Bylaws.

(c) Proposed contracts to be issued to subscribers showing a table of rates to be charged and the benefits to which they will be entitled.

(d) Proposed contracts, if any, between the health service corporation and providers.

(e) Financial statements.

IV. The commissioner shall issue a license when the commissioner finds:

(a) The applicant is established as a bona fide nonprofit health service corporation;

(b) The applicant has paid an annual license fee in accordance with RSA 400-A:29;

(c) The contracts between the applicant and providers, if any, obligate the respective providers to provide the service or thing to which the subscriber may be entitled under the terms of the contract to be issued to subscribers;

(d) The rates to be charged and the benefits to be provided are reasonable and nondiscriminatory;

(e) The financial condition of the applicant is sound and provides assurance of its ability to meet its obligations; and

(f) The applicant is reliable, entitled to public confidence and has complied with the laws of the state applicable to it.

V. Any such license may be revoked for cause shown and after notice and hearing upon failure to maintain the requirements of this chapter.

VI. All such licenses shall expire on June 14, but may be renewed upon payment of the annual license fee.


Source. 1997, 190:1. 2000, 162:4, eff. July 22, 2000.

    420-A:5 Directors. 

The directors of a health service corporation:

I. Shall at all times include representation from the following groups:

(a) The general public exclusive of those falling within subparagraphs (b) and (c) and paragraph II.

(b) Physicians actively engaged in practice.

(c) Administrators or trustees of hospitals, if any, which have contracted with the health service corporation to render nonprofit hospital service or indemnity to subscribers.

II. May include representatives of other health care providers. The number of directors described in subparagraph I(a) shall exceed the combined total of the number of directors described in subparagraphs I(b) and (c) and this paragraph.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:6 Liability of Directors, Officers, and Trustees. 

I. A health service corporation may indemnify any person who serves as director, officer, or trustee of such corporation by contract or by including an indemnity provision in its articles of agreement or bylaws substantially in accordance with RSA 293-A:8.50 through RSA 293-A:8.58. Indemnity may be offered for any and all damages occurring on or after January 1, 1991.

II. A health service corporation may amend its articles of agreement to contain a provision eliminating or limiting the personal liability of a director, officer, or trustee to such corporation and its members and subscribers for monetary damages for breach of fiduciary duty as a director, an officer, or both, except with respect to:

(a) Any breach of the director's, officer's or trustee's duty of loyalty to the corporation and its members and subscribers.

(b) Acts or omissions which are not in good faith or which involve intentional misconduct or a knowing violation of law.

(c) Actions for which a director, officer, or trustee derived an improper personal benefit.

III. Paragraph II shall not be construed to eliminate or limit the liability of a director, an officer, a trustee or any combination thereof, for any act or omission occurring prior to July 13, 1991.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:7 License to Agents. 

I. No person, for himself or in behalf of any person, shall sell or offer to sell any such health service as is provided for in this chapter without being licensed therefor by the commissioner pursuant to RSA 402-J.

II. Upon written notice by a health service corporation licensed to do business in this state of its appointment of a person to act as its agent under this chapter, the commissioner shall, if the commissioner is first satisfied that the appointee is a suitable person and intends to hold himself out in good faith as an agent, upon payment of the proper fee by the applicant, issue to the appointee a license to act as such agent.

III. A license previously issued may be renewed upon the application of the health service corporation upon payment of the proper fee.

IV. The commissioner may at any time after granting such license, for cause shown and after notice and hearing, determine such licensee to be unsuitable to act as such agent, and shall thereupon revoke such license and notify both the health service corporation and the agent of such revocation.

V. Unless revoked by the commissioner, or unless the health service corporation by written notice to the commissioner cancels the agent's authority to act for it, such license issued to an agent, or any renewal of such license, shall expire on June 14 of the second year after its issue.

VI. If a person acts or aids in any manner in the negotiation of health insurance contracts, or solicits or receives any risk or application for such service, without a license from the insurance commissioner, or if the license granted to such person or to the health service corporation for which the person acts as agent has been revoked, such person shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person; but any contract issued on an application thus procured shall bind the health service corporation if otherwise valid. This paragraph shall not apply to any office employee of the health service corporation, or to any persons rendering their services without compensation.


Source. 1997, 190:1. 2000, 315:22. 2005, 206:8, eff. Jan. 1, 2006.

    420-A:8 Filing and Approval of Contracts and Rates. 

I. No health service corporation shall enter into any contract with subscribers until it shall have filed with the commissioner a copy of the form of such contract, including all riders and endorsements to the contract and until the commissioner's approval thereof shall have been obtained. Any form of contract not disapproved by the commissioner within 90 days after the filing shall be deemed to have been approved as filed.

II. No health service corporation shall enter into any contract with subscribers until it shall have filed with the commissioner a full schedule of rates to be paid by the subscribers and shall have obtained the said commissioner's approval. The commissioner may refuse such approval if the commissioner finds such rates are excessive, inadequate, or discriminatory. For the purpose of determining the proper rates to be charged for such services, the commissioner may employ a competent actuary who shall be paid by the health services corporation for which the services are rendered.


Source. 1997, 190:1, eff. Jan. 1, 1998.

    420-A:9 Contracts With Subscribers. 

Every contract between a health service corporation and a subscriber shall be in writing, a copy of which shall be furnished to the subscriber and shall contain the following provisions:

I. A statement of the amount payable to the health service corporation by the subscriber and the manner in which such amount is payable.

II. A statement of the nature and extent of the benefits to be provided, and, if any benefits are to be limited or excepted, an enumeration of such limitations or exceptions shall be printed with the same prominence as the statement of the benefits conferred.

III. A statement that a maternity benefits rider will be made available at the subscriber's request, if maternity care is not covered under the contract. Nothing in this paragraph shall be construed to apply to supplemental health insurance and disability insurance policies.

IV. A statement of the terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party.

V. A statement that the contract includes the endorsements thereon and attached papers, if any, and that it comprises the entire contract.

VI. A provision that no statement by the subscriber in the application for a contract shall void the contract or be used in any legal proceeding thereunder unless such application or an exact copy is included or attached to the contract.

VII. A statement of the period of grace which will be allowed the subscriber for making any payment due under the contract. Such period shall be not less than 10 days.

VIII. Notwithstanding any provision of any policy of insurance issued under the provisions of this section, whenever such policy provides for reimbursement for any service which may be legally performed by a person licensed as an advanced practice registered nurse, reimbursement under such policy shall not be denied when such service is rendered by a person so licensed.

IX. No health service corporation shall, when issuing or renewing a policy or contract of insurance or any certificate under such policy or contract covered by this chapter, deny coverage or limit coverage to any resident of this state on the basis of health risk or condition except that a waiting period consistent with insurance department rules may be imposed for pre-existing medical conditions. If a health service corporation accepts an application for group coverage, such acceptance shall be subject to the following:

(a) If the group has coverage in effect through another plan, the health service corporation shall accept all persons covered under the existing plan. If the group does not have coverage in effect through another plan, the health service corporation shall accept all persons for which the group seeks coverage.

(b) Once a group policy has been issued, any person becoming eligible for coverage shall become covered by enrolling within 31 days after becoming eligible. Any person so enrolling shall not be required to submit evidence of insurability based on medical conditions. If a person does not enroll at this time, such person is a late enrollee.

(c) Once a group policy has been issued, the health service corporation shall provide the group with an annual open enrollment period for late enrollees. During the open enrollment period, any late enrollee shall be permitted to enroll without submitting any evidence of insurability based on medical conditions. For late enrollees only, the pre-existing condition provisions shall apply for 18 months from the date of enrollment.

X. An insurer issuing policies of group insurance shall allocate the costs associated with maternity and childbirth over both males and females covered by its entire block of business in this state. In cases in which, because of the amount written in the state, allocation to an entire block of business needs to occur, the carrier may apply for a waiver from the commissioner.

XI. A statement allowing subscribers with Medicare supplement insurance benefits a period of at least one year after the incurral of a covered expense within which the subscriber shall furnish any proof of loss required by the insurer. Failure to furnish such proof within such time shall not invalidate or reduce any claim if it shall be shown not to have been reasonably possible to furnish such proof and such proof was furnished as soon as was reasonably possible.

XII. A provision that such contract shall be signed by the president and secretary before it shall become effective.

XIII. A statement that all benefits payable shall be paid to the participating providers except those in reimbursement of payments made by the subscriber to a non-participating provider and for which the corporation was liable at the time of payment.


Source. 1997, 190:1. 2009, 54:5, eff. July 21, 2009.

    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 not limited to, marketing, educational, or information letters; and

(c) Sales talks, presentations and material prepared by insurers for use by agents and brokers, and representations made by agents and brokers in accordance therewith.

II. "Commissioner" means the insurance commissioner.

II-a. "
Date of enrollment
" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

III. "Enrolled participant" means a person who has entered into a contractual arrangement or on whose behalf a contractual arrangement has been entered into with a health maintenance organization to receive health care services.

IV. "Evidence of coverage" means any certificate, agreement, or contract issued to an enrolled participant setting out the coverage to which such participant is entitled including those issued pursuant to a contract under section 1876 or section 1833 of the federal Social Security Act (42 U.S.C. section 1395 et seq.) as amended.

V. "Health care services" means physician, hospitalization, laboratory, x-ray service and medical equipment and supplies, which may include but are not limited to: medical, surgical, and dental care; psychological, obstetrical, osteopathic, optometric, optic, podiatric, chiropractic, nursing, physical therapy services, and pharmaceutical services; health education; preventive medical, rehabilitative, and home health services; inpatient and outpatient hospital services, extended care, nursing home care, convalescent institutional care, laboratory and ambulance services, appliances, drugs, medicines, and supplies; and any other care, service, or treatment of disease, correction of defects, or the maintenance of the physical and mental well-being of enrolled participants.

VI. "Health maintenance organization" means a public or private organization, organized under the laws of this state or the laws of another state which:

(a) Provides or otherwise makes available to enrolled participants health care services;

(b) Is compensated for the provision of one or more health care services to an enrolled participant on a primarily predetermined periodic rate basis;

(c) Provides physicians' services directly through physicians who are either employees or partners of such an organization, or under arrangements with one or more physicians or groups of physicians.

VII. "Provider" means any physician, hospital or other institution, organization, or other person who furnishes health care services.


Source. 1977, 282:1. 1997, 282:1. 2007, 289:14, eff. Jan. 1, 2008.

    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 at the expense of the health maintenance organizations.

II. Every health maintenance organization and provider shall submit its books and records relating its operation to such examinations and in every way facilitate them. For the purpose of examinations, the commissioner may issue subpoenas, administer oaths to, and examine the officers and agents of the health maintenance organization.


Source. 1977, 282:1, eff. Aug. 21, 1977. 2018, 36:2, eff. May 15, 2018.

    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 all written complaints initiated by enrolled participants which shall include a full description of all procedures taken under said complaints and their resolution.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    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 shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrolled participant of, or person considering enrolling in, a health maintenance organization;

(b) A statement or item of information shall be deemed to be misleading, whether or not it may be literally true, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information reasonably may be understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation, or disadvantage of possible significance to an enrolled participant of, or person considering enrollment in, a health care plan, if such benefit or advantage or absence of limitation, exclusion or disadvantage does not in fact exist;

(c) An evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge regarding health care plans or evidences of coverage therefor, to expect benefits, services, charges, or other advantages which the evidence of coverage does not provide or which the health care plan issuing such evidence of coverage does not regularly make available for enrolled participants covered under such evidence of coverage.

(d) In the event that a person is covered by more than one plan that requires pre-certification, the member shall obtain pre-certification from the primary plan. Although the member shall not be required to obtain pre-certification from the secondary plan, the secondary plan shall not be required to treat such services as covered services if the services do not meet its certification criteria. The secondary plan shall not refuse payment for such services solely on the basis that the services were not pre-certified by the secondary plan.

II. RSA 406-A and RSA 417 shall be construed to apply to health maintenance organizations and evidences of coverage, except to the extent that the commissioner determines that the nature of the health maintenance organizations, and evidences of coverage render such statutes inappropriate.

III. No health maintenance organization, unless licensed as an insurer, may use in its name, evidences of coverage, contracts, or literature, any of the words "insurance," "casualty," "surety," "mutual," or any other words descriptive of the insurance, casualty, or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this state.

IV. No health maintenance organization shall exclude part-time employees or refuse to offer the same insurance benefits to part-time employees as it offers to the employee groups of which the part-time employees would be members if they were full-time employees. The insurer shall offer to include the part-time employees as part of the employer's employee group, at the full rate to be paid by the employer, at a rate prorated between the employer and the employee, or at the employee's expense. A part-time employee shall be any employee who regularly works at least half of the weekly hours of the full-time employee in the employee group of which the part-time employee would be a member if he were a full-time employee, but who works a minimum of at least 15 hours per week.

V. Every health maintenance organization which solicits bids from pharmacies for contracts to be preferred providers shall accept and list as preferred providers all pharmacies which meet the bid acceptable to the health maintenance organization.

VI. No health maintenance organization shall, when issuing or renewing a policy or contract of insurance or any certificate under such policy or contract covered by this chapter, deny coverage or limit coverage to any resident of this state on the basis of health risk or condition except that a waiting period consistent with insurance department rules may be imposed for pre-existing medical conditions. If a health maintenance organization accepts an application for group coverage, such acceptance shall be subject to the following:

(a) If the group has coverage in effect through another plan, the health maintenance organization shall accept all persons covered under the existing plan. If the group does not have coverage in effect through another plan, the health maintenance organization shall accept all persons for which the group seeks coverage.

(b) Once a group policy has been issued, any person becoming eligible for coverage shall become covered by enrolling within 31 days after first becoming eligible. Any person so enrolling shall not be required to submit evidence of insurability based on medical conditions. If a person does not enroll at this time, he is a late enrollee.

(c) Once a group policy has been issued, the health maintenance organization shall provide the group with an annual open enrollment period for late enrollees. During the open enrollment period, any late enrollee shall be permitted to enroll without submitting any evidence of insurability based on medical conditions. For late enrollees only, the pre-existing condition provisions shall apply for 18 months from the date of enrollment.

VII. An insurer issuing policies of group insurance shall allocate the costs associated with maternity and childbirth over both males and females covered by its entire block of business in this state. In cases in which, because of the amount written in the state, allocation to an entire block of business needs to occur, the carrier may apply for a waiver from the insurance commissioner.

VIII. [Repealed.]

IX. [Repealed.]


Source. 1977, 282:1. 1986, 114:4. 1992, 113:1; 222:3. 1993, 162:5. 1995, 126:4. 1996, 149:4. 1997, 345:8, I. 2007, 289:16, eff. Jan. 1, 2008.

    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 health maintenance organization under this chapter. When the certificate of authority is suspended, the organization shall not during the period of such suspension enroll any additional enrolled participants except newborn children or other newly acquired dependents of existing enrolled participants, and shall not engage in any advertising or solicitation whatever;

II. Revoke the certificate of authority to operate as a health maintenance organization under this chapter. When the certificate of authority is revoked, such organization shall proceed under the supervision of the commissioner, immediately following the effective date of the order of revocation, to wind up its affairs, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of such organization. It shall engage in no further advertising or solicitation whatsoever. The commissioner may, by written order, permit such further operation of the organization as he may find to be in the best interest of enrolled participants, to the end that enrolled participants will be afforded the greatest practical opportunity to obtain continuing health care coverage;

III. Impose a penalty of not more than $2,500 for each and every unlawful act committed; each violation shall constitute a separate fineable offense;

IV. Issue an administrative order requiring the health maintenance organization: to cease or modify inappropriate conduct or practices by it or any of the personnel employed or associated with it; to fulfill its contractual obligations; to provide a service which has been improperly denied; or to take appropriate steps to restore the ability of the organization to provide a contracted-for service; and

V. Apply to any court for such legal or equitable relief as the commissioner deems appropriate.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    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 or investments as the commissioner may permit.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    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 political subdivisions of the state of New Hampshire or from employees or retirees of such political subdivisions, either directly or indirectly. Nor shall any tax be levied on any revenues of such an organization that are derived from any business of the organization where the organization has assumed no insurance risk and is providing administrative services, only.


Source. 1977, 282:1. 1995, 256:3, eff. July 1, 1995.

    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 this chapter. An insurance company licensed in this state, or a hospital, medical or health services corporation shall obtain a certificate of authority pursuant to RSA 420-B:2 and shall comply with all of the provisions of this chapter with respect to its health maintenance organization activities. Notwithstanding any other law which may be inconsistent herewith, any 2 or more such insurance companies, hospitals or medical service corporations, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care services by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.

II. Notwithstanding any provisions of the laws of this state relating to insurance corporations engaged in the business of insurance, or any provisions of RSA 420-A relating to health service corporations, an insurer or health service corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of failure of the health maintenance organization to meet its obligations. The enrolled participants of a health maintenance organization constitute a permissible group under such laws. Under the contracts set forth in this paragraph, the insurer or health service corporation may make benefit payments to health maintenance organizations for health care services rendered by providers pursuant to the health care plan.


Source. 1977, 282:1. 1997, 190:15. 2011, 39:1, eff. July 8, 2011.

    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 of August 21, 1977, shall submit an application for a certificate of authority within 120 days of August 21, 1977. Each such applicant may continue to operate without certificate of authority until the commissioner acts upon the application.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    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 an insurer or hospital or medical service corporation licensed and regulated pursuant to the insurance laws or the hospital or medical service corporation laws of this state, except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.

II. The solicitation of enrolled participants or the provision of factually accurate information regarding coverage, rates, locations and hours of service, concepts and programs for the delivery of health care services, names of affiliated institutions, and credentials of participating providers, by a health maintenance organization or its agents to potential enrolled participants and to the general public shall not be construed to be violative of any provision of the laws of this state relating to solicitation or advertising by health professionals, nor be grounds for revocation or suspension of the license of a physician or surgeon under RSA 329:17.

III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:6-z, RSA 415:6-a1, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:18-dd, RSA 415:18-ee, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.


Source. 1977, 282:1. 1989, 186:4. 1990, 114:2, 3. 1994, 166:10. 1995, 112:18. 1996, 188:11. 1997, 344:8, 16; 345:6. 1999, 323:8. 2000, 207:7. 2006, 187:4. 2007, 289:36. 2008, 389:4. 2010, 362:4. 2011, 133:4; 189:9, 11. 2012, 278:4. 2014, 299:4, eff. Sept. 30, 2014; 299:7, eff. Oct. 1, 2017. 2015, 263:10, eff. Jan. 1, 2017; 263:11, eff. Oct. 1, 2017 at 12:01 a.m.; 263:13, eff. Jan. 1, 2021. 2016, 326:6, eff. Aug. 23, 2016; 326:7, eff. Oct. 1, 2017 at 12:02 a.m.; 326:8, eff. Jan. 1, 2021 at 12:01 a.m.; 326:10, eff. Jan. 1, 2017 at 12:01 a.m. 2018, 4:15, eff. Feb. 8, 2018; 4:16, eff. Jan. 1, 2021 at 12:02 a.m.; 361:6, eff. Jan. 1, 2019; 361:7, eff. Jan. 1, 2021 at 12:02 a.m. 2019, 113:6, eff. Aug. 20, 2019; 113:7, eff. Jan. 1, 2021 at 12:03 a.m. 2020, 13:13, eff. Sept. 14, 2020; 13:14, eff. Jan. 1, 2021 at 12:04 a.m.; 30:13, eff. Sept. 21, 2020; 30:14, eff. Jan. 1, 2021 at 12:04 p.m.; 39:8, eff. Jan. 1, 2021 at 12:04 a.m.; 39:24, eff. June 30, 2021; 39:25, eff. Jan. 1, 2021 at 12:05 p.m.

    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 a certificate of authority under this chapter from qualifying as a "health maintenance organization" under Public Law 93-222 as defined in 42 U.S.C. section 300e(a).


Source. 1977, 282:1, eff. Aug. 21, 1977.

    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 organized so that providers and the organization are in some part at risk for the cost of services in a manner similar to a health maintenance organization, but who fails to meet the requirements set forth in this chapter, may operate such a system if the commissioner finds that the proposed operation will benefit persons who will be served by it. The operation shall be licensed and regulated in the same manner as a health maintenance organization under this chapter, except to the extent that the commissioner determines that the regulation is inappropriate to the system of health care delivery and financing. A person operating a system of health care delivery and financing pursuant to this section shall not advertise or solicit or in any way identify itself in a manner implying to the public that it is a health maintenance organization licensed under this chapter.


Source. 1986, 56:1, eff. July 4, 1986.

    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 to and inform its employees or members of the option to enroll in at least one health maintenance organization holding a valid certificate of authority which provides health care services in the geographic areas in which a substantial number of such employees or members reside; provided, however, that such employer or employee benefit fund shall not be required to make available or inform its employees or members about such option if no health maintenance organization is available to such employer or employee benefit plan. Where there is a prevailing collective bargaining agreement, the selection of the available health maintenance organizations shall be made pursuant to the agreement.

II. No employer in this state shall be required to pay more for health benefits as a result of the application of this section than would otherwise be required by any prevailing collective bargaining agreement or other contract for the provision of health benefits to its employees, provided that the employer or benefits fund shall pay to the health maintenance organization chosen by each employee or member an amount equal to the lesser of:

(a) The amount paid on behalf of its other employees or members for health benefits; or

(b) The health maintenance organization's charge for coverage approved by the commissioner.

III. Should federal legislation requiring employers to offer to employees the option to enroll in a health maintenance organization be repealed or expire, the provisions of RSA 420-B:24, I and II shall no longer apply.


Source. 1989, 186:5, eff. July 1, 1989.

    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 to the greater of:

(a) $6,000,000; or

(b) Seven and one-half percent of annual premium revenues as reported on the most recent annual financial statement filed with the commissioner. The minimum net worth shall be met by the health maintenance organization upon expiration of the certificate of authority.

III. In addition to paragraphs I and II, if at any time uncovered expenditures exceed 15 percent of the total health care expenditures, a health maintenance organization shall increase the required minimum net worth by 120 percent of the health maintenance organization's outstanding liability for uncovered expenditures for enrollees including incurred but not reported claims which shall be calculated as of the first date of the month and retained for the remainder of the month. The increase to minimum net worth required by this paragraph shall not exceed $5,000,000. Health maintenance organizations shall file a report within 45 days after the end of the calendar quarter with information sufficient to demonstrate compliance with this section.

IV. In addition to paragraphs I, II and III, the commissioner shall require additional capital if he finds that the health maintenance organization does not have reasonable and adequate specific stop-loss reinsurance for its individual members.

V. Every health maintenance organization shall, when determining liabilities, include an amount estimated in the aggregate to provide for any unearned premium and for the payment of all claims for health care expenditures which have been incurred, whether reported or unreported, which are unpaid and for which such organization is or may be liable, and to provide for the expense of adjustment of settlement of such claims.

VI. Such liabilities shall be computed in accordance with rules adopted by the commissioner upon reasonable consideration of the ascertained experience and character of the health maintenance organization.


Source. 1989, 186:5. 1990, 114:4, eff. July 1, 1990.

    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.

    420-B:4 Jurisdictional Power of Attorney. 

Any applicant for a certificate of authority who is not domiciled in this state shall file with its application a power of attorney duly executed appointing the commissioner and his successors in office, and duly authorized deputies, as the true and lawful attorney of such applicant in and for the state upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising in this state may be served.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    420-B:5-a Renewal of Certificate of Authority. 

The certificate shall be renewed annually on June 14 if the company complies with the requirements of this chapter, the commissioner regards it as safe, reliable, and entitled to confidence, and the company continues to conduct a meaningful business in New Hampshire, as determined by the commissioner.


Source. 1989, 186:2, eff. July 1, 1989.

    420-B:5-b New License Required for Changed Conditions. 

The commissioner shall require a health maintenance organization to apply for a new certificate in accordance with this chapter, if, after notice and hearing, the commissioner finds that the organization has undergone a substantial change in finances or managerial control since its last application for a certificate. The current certificate shall expire upon approval of the new application or 30 days after the decision of the commissioner that a substantial change has occurred, whichever is sooner.


Source. 1989, 186:2, eff. July 1, 1989.

    420-B:5 Issuance of Certificate of Authority. 

The commissioner shall issue a certificate of authority to any person filing an application within 90 days after filing of a completed application, payment of all required fees and receipt of endorsement or approval of the state health planning and development agency, as provided by law or regulation, if he is satisfied that the applicant is safe, reliable, entitled to confidence, in sound financial condition and that issuing the certificate of authority would be in the public interest.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    420-B:6 Pre-Certificate Activities. 

I. Upon request of any applicant, and subject to any regulations the commissioner may impose, the commissioner, in his discretion, may permit an applicant to contact potential enrolled participants prior to the issuance of a certificate of authority, to discuss the health care services the applicant proposes to offer and the proposed evidences of coverage.

II. The commissioner may, in his discretion in accordance with such regulations as he may impose, permit an organization to contact potential enrolled participants prior to the granting of a certificate of authority, to discuss the health care services such health maintenance organization proposes to offer if a certificate of authority is granted.


Source. 1977, 282:1, eff. Aug. 21, 1977.

    420-B:7 Powers of Health Maintenance Organizations. 

The powers of a holder of a certificate of authority issued pursuant to RSA 420-B:5 shall include, in addition to any powers conferred by the law under which the health maintenance organization is organized, and subject to all restrictions imposed in this chapter, or by the commissioner, the following:

I. The power to purchase, lease, construct, renovate, operate, or maintain medical clinics and their ancillary equipment as may reasonably be required for its principal office or for such other purposes as may be necessary in the transaction of the business of the health maintenance organization;

II. The power to furnish health care services on a prepaid basis through providers which are under contract with, otherwise associated with, retained by or employed by the health maintenance organization;

III. The power to render health care services on a basis other than prepaid, including charitable and fee for service, through providers which are under contract with, otherwise associated with, retained by, or employed by the health maintenance organization;

IV. The power to make loans to a medical group under contract with the health maintenance organization in furtherance of its program, or make loans to a corporation or corporations under its control for the purpose of acquiring or constructing medical clinics, or in furtherance of a program providing health care services to enrolled participants;

V. The power to enter into evidences of coverage to provide an agreed upon set of health care services to enrolled participants or groups of enrolled participants in exchange for a prepaid per capita, or prepaid aggregate, fixed sum;

VI. The power to market evidences of coverage, enroll enrolled participants and administer its program of marketing, or contract with any person for the performance, on behalf of the health maintenance organization, of such functions;

VII. The power to contract with an insurance company licensed in this state, or with a hospital medical service or health service corporation authorized to do business in this state, for the provisions of insurance, indemnity, or reimbursement against the cost of health care services provided by the health maintenance organization;

VIII. The power to offer, in addition to health care services, indemnity benefits covering out-of-area or emergency services; and

IX. The power to receive and accept from governmental or private agencies or any persons, payments or grants covering all or part of the cost of the services provided or arranged for by the health maintenance organization.

X. The power to offer out-of-plan covered services if those services are provided by a point-of-service product on an in-plan basis.

XI. The power to act as a health care insurer as defined in RSA 420-C:2, IV only when offering a Medicare Advantage plan in accordance with 42 U.S.C. sections 1395w-21 through1395w-29.


Source. 1977, 282:1. 2002, 207:7, eff. May 16, 2002. 2020, 39:13, eff. July 29, 2020.

    420-B:8-a Repealed by 1996, 188:14, IV, eff. Jan. 1, 1997. 

    420-B:8-aa Dependent Coverage. 

I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

II. Nothing in this section shall be construed to require:

(a) Coverage for services provided to a dependent before the effective date of this section; or

(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.

III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent child eligible pursuant to this section.

IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:

(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or

(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).

VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days following the effective date of this section.

(b) Such notice shall include information regarding the required special open enrollment period.


Source. 2007, 352:3. 2009, 235:11. 2010, 243:10, eff. Sept. 23, 2010.

    420-B:8-b Health Maintenance Organization Benefits for Mental and Nervous Conditions and Treatment for Chemical Dependency. 

I. (a) Benefits for mental or nervous conditions shall conform to the requirements of RSA 415:18-a or alternatively with the basic health services requirements of the Health Maintenance Organization Act of 1973
 (P.L. 93-222), any amendments, and federal regulations issued under the authority of such federal law. However, where a health maintenance organization provides these alternative benefits, such benefits shall not be subject to any deductible. The coinsurance required by the enrolled participant shall not exceed 20 percent of the reasonable and customary charge for the services provided.

(b) In addition to the requirements of subparagraph (a), every health maintenance organization offering such benefits shall provide to its subscribers a list of psychiatrists and mental health care providers within the organization's network. The health maintenance organization shall allow its subscribers 2 visits for diagnosis followed by up to 3 treatment visits in each contract year. Subsequent visits within the contract year may be subject to utilization review. The policy shall also include a statement that a primary care physician may refer an enrolled participant to a psychiatrist or other mental health care provider within the organization's network. There shall be no economic penalty to the primary care physician for such a referral.

II. No evidence of coverage, or amendment thereto, issued, renewed or continued on or after January 1, 1993, shall contain any provision denying insurance benefits for psychiatric or psychological services, including psychological examinations, solely because they are rendered to an insured or a dependent in compliance with the lawful order of any court of this state. Benefits for such services shall be as favorable as for other psychiatric or psychological services, including psychological examinations, and shall be subject to the same dollar limits, deductibles, co-payments, and co-insurance factors and to terms and conditions of the policy or certificate, including any managed care provisions.

III. Coverage shall be provided for expenses arising from treatment for chemical dependency, including alcoholism, up to a specified limit which may be defined in terms of a dollar amount or a maximum number of days or visits. Coverage shall include both an inpatient and an outpatient benefit for detoxification and rehabilitation.

IV. "Mental and nervous conditions" shall be defined as mental disorders, as defined in the most recent edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" (DSM), excluding those disorders designated by a "V Code" and those disorders designated as criteria sets and axes provided for further study in the DSM. This term shall not include chemical dependency including alcoholism.

V. The commissioner may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Mental Health Parity Act of 2008 that relate to the business of insurance.


Source. 1989, 186:3. 1992, 177:5. 1995, 245:1. 1996, 188:9. 1998, 385:2. 2002, 204:2. 2009, 235:12, eff. Sept. 14, 2009.

    420-B:8-c Cancellation or Nonrenewal of Group Health Maintenance Organization Contracts. 

No group health maintenance organization contract, authorized under this chapter, may be cancelled or nonrenewed by the health maintenance organization, except for nonpayment of premium, unless the group contract holder receives either a notice of cancellation or nonrenewal or an offer of renewal in accordance with this section. The notice of cancellation or nonrenewal or offer of renewal shall be delivered to the group contract holder or mailed to the group contract holder's last address as shown in the records of the health maintenance organization at least 45 days prior to the renewal date of the contract. Notice of cancellation for lack of participation, if permitted by the terms of the contract, shall be delivered to the group contract holder or mailed to the group contract holder's last address as shown in the records of the health maintenance organization, at least 30 days prior to the effective date of the cancellation.


Source. 1990, 194:4. 1991, 23:4, eff. Jan. 1, 1992.

    420-B:8-d Cancellation or Nonrenewal of Non-Group Health Maintenance Organization Contracts. 

No non-group health maintenance organization contract, authorized under this chapter, may be cancelled or nonrenewed by the health maintenance organization except for nonpayment of premium, unless the enrolled participant receives either a notice of cancellation or nonrenewal or an offer of renewal in accordance with this section. The notice of cancellation or nonrenewal or offer of renewal shall be delivered to the enrolled participant or mailed to the enrolled participant's last address as shown in the records of the health maintenance organization at least 30 days prior to the renewal date of the contract.


Source. 1990, 194:4. 1991, 23:5, eff. Jan. 1, 1992.

    420-B:8-e Repealed by 2010, 61:3, III, eff. May 18, 2010. 

    420-B:8-ee Coverage for Dental Procedures. 

I. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certificate holder who is a resident of New Hampshire coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:

(a) Is a child under the age of 13 who is determined by a licensed dentist in conjunction with a licensed primary care physician to have a dental condition of significant dental complexity which requires certain dental procedures to be performed in a surgical day care facility or hospital setting; or

(b) Is a person who has exceptional medical circumstances or a developmental disability as determined by a licensed primary care physician which place the person at serious risk.

II. All of the terms and conditions of the covered person's policy shall apply to these services.


Source. 1998, 280:4. 2003, 278:4. 2010, 188:10, eff. Aug. 20, 2010. 2018, 188:8, eff. Aug. 7, 2018.

    420-B:8-f Benefits for Scalp Hair Prostheses. 

I. Benefits for scalp hair prostheses shall conform to the requirements of RSA 415:18-d. Such benefits shall not be subject to any greater deductible than any other prostheses benefits provided by the health maintenance organization. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided. Such coverage, however, shall be subject to a written recommendation by the treating physician stating that the hair prosthesis is a medical necessity. Such coverage shall be subject to the same limitations and guidelines as other prostheses.

II. For the purposes of this section:

(a) "Prostheses" means artificial appliances used to replace lost natural structures. Prostheses include, but are not limited to, artificial arms, legs, breasts or glass eyes.

(b) "Scalp hair prostheses" means artificial substitutes for scalp hair that are made specifically for a specific individual.


Source. 1992, 246:5. 2001, 276:5, eff. Sept. 14, 2001.

    420-B:8-ff Coverage for Nonprescription Enteral Formulas. 

I. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.

II. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are resident of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.

III. The benefits included in this section shall not be subject to any greater deductible than any other benefits provided by the insurer. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the service provided.


Source. 1995, 235:5. 1996, 131:6. 2010, 188:11, eff. Aug. 20, 2010.

    420-B:8-g Coverage During Adoption Proceedings. 

All contracts issued by a health maintenance corporation which provide coverage for a family member of the subscriber shall, as to such family member's coverage, also provide that health insurance benefits applicable for children are payable with respect to any minor from the date such minor is placed in the custody of the subscriber pursuant to an adoption proceeding under the provisions of RSA 170-B. Such health insurance benefits shall terminate upon dismissal or withdrawal of the petition for adoption.


Source. 1992, 222:9, eff. Jan. 1, 1993.

    420-B:8-gg Coverage for Prescription Contraceptive Drugs and Prescription Contraceptive Devices and for Contraceptive Services. 

Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of group health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient services shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for outpatient contraceptive services under the same terms and conditions as for other outpatient services. "
Outpatient contraceptive services
" means consultations, examinations, and medical services, provided on an outpatient basis, including the initial screening provided through a pharmacy pursuant to RSA 318:47-l at a rate established by contract between the pharmacy and the insurer or its pharmacy benefits manager, and related to the use of contraceptive methods to prevent pregnancy which has been approved by the U.S. Food and Drug Administration. Each health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any group health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover all prescription contraceptive drugs and prescription contraceptive devices approved by the U.S. Food and Drug Administration under the same terms and conditions as other prescription drugs. Nothing in this section shall be construed as altering the terms and conditions of a contract relating to prescription drugs and outpatient services.


Source. 1999, 252:3. 2010, 188:13, eff. Aug. 20, 2010. 2018, 205:6, eff. Jan. 1, 2019.

    420-B:8-h Notification of Allowable Benefit. 

All health maintenance organizations shall provide to each subscriber, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.


Source. 1993, 102:6, eff. Jan. 1, 1994.

    420-B:8-i Incontestable Provision. 

The validity of the contract shall not be contested except for nonpayment of premiums, after it has been in force for 2 years from its date of issue. No statement made by any person covered under the contract relating to insurability shall be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person's lifetime, and not unless it is contained in a written instrument signed by the person making such statement. No such provision, however, shall preclude the assertion, at any time, of defenses based upon the person's ineligibility for coverage under the plan or upon other provisions in the plan, except for any provisions establishing, as a requirement of eligibility, the furnishing of satisfactory evidence of insurability to the health maintenance organization.


Source. 1993, 167:4, eff. Jan. 1, 1994.

    420-B:8-j Newborn Children. 

I. All individual and group health maintenance organization contracts shall provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the insured or subscriber or a dependent child of the insured or the subscriber from the moment of birth.

II. Coverage for newly born children shall consist of coverage of injury or sickness including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities.

III. If payment of a specific premium or subscription fee is required to provide coverage for a child, the contract may require that notification of birth of a newly born child and payment of the required premium or fee must be furnished to the health maintenance organization within 31 days after the date of birth in order to have the coverage continue beyond such 31-day period. Unless the contract specifically provides that grandchildren of the insured or subscriber are eligible for coverage, coverage for newly born children of a dependent child of the insured or subscriber shall not continue beyond the initial 31-day period following birth. Nor shall such newly born children be considered dependents of the insured for any purpose addressed in this title.

IV. This section applies to all health maintenance organization contracts delivered or issued for delivery or renewed in this state on or after January 1, 1997.


Source. 1996, 188:10, eff. Jan. 1, 1997.

    420-B:8-k Coverage for Diabetes Services and Supplies. 

Every health maintenance organization and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the medically appropriate and necessary outpatient self-management training and educational services, pursuant to a written order of a primary care physician or practitioner, including but not limited to medical nutrition therapy for the treatment of diabetes, provided by a certified, registered, or licensed health care professional with expertise in diabetes, subject to the terms and conditions of the policy. Each health maintenance organization that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides a prescription rider shall cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes subject to the terms and conditions of the policy. Each health maintenance organization that provides coverage for prescription insulin drugs shall cap the total amount that a covered person is required to pay for each covered insulin drug prescription at an amount not to exceed $30 for each 30-day supply of each insulin prescription. The maximum $30 copayment for each 30-day supply of each covered insulin drug prescription shall apply when an original prescription is dispensed as well as when refills of the prescription are dispensed, including early refills. Coverage for prescription insulin drugs shall not be subject to any deductible. Each health maintenance organization that issues or renews any individual or group policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses which provides for durable medical equipment coverage shall provide coverage for medically appropriate or necessary equipment used to treat diabetes subject to the terms and conditions of the policy.


Source. 1997, 258:6. 2010, 188:13, eff. Aug. 20, 2010. 2020, 13:4, eff. Sept. 14, 2020.

    420-B:8-l Medicare Risk Contracts. 

I. The requirements of RSA 417-E, RSA 420-B:8-b, RSA 420-B:8-e, RSA 420-B:8-f, and RSA 420-B:8-ff shall not apply to a Medicare risk policy issued pursuant to a contract under section 1876 or section 1833 of the federal Social Security Act (42 U.S.C. section 1395 et seq.) as amended.

II. In the event of termination of the contract between the Centers for Medicare and Medicaid Services (CMS) and the contractor, all current enrollees of the contractor who will lose their coverage as a result of this contract termination, shall be given an opportunity to enroll, without evidence of insurability, in any Medicare Supplement policy approved for sale in this state which is then being offered by the contractor.


Source. 1997, 282:3. 2003, 145:6, eff. Aug. 16, 2003.

    420-B:8-m Patients' Bill of Rights. 

All health maintenance organizations shall provide to each new subscriber who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.


Source. 1997, 331:17, eff. Aug. 22, 1997.

    420-B:8-n Point of Service Plans. 

I. A health maintenance organization may offer a point-of-service plan in accordance with the requirements of this section. A point-of-service plan is a health maintenance organization contract which includes coverage for both in-network services and coverage for services provided by non-contracted providers.

II. A point-of-service plan offered by a health maintenance organization shall:

(a) Provide incentives for enrollees to use in-network covered services.

(b) Offer out-of-network covered services only if those services are also covered on an in-network basis.

(c) Cover out-of-network emergency services as if they had been provided in-network.

III. A point-of-service plan offered by a health maintenance organization may:

(a) Limit or exclude specific types of services, other than emergency services, from coverage when obtained out-of-network.

(b) Include provisions for member cost sharing, annual out-of-pocket limits and annual and lifetime benefit allowances for out-of-network covered services which are separate from any limits and allowances applied to in-network covered services.

(c) Cover at the out-of-network benefit level, services provided by a participating provider for which proper authorization or referral was not obtained.

IV. Subject to the provisions of RSA 420-G, a health maintenance organization may limit the groups to which point-of-service plans are offered. If a point-of-service plan is offered to a group, it must be offered to all eligible members of the group.

V. A health maintenance organization may not expend more than 20 percent of its total annual health care expenditures on out-of-network covered services. If compliance with this requirement is not demonstrated on a quarterly basis on the health maintenance organization's quarterly financial report, the commissioner may prohibit the health maintenance organization from offering a point-of-service plan to new groups until compliance has been demonstrated.

VI. A health maintenance organization shall comply with all applicable form and rate filing requirements. In complying with said requirements, the health maintenance organization shall:

(a) Design the benefit levels for in-network covered services and out-of-network covered services to achieve the desired level of in-network utilization;

(b) Provide or arrange for adequate systems to:

(1) Process and pay claims for out-of-network covered services;

(2) Meet the requirements for point-of-service plans under this section; and

(3) Generate accurate financial and regulatory reports on a timely basis in order for the commissioner to evaluate experience with the point of service plan and monitor compliance with the requirements of this section.

VII. An explanation of benefits shall be provided to enrollees who obtain services at the out-of-network benefit level which is adequate to permit the enrollee to determine his or her financial liability under the plan.

VIII. All point-of-service contracts and certificates shall contain a provision permitting the enrollee to assign any benefits provided for medical or dental care on an expense-incurred basis to the provider of care. An assignment of benefits under this paragraph does not affect or limit the payment of benefits otherwise payable under the contract or certificate.

IX. Subscriber contracts and member handbooks shall contain a clear and concise explanation of the point of service plan. The explanation shall include:

(a) The method of reimbursement;

(b) The required co-payments, co-insurance and deductibles, as applicable;

(c) Other uncovered costs or charges;

(d) The services that an enrollee is permitted to obtain at the out-of-network benefit level; and

(e) Instructions for submitting claims for services obtained at the out-of-network benefit level.


Source. 2002, 207:8, eff. May 16, 2002.

    420-B:8-o Third-Party Payment of Covered, Court-Ordered Services. 

The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such services shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to the terms and conditions of the policy or certificate, including any managed care provisions. However, the claimant or claimant's representative shall have 48 hours from the commencement of a court-ordered service, placement, or program to seek any pre-authorization, pre-certification, or referral required under the terms of the policy. The determination of these preservice claims for court-ordered services for a minor shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 48 hours after receipt of the request and sufficient information, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the insurer shall notify the claimant or claimant's representative within 24 hours of receipt of the request and shall advise the claimant or claimant's representative of the specific information necessary to determine to what extent benefits are covered or payable. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the claim determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of:

I. The insurer's receipt of the specified additional information; or

II. The end of the period afforded the claimant or claimant's representative to provide the specified additional information.


Source. 2004, 117:3, eff. Aug. 15, 2004.

    420-B:8-p Coverage for Certified Midwives. 

Every health maintenance organization and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group health insurance providing maternity benefits shall also provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage consistent with the terms and conditions of the policy for services rendered by a midwife certified under RSA 326-D. Such coverage shall be subject to each insurer's standards and mechanisms for credentialing and contracting pursuant to RSA 420-J:4 and RSA 420-J:8 respectively, where applicable, and contingent upon services being provided in a licensed health care facility or at home and within the scope of practice of a certified midwife. Benefits provided shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.


Source. 2006, 8:4. 2008, 298:4. 2010, 188:13, eff. Aug. 20, 2010.

    420-B:8-q Coverage for Dependents. 

If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this section. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this section. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this section commences.


Source. 2007, 289:15, eff. Jan. 1, 2008.

    420-B:8-r Coverage for Children's Early Intervention Services. 

Every health maintenance organization and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group health insurance providing benefits for medical, rehabilitation, or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for expenses arising from the services of licensed and credentialed occupational therapists, physical therapists, speech-language pathologists, and clinical social workers working with children from birth to 36 months of age with an identified developmental disability and/or delay as specified in rules adopted pursuant to RSA 171-A:18, IV as long as the providing therapist receives a referral from the child's primary care provider if applicable. The benefits in this section shall not be subject to deductibles, copayments, or coinsurance; provided that the benefits included in this section may have a cap of $3,200 per child per year not to exceed $9,600 by the child's third birthday. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2) or a catastrophic health plan, as defined under the Patient Protection and Affordable Care Act of 2009, a carrier shall be exempt from the deductible provisions of this section and may apply a deductible to children's early intervention therapy services until an enrollee's deductible has been satisfied for the year. Notwithstanding any provision of law or rule to the contrary, the coverage under this section shall apply to the medical assistance program, pursuant to RSA 161 and RSA 167.


Source. 2007, 338:4. 2010, 188:13, eff. Aug. 20, 2010. 2020, 26:42, eff. Sept. 18, 2020. 2021, 56:11, eff. July 24, 2021.

    420-B:8 Forms of Evidence of Coverage. 

I. No evidence of coverage, or amendment thereto, shall be issued to any person in this state until a copy of the evidence of coverage, or amendment thereto including all rates to be charged, has been filed with and approved by the commissioner.

II. Every health maintenance organization shall provide evidence of coverage to each enrolled participant. If the enrolled participant obtains coverage through an insurance policy or a contract issued by a hospital, medical or health service corporation, whether by option or otherwise, the insurer or hospital or medical service corporation shall issue the evidence of coverage. Otherwise, the health maintenance organization shall issue the evidence of coverage. When a group of enrolled participants comprise a family unit a single evidence of coverage of said family unit shall be sufficient.

III. All forms of evidence of coverage issued by the health maintenance organization to enrolled participants, or other marketing documents purporting to describe the organization's health care services, shall contain clear and complete information indicating:

(a) The health care services and other benefits to which the enrolled participant is entitled;

(b) Any exclusions or any limitations on services or any other benefits to be provided, including any deductible or co-payment feature or any restrictions relating to pre-existing conditions;

(c) Where and in what manner information is available as to how services may be obtained;

(d) The predetermined periodic rate of payment for health care services and other benefits and other charges, if any, which the enrolled participant is obliged to pay; and

(e) All criteria relating to disenrollment or denials of re-enrollment.

(f) With respect to subscribers with Medicare supplement insurance benefits, the health maintenance organization shall allow each such subscriber a period of at least one year after the incurral of a covered expense within which the subscriber shall furnish any proof of loss required by the insurer. Failure to furnish such proof within such time shall not invalidate nor reduce any claim if it shall be shown not to have been reasonably possible to furnish such proof and such proof was furnished as soon as was reasonably possible.

III-a. Every health maintenance organization shall state on its forms of evidence of coverage that a maternity benefits rider will be made available at the request of the enrolled participant, if maternity care is not covered in the insurance policy, contract or evidence of coverage. Nothing in this paragraph shall be construed to apply to supplemental health insurance and disability insurance policies.

III-b. The coverage of any family member insured by such policy, pursuant to RSA 420-B:8-aa, I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

III-c. Non-group contracts issued by a health maintenance organization shall contain the following provision: Insurance with Other Insurers. If there be other valid coverage, not with this insurer, providing benefits for the same loss on a provision of service basis or an expense incurred basis, payment shall not be prorated or reduced. In such a case, the insured shall be entitled to payment from both insurers. However, the provisions of this paragraph shall not prohibit the issuance of contracts including a "benefits deductible." The term "benefits deductible," as used in this paragraph means the term as defined in RSA 415:6, II(4).

IV. (a) The periodic rate of payment for health care services and other benefits and other charges, if any, included in any form of evidence of coverage shall be reasonable in relation to the benefits and health care services provided and not excessive, inadequate or discriminatory.

(b) A grace period shall be allowed the enrolled participant for making any payment due under the contract. Such period shall not be less than 10 days.

V. No health maintenance organization authorized under this chapter shall cancel the enrollment of an enrolled participant or refuse to transfer an enrolled participant from a group to an individual basis for reasons relating to health status.

VI. All advertising intended for use in this state whether through written, radio, or television medium shall be submitted to the commissioner of this state for review and approval by the commissioner prior to use, except that the commissioner may waive prior approval for any such materials which the department of health and human services has approved for use in the medicaid program.

VII. The commissioner may, at any time, after a hearing, if one is requested, withdraw his approval of any advertising, evidence of coverage or amendment thereto on any of the grounds stated as material to approval. It shall be unlawful for any health maintenance organization to issue any evidence of coverage or amendment thereto after the effective date of such withdrawal of approval.


Source. 1977, 282:1. 1993, 167:3; 196:6. 1995, 112:17. 1996, 188:8. 1997, 282:2. 2009, 235:10, eff. Sept. 14, 2009.

    420-B:9 Reports to the Commissioner. 

I. Every organization subject to this chapter annually, on March 1, shall file a report with the commissioner and with the commissioner of health and human services, said report verified by an appropriate official of the organization, showing its financial condition on the last day of the preceding fiscal year.

II. Such report shall be filed on forms prescribed by the commissioner and shall include:

(a) A financial statement of the organization, including its balance sheet and statement of income, and expenditures for the preceding year, certified by an independent public accountant;

(b) Any changes in the information submitted pursuant to RSA 420-B:4; and

(c) Such other information relating to the performance of the health maintenance organization as the commissioner or the commissioner of health and human services may require.


Source. 1977, 282:1. 2001, 224:8, eff. Jan. 1, 2002.

    420-C:1 Purpose. 

The purpose of this chapter is to assure that health benefit plans encourage covered persons to seek health care services from preferred providers and that contracts or agreements between preferred providers and health care insurers are fair and in the public interest. Further, this chapter establishes reasonable regulatory requirements for health care insurers in a manner to contain health care costs while preserving the quality of care.


Source. 1987, 112:1, eff. July 5, 1987.

    420-C:2 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

II. "Covered person" means an individual entitled to reimbursement for expenses of health care services under a policy issued or administered by a health care insurer.

II-a. "
Date of enrollment
" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

III. "Health benefit plan" means the contract between the covered person or policyholder and the health care insurer which defines the services covered.

IV. "Health care insurer" means an insurance company, including nonprofit (tax exempt) health service corporations as defined in RSA 420-A, authorized in this state to issue policies that provide reimbursement for expenses of health care services.

V. "Health care services" means services or products rendered by a preferred provider which may include physician, hospitalization, laboratory, and x-ray services, and medical equipment and supplies, and which further may include, but are not limited to: medical, surgical, and dental care; psychological, obstetrical, osteopathic, optometric, optic, podiatric, chiropractic, nursing, physical therapy, and pharmaceutical services; health education; preventive medical, rehabilitative, and home health services; inpatient and outpatient hospital services, extended care, nursing home care, convalescent institutional care, laboratory and ambulance services, appliances, drugs, medicines, and supplies; and any other care, service, or treatment of disease, correction of defects, or the maintenance of the physical and mental well-being of the insured.

VI. "Preferred provider" means a licensed provider or group of providers who have contracted with or been designated by the health care insurer to provide health care services to covered persons under a health benefit plan.

VII. "Provider" means any physician, hospital or other institution, organization, or other person who furnishes health care services.


Source. 1987, 112:1. 2007, 289:17, eff. Jan. 1, 2008.

    420-C:3 Reimbursement Agreements. 

Notwithstanding any other law to the contrary, a health care insurer may:

I. Enter into contracts or other agreements with preferred providers for the delivery of health care services to covered persons. Such contracts or agreements may:

(a) Establish the amount and method of payment to the preferred provider;

(b) Establish a procedure for the review and control of utilization of health care services; and

(c) Establish a mechanism for determining whether the health care services rendered are medically necessary.

II. Issue or administer policies or contracts which provide incentives for the covered person to use the health care services of preferred providers.

III. Issue or administer policies or contracts which provide benefits for health care services only if the services have been rendered by a preferred provider.


Source. 1987, 112:1, eff. July 5, 1987.

    420-C:4-a Dependent Coverage. 

I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

II. Nothing in this section shall be construed to require:

(a) Coverage for services provided to a dependent before the effective date of this section; or

(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.

III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.

IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:

(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or

(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).

VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days following the effective date of the passage of this law.

(b) Such notice shall also include information regarding the required special open enrollment period.


Source. 2007, 352:4. 2009, 235:13. 2010, 243:11, eff. Sept. 23, 2010.

    420-C:4-b Coverage for Dependents. 

If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this section. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this section. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this section commences.


Source. 2007, 289:18, eff. Jan. 1, 2008.

    420-C:4-c Pre-certification Requirement. 

In the event that a person is covered by more than one plan that requires pre-certification, the member shall obtain pre-certification from the primary plan. Although the member shall not be required to obtain pre-certification from the secondary plan, the secondary plan shall not be required to treat such services as covered services if the services do not meet its certification criteria. The secondary plan shall not refuse payment for such services solely on the basis that the services were not pre-certified by the secondary plan.


Source. 2007, 289:18, eff. Jan. 1, 2008.

    420-C:4 Health Benefit Plans. 

Health benefit plans issued under RSA 420-C:3 may include, but shall not be limited to, the following components which are designed to control the cost and improve the quality of health care for covered persons:

I. A per capita payment to preferred providers.

II. Differences between the benefit levels for the health care services of preferred providers and the benefit levels for the services of other providers.

III. Reasonable deductibles which may be different for preferred providers than for other providers.

IV. The standards to be met by a provider in order to become a preferred provider.

V. The preferred providers with whom the health insurer has contracted.

VI. Any other incentives allowed to covered persons if a preferred provider's services are used.

VI-a. A maternity benefits rider for covered persons who request it, if maternity benefits are not part of the health benefits plan. Nothing in this paragraph shall be construed to apply to supplemental health insurance and disability insurance policies.

VII. No preferred provider shall, when issuing or renewing a policy or contract of insurance or any certificate under such policy or contract covered by this chapter, deny coverage or limit coverage to any resident of this state on the basis of health risk or condition except that a waiting period consistent with insurance department rules may be imposed for pre-existing medical conditions. If a preferred provider accepts an application for group coverage, such acceptance shall be subject to the following:

(a) If the group has coverage in effect through another plan, the preferred provider shall accept all persons covered under the existing plan. If the group does not have coverage in effect through another plan, the preferred provider shall accept all persons for which the group seeks coverage.

(b) Once a group policy has been issued, any person becoming eligible for coverage shall become covered by enrolling within 31 days after first becoming eligible. Any person so enrolling shall not be required to submit evidence of insurability based on medical conditions. If a person does not enroll at this time, he is a late enrollee.

(c) Once a group policy has been issued, the preferred provider shall provide the group with an annual open enrollment period for late enrollees. During the open enrollment period, any late enrollee shall be permitted to enroll without submitting any evidence of insurability based on medical conditions. For late enrollees only, the pre-existing condition provisions shall apply for 18 months from the date of enrollment.

VIII. An insurer issuing policies of group insurance shall allocate the costs associated with maternity and childbirth over both males and females covered by its entire block of business in this state. In cases in which, because of the amount written in the state, allocation to an entire block of business needs to occur, the carrier may apply for a waiver from the insurance commissioner.


Source. 1987, 112:1. 1992, 222:4. 1993, 162:6, eff. July 1, 1993; 196:7, eff. Jan. 1, 1994.

    420-C:5-a Prohibiting Limitations on Liability;  Disclosure of Information. 

I. No contract between a health care insurer and a physician, for the purpose of delineating the rights and obligations of the parties within the provider network, shall limit the liability of the health care insurer for any actions of the physician for which the health care insurer might otherwise be liable.

II. No contract between a health care insurer and a health care provider shall limit what information such health care provider may disclose to patients or to prospective patients regarding the provisions, terms, or requirements of the health care insurer's products as they relate to the needs of such provider's patients except for trade secrets of significant competitive value.

III. No contract shall use the term physician for the purpose of allowing a health care insurer to avoid contracting with other health care professionals for health care services. A physician shall mean a person licensed to practice medicine under RSA 329. Nothing in this section shall be construed to require a health care insurer to contract with a health care provider.

IV. No contract between a health care insurer and a health care provider shall limit coverage for preexisting conditions beyond 9 consecutive months from the date of enrollment.


Source. 1995, 126:5. 1996, 149:5. 1998, 377:2. 2007, 289:19, eff. Jan. 1, 2008.

    420-C:5 Discrimination Prohibited. 

No health care insurer shall discriminate against any provider on the basis of religion, race, color, national origin, age, sex, gender identity, sexual orientation, or marital status. Reasonable terms and conditions including, but not limited to, those based on economic or geographic considerations, certain affiliations, or professional privileges shall not be prohibited under this section.


Source. 1987, 112:1, eff. July 5, 1987. 2019, 332:18, eff. Oct. 15, 2019.

    420-C:6 Rulemaking. 

I. The commissioner may adopt rules under RSA 541-A necessary for the implementation and administration of this chapter, relative to:

(a) The length of time necessary for health care insurers to comply with this chapter; and

(b) The information he shall require health care insurers to provide to demonstrate compliance with this chapter.

II. The commissioner may adopt rules under RSA 541-A relative to the administration of this chapter.


Source. 1987, 112:1. 2002, 207:30, eff. July 15, 2002.

    420-C:7 Notice. 

Any health care insurer commencing a preferred provider agreement shall notify the commissioner within 30 days.


Source. 1987, 112:1, eff. July 5, 1987.

    420-C:8 Other Applicable Statutes. 

Preferred provider agreements and health benefit plans subject to this chapter shall also be governed by the provisions of RSA 420-G and RSA 420-J.


Source. 1997, 344:9, eff. July 1, 1997; 344:17, eff. Jan. 1, 1998.

    420-D:1 Definitions. 

In this chapter:

I. [Repealed.]

II. "Commissioner" means the insurance commissioner.

III. "
Continuing care
" or "
life care
" means furnishing or promising to furnish to a person, other than one who is related by consanguinity or affinity up to, but not including, the third degree, services that shall include board or lodging, or both, and may include nursing services, medical services, or other health related services, irrespective of whether the board, lodging, and services are provided at the same location or provided by a third party, pursuant to a contractual agreement extending for the life of such person or for a period of a year or more in consideration of payment of an entrance fee which may also include additional periodic charges for the services provided and including contracts which are terminable by either party. Continuing care or life care includes contracts with residents meeting the requirements in this paragraph, where the resident contracts to receive board or lodging or both in the future and does not move immediately into the facility.

IV. "Department" means the insurance department.

V. "
Entrance fee
," "
entrance deposit
," or "
accommodation fee
" means an initial or deferred payment, agreed upon in the contract, of a sum, usually a lump sum, in cash or in kind, to a provider in return for acceptance as a resident. This definition shall not apply to the payment of a sum which is less than the total of periodic payments, as defined in paragraph X of this section, for one year or $10,000.

VI. "
Facility
" means any facility or institution providing board, lodging, or other services under a contract for continuing care.

VII. "Licensed" means that the provider has obtained a certificate of authority from the commissioner.

VIII. "
Living unit
" means a room, apartment, or other area within a facility used exclusively by one or more, but usually no more than 2 residents living independently and does not include a nursing home unit, skilled nursing facility, hospital room, assisted living unit, or any other similar units or facility licensed under RSA 151.

IX. "Manager" means a person who operates a facility.

X. "
Periodic payments
" or "
monthly care fees
" means those payments in addition to the entrance fee made by a resident to a provider for continuing care during the entire period that the contractual agreement for continuing care is in effect.

XI. "Provider" means a person contracting to provide continuing care at a facility. This may be a natural person, partnership, or any other type of business organization, whether organized for profit or not.

XII. "Resident" means a person entitled, pursuant to a contract with the provider, to receive continuing care in a facility.

XIII. "Solicit" means all actions by a person or provider seeking to have individuals enter into a continuing care agreement. This includes, but is not limited to, mail, telephone, personal contacts, and media advertisements.

XIV. (a) "
Unearned portion of entrance fee
" means that portion of the entrance fee which a provider contracts to return to a resident should the resident cancel the contract for continuing care. This may be nothing, or the contract may call for the provider to "earn" a specific percentage of the entrance fee per month.

(b) "Earned portion of entrance fee" means that portion of the entrance fee "earned" by the provider under the terms of the contract, which the provider may retain.

XV. "Just cause" means conduct constituting a criminal offense involving moral turpitude, gross dereliction of duty, or gross abuse of authority.


Source. 1988, 44:2. 1989, 26:1, 2. 2001, 276:6. 2010, 144:1-5, eff. Jan. 1, 2011.

    420-D:10 Entrance Fee Escrow Account. 

I. An escrow account for entrance fees shall be established and approved by the commissioner before a certificate of authority under this chapter shall be issued. Entrance fees paid by prospective residents before occupancy of a facility living unit or by prospective residents under a contract issued pursuant to RSA 420-D:3-a, and which total over $1,000 shall be placed in this account. All entrance fees subject to this section shall be placed in the account on the first working day after receipt. Interest on such fees shall be paid at the current market rate as established by the commissioner to the prospective resident if the resident is not allowed by the provider, for any reason, to enter the facility, provided however if the entrance fee is paid pursuant to a contract under RSA 420-D:3-a, the entrance fee shall be returned to the consumer with interest, if the contract is not signed or the consumer exercises the right of rescission under RSA 420-D:12, I(m).

II. The provider shall deliver to the escrow agent the sum total of all entrance fees paid in for each resident or prospective resident. A list of the names, addresses, and sum totals of all entrance fees paid by each resident or prospective resident shall be maintained by the provider or the escrow agent for the provider. If an entrance fee has been paid by another on behalf of a resident, a statement shall be included as to whom the amount in escrow is to be returned to, should return become necessary.

III. Release of escrowed amounts to the provider shall be made as follows:

(a) For living units that have been previously occupied, when the new resident makes the first monthly payment.

(b) For living units not previously occupied:

(1) When aggregate fees received or receivable equal 50 percent of total entrance fees due at full occupancy, except that any entrance fee payments that are less than 35 percent of the amount due from a resident will not be counted; or

(2) When entrance fees plus proceeds of any first mortgage or other long term loan in lieu of a first mortgage plus other funds on hand equal 
1/2 of the total cost of the facility, plus 
1/2 of the start-up losses shown in the certificate of authority application; or

(3) When a permanent mortgage or other long term loan commitment has been received and the mortgagee's commitment conditions prior to disbursement have been satisfied, other than completing construction and closing purchase.

(c) For a resident that has not moved into the facility pursuant to RSA 420-D:3-a, 10 days after the contract is fully executed by all parties.

IV. The escrow agent shall return funds, including all interest, to the person who originally made the payment to the provider, if the funds so deposited are not released to the provider under the conditions enumerated in paragraph I or II within 3 years of the escrow date. The commissioner may extend this period for up to 2 years upon written application by the provider.

V. The escrow provisions under this chapter shall not apply to nonrefundable application fees that do not exceed one month's periodic payments for services rendered by the provider.

VI. If approved by the commissioner, a provider may post bond, negotiable securities, or a letter of credit with the commissioner in lieu of escrow. The institution providing a bond or a letter of credit must meet all requirements of and have the full approval of the commissioner. The amount of the bond, negotiable securities, or letters of credit shall be in the same amount as if the funds received from residents or prospective residents had been placed in escrow. Under this paragraph, a record of persons who made entrance fee payments and the amount of such payments shall be maintained as required under paragraph I of this section.

VII. An escrow agent shall return funds to the person, or the estate of the person if deceased, who paid the entrance fee, if requested by the provider. A request to return funds to any other person shall be approved by the commissioner.


Source. 1988, 44:2. 2010, 144:10, 11, eff. Jan. 1, 2011.

    420-D:11 Pledging Assets. 

Only unencumbered assets of a facility may be pledged as collateral for another facility.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:12 Contracts With Residents. 

I. Each contract between a provider and a resident shall:

(a) Be written in plain, non-technical language.

(b) Cover only one resident, or 2 if sharing the same unit, and shall include the total amount transferred by the resident, or on behalf of the resident, to the provider. If securities or real or personal property are transferred to the provider instead of cash, the provider shall describe exactly the securities, property, or other goods transferred and the market value of securities or the professional appraised value of property or goods as of the date they were tendered.

(c) State specifically and in full detail all services and items to be provided to the resident including the locations where services and items will be provided, the duration of such services, and how often they are to be provided. The contract shall also describe which services or items are included in the agreement for continuing care and which services or items will be made available by the provider at an extra cost to the resident.

(d) State the conditions upon which the provider may evict a resident or terminate the contract for continuing care and the conditions upon which a resident may terminate his or her residency or terminate the contract for continuing care. A statement as to what portion of the entrance fee shall be returned under each condition shall also be included in accordance with RSA 420-D:12, II.

(e) Describe conditions required for a person to continue as a resident.

(f) Describe any conditions under which a person delinquent in his or her periodic payments may remain and if there is a specific time limit.

(g) State the entrance fees and periodic payment changes that may occur if a resident marries or if a spouse joins a resident in a living unit. It shall also state the fee changes that may occur if either one of the 2 people who occupy the same living unit dies or otherwise leaves that living unit.

(h) Describe the terms and conditions under which a provider or a resident may cancel an agreement for continuing care. The contract shall also state that a minimum of 30 days' notice of cancellation must be given, except that a written medical finding by 2 doctors that a resident is a danger to himself or others shall require only reasonable notice.

(i) Describe in clear detail all the terms under which a contract is cancelled upon the departure or death of a resident.

(j) State the basis upon which the entrance fees are earned by the provider at the death of a resident, what portion, if any, shall be turned over to the estate of the resident, and the formula for calculating all amounts earned by the provider.

(k) Describe the conditions under which periodic payments may change. The contract shall state that a 60-day notice is required before a change in periodic payments shall take effect, except those periodic payments required by federal or state assistance programs.

(l) State that periodic payments for care paid in a lump sum shall not be changed during the period covered, unless the resident is receiving federal or state assistance and the change is mandated by those programs.

(m) Provide a period of 10 days during which a prospective resident may cancel a contract and have his deposit returned and that there is no requirement to move in during those 10 days.

(n) Provide that, within the 10 days under subparagraph (m), the provider shall make a full refund of all money, securities, goods, or property tendered by the prospective resident, except for any non-refundable initial application fee that does not exceed one month's periodic charges and any payments for actual services or goods provided to the prospective resident.

(o) Describe under what conditions a resident may be transferred to another living unit or another part of the facility together with the financial adjustments to be made as a result of such changes.

(p) Provide for full refund, except any initial non-refundable application fee of less than one month's periodic payment, if, before occupancy, death occurs or if there is a medically certified incapacity to move in.

II. (a) No contract issued pursuant to this section shall allow dismissal of a resident prior to the end of a contractual period, except for just cause in written form or if 2 doctors, one of whom is not an employee or associated with the facility, find that the resident is a danger to himself or to others. In such cases, the minimum refund shall be the unearned portion of the entrance fee in the contract with the resident.

(b) The commissioner or his designee shall intervene prior to a dismissal if so requested by the resident. If the commissioner finds that a resident is being or has been unjustly dismissed, he may, in his capacity as the intervenor, order the return of the entire entrance fee or take any other necessary action on behalf of a resident.


Source. 1988, 44:2. 2010, 144:12, eff. Jan. 1, 2011.

    420-D:13 Transfer or Sale of Interest. 

I. Any provider who plans to sell or otherwise transfer control, whether partial or entire, or an interest in the management or assets of a continuing care community certified under this chapter shall notify the commissioner of the proposed change. The notification shall specify the amount of interest involved in the transfer, the type of transfer, and to whom. The commissioner may refuse to approve such transfer until full disclosure has been made, to his satisfaction, of the terms and conditions of the transfer and he has determined that such transfer is in the best interests of the residents and the state of New Hampshire.

II. If the commissioner determines that management control or more than 50 percent of the assets of the facility have been or are about to be transferred to another party, he shall cancel the existing certificate of authority and require that an application for a certificate of authority be submitted by the new provider within 30 days.

III. [Repealed.]


Source. 1988, 44:2. 1999, 249:6, II, eff. Sept. 7, 1999.

    420-D:14 Waiver Prohibited. 

Contracts entered into prior to the date the provider receives the certificate of authority are valid and binding for those providers offering or providing continuing care on January 1, 1989; except that a resident or a prospective resident who has signed a contract prior to that date may request that his contract with the provider be changed to conform with the provisions of this chapter. However, any changes made to such contracts after the date when rules adopted by the commissioner in accordance with RSA 420-D:17 take effect shall conform to all provisions of this chapter and such rules.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:15 Right to Organize and to Obtain Outside Consultation. 

I. All residents have the right to self-organize, the right to be represented by an individual of their own choice, and the right to engage in concerted activities for their own purposes. They shall have the right both individually and severally to obtain outside advice and consultation of their own choosing on any matter, including, but not limited to, medical, legal, and financial matters.

II. A provider shall be available for meetings at least once each quarter of the year with residents or their representative. The meetings shall be for the purpose of providing a forum for free and open discussion of any point either wishes to discuss. If requested, the manager of a facility shall be present at such meetings, and the residents' organization may also request that an owner, partner, director, or other official of the provider operating the facility be present. Residents shall be given at least 2 weeks' notice of each such meeting.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:16 Rehabilitation or Liquidation. 

I. The commissioner may, if it is in the best interest of the residents, petition the appropriate court to appoint a trustee to rehabilitate or liquidate a facility. Such rehabilitation or liquidation shall occur only if the commissioner finds, after proper notice and hearing, any of the following:

(a) That a provider is insolvent or bankrupt or in danger of becoming insolvent or bankrupt.

(b) That a provider has failed to maintain required liquid reserves under RSA 420-D:8.

(c) That any part of the reserve fund escrow amount under RSA 420-D:10 has been or is about to be released in violation of RSA 420-D:10.

(d) That a provider has been or is about to become unable to meet the cash flow or income projections for the period.

(e) That the certificate of authority has been suspended or revoked.

(f) That the provider named in a certificate has sold a majority interest or transferred management control to others without prior notification and approval by the commissioner.

II. A rehabilitation order shall authorize the commissioner, or the trustee, to take possession of the property of the provider, including all facilities owned by the provider within the state, to operate, including the employment or discharge of any facility employees as he may determine necessary, and to manage and take other measures the court may direct as necessary. The commissioner, trustee, provider, or the court on its own motion may petition for removal of a rehabilitation order and return the management of the facility to the provider, if the provider demonstrates that the objectives of the original order have been met and that no further jeopardy to the residents exists.

III. If attempts to rehabilitate the facility fail, the commissioner may apply to the court for an order to liquidate. A liquidation order, however, shall not require a prior rehabilitation order. An order to liquidate shall automatically revoke the certificate of authority for all facilities of the provider and shall include an order to liquidate all facilities owned by such provider.

IV. In applying for an order to rehabilitate or liquidate, the commissioner shall consider the best interests of the residents who have contracted for continuing care at the facility. The proceeds of liquidation shall be paid to other providers as full or partial entrance fees for the affected residents or shall otherwise be used on behalf of the residents of the facility being liquidated. Except as provided in paragraph V of this section, in the event of liquidation, all continuing care agreements with a provider shall be deemed preferred claims against the assets of the provider.

V. A provider may avoid a rehabilitation order by posting a bond in an amount which is satisfactory to the commissioner. The bond shall be from a maker in this state who is acceptable to the commissioner and shall be in favor of the commissioner on behalf of those entitled to refunds or damages. It shall be in an amount sufficient to cover any refunds due the residents plus other amounts as determined necessary by the commissioner to protect the residents. Nothing in this chapter shall be construed to impair the priority, with respect to the lien property, of mortgages, security agreements, lease agreements, or installment sales agreements on property not otherwise encumbered which have been entered into by a provider with an issuer of bonds or notes and bonds which are secured by a resolution, ordinance, or indenture of trust if such mortgages or agreements were duly recorded at least 4 months prior to the institution of liquidation proceedings.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:17 Rulemaking. 

The commissioner shall adopt rules pursuant to RSA 541-A and after public hearing, relative to:

I. Procedures for application for a certificate of authority under RSA 420-D:2.

II. [Repealed.]

III. Any application fees required under RSA 420-D:2.

IV. Procedures and fees for the renewal process under RSA 420-D:3.

V. Manner of filing and any other information to be contained in the disclosure statement required under RSA 420-D:4.

VI. Procedures for revocation or suspension of a certificate of authority under RSA 420-D:5.

VII. Procedures for hearings and notice requirements under this chapter.

VIII. Manner of filing and other information to be contained in the annual report required in RSA 420-D:7.

IX. The definition of major changes under RSA 420-D:7, II(c).

X. The definition of liquid reserves as required under RSA 420-D:8.

XI. Escrow conditions for liquid reserves under RSA 420-D:8.

XII. Procedures for obtaining and extending liens under RSA 420-D:9.

XIII. Procedures for placing entrance fees in escrow accounts and for releasing such fees under RSA 420-D:10.

XIV. The manner and content of all forms required under this chapter.

XV. What shall constitute cause for intervention under RSA 420-D:12, II.

XVI. A schedule of fees to cover the costs of administering this chapter.

XVII. Continuing care facilities under the division of charitable trusts in accordance with RSA 420-D:2, III.

XVIII. [Repealed.]


Source. 1988, 44:2; 44:6. 1999, 249:6, III, eff. Sept. 7, 1999.

    420-D:18 Dividends. 

A provider subject to this chapter shall obtain prior approval from the commissioner before declaring and distributing any dividends or funds or other assets to owners.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:19 Repealed by 2001, 276:6, II, eff. Sept. 14, 2001. 

    420-D:2 Certificate of Authority. 

I. No person or provider may solicit funds, accept payments of any kind, or otherwise engage in providing any form of continuing care without a certificate of authority issued under this chapter. An application for a certificate shall include the proposed disclosure statement required under RSA 420-D:4 and in addition to any other state or federal licensure or certification which may be required, a statement indicating that all of the requirements under this chapter have been met. The commissioner shall take prompt action on requests for a certificate and shall, within a reasonable time, issue a certificate or a written rejection. If he rejects an application, he may do so outright or state the conditions which must be met before a certificate shall be issued. The applicant may request reconsideration and shall be granted a hearing in accordance with rules adopted by the commissioner. Certificates issued under this section shall continue in effect until revoked by the commissioner or until sale or transfer of management control to another owner or provider.

II. [Repealed.]

III. Continuing care facilities which reported to or were under the supervision of the director of charitable trusts of the department of justice under RSA 7:19 through 32-a on January 1, 1989, shall be exempt from the provisions of this chapter. However, any such facility may elect by a one-time irrevocable election to be subject to the provisions of this chapter by filing an application for a permanent certificate of authority with the commissioner.


Source. 1988, 44:2. 1990, 36:1. 1999, 249:2, 6, I, eff. Sept. 7, 1999.

    420-D:20 Civil Liability. 

I. In the following circumstances, a provider or his agent shall be liable for damages, entrance fees with any accrued interest, and attorneys' fees, plus any other fees paid in advance of receipt of services:

(a) If the provider or agent enters into contracts for continuing care for a facility that does not have a certificate of authority under this chapter;

(b) If he did not deliver a disclosure statement before entering into a contract; or

(c) If a disclosure statement is misleading and induces acceptance of a contract for continuing care or induces payment of any money or transfer of anything of value by a resident or prospective resident.

II. Negligent misrepresentation or omission shall not preclude recovery under this section.

III. An action pursuant to this section may be avoided if the provider, upon written approval of the commissioner, makes a good faith offer to refund all fees and costs listed in paragraph I. Failure of a resident or prospective resident to accept such an offer within 60 days shall preclude further action by such resident or prospective resident. Any action brought pursuant to this section shall be in accordance with applicable state law. An action brought under this chapter shall not limit the liability of the provider under other state laws. A private party shall not be liable by implication unless expressly permitted under this chapter.


Source. 1988, 44:2. 1999, 249:3, eff. Sept. 7, 1999.

    420-D:21 Investigations;  Subpoenas. 

The commissioner may make such investigations as he or she deems necessary both within and outside the state in accordance with the provisions of RSA 400-A:16 and RSA 400-A:20 through RSA 400-A:22.


Source. 1988, 44:2, eff. Jan. 1, 1989. 2016, 111:6, eff. May 20, 2016.

    420-D:22 Records and Assets to be Kept Within State. 

All records and assets of a provider shall be established and kept in the state of New Hampshire and shall not be removed from this state by a provider or his agent unless agreed to in writing by the commissioner prior to such removal. The commissioner shall consent to such removal only if the provider submits satisfactory evidence that the removal will facilitate a more economical operation and will not diminish the service or protection given to the residents remaining in this state. The commissioner may order the return of the records and assets if such return is in the best interests of the residents or of the state.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:23 Audits. 

The commissioner or the commissioner's agent shall audit the books and records of a facility subject to this chapter once every 5 years, or more frequently as the commissioner deems necessary to assure the accuracy of reports to him or her taking into consideration other independent audits required under this chapter.


Source. 1988, 44:2. 2002, 207:9, eff. July 15, 2002.

    420-D:24 Cease and Desist Orders. 

If it appears that any person subject to this chapter has engaged or is about to engage in acts violating this chapter or any rule adopted pursuant to it, the commissioner may issue an order to cease and desist and bring court action to enforce compliance or enjoin such action. Upon proper request, a court may issue a permanent or temporary injunction, restraining order, or writ of mandamus, and a receiver or conservator may be appointed for the defendant or the defendant's assets. The commissioner shall not be required to post bond.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:25 Fees. 

The commissioner shall charge providers subject to this chapter a fee for services rendered to them by the department of insurance. The fees shall be established and adopted by rule under RSA 541-A and shall be sufficient to cover the costs of administering this chapter.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:26 Criminal Penalties. 

Any person, partnership, association or corporation, including state or county or local governmental units or any division, department, board or agency thereof, establishing, conducting, managing, or operating any facility within the meaning of this chapter without first obtaining a certificate as provided in this chapter, or who violates any rule adopted under this chapter, shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person. Nothing in this section shall preclude any other action at law against such person.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:27 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 application, and to this end the provisions of this chapter are severable.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:3-a Continuing Care at Home Contracts. 

I. A provider may contract to provide continuing care to a resident who remains at home and does not move immediately into a facility if the provider:

(a) Holds a certificate of authority issued under this chapter to provide continuing care.

(b) Owns and operates a facility located in New Hampshire where the resident has the right to receive board, lodging, or both, and other services.

(c) Satisfies the commissioner that the proposal to offer continuing care contracts to residents who do not move immediately into the facility will not place the provider in an unsound financial condition and will not be injurious or hazardous to any resident contracting with the provider for continuing care.

(d) Otherwise complies with all requirements of this section and RSA 420-D.

II. Any provider that issues contracts under this section shall:

(a) Be in good standing with the commissioner, not subject to action pursuant to RSA 420-D:5.

(b) Be responsible for all services the provider or any third party provides to the resident in the resident's home pursuant to the contract, and shall exercise direct control and oversight over any individual or entity providing those services.

(c) Have procedures to ensure that any third party providing services to the resident in the resident's home pursuant to the contract is trustworthy and certified, licensed, or otherwise qualified under state law to provide those services.

III. The provider and any person employed by the provider that assists in delivery of services to the resident in the resident's home shall have a business location within the state of New Hampshire, hold appropriate licenses and shall be available to address complaints, questions, and concerns of residents.


Source. 2010, 144:6, eff. Jan. 1, 2011.

    420-D:3 Renewal of Certificate of Authority. 

Certificates of authority shall continue in effect until revoked by the commissioner. Certificates shall not be transferred during this time to another provider or owner. The commissioner shall establish a fee for applications for certificates of authority by rules adopted under RSA 541-A.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:4 Disclosure Statement. 

I. Each provider shall provide each prospective resident with a disclosure statement which has been approved by the commissioner. The disclosure statement shall be delivered before the initial transfer of funds or before any contract is consented to by each prospective resident of the facility. The disclosure statement shall include, in conspicuous large type, the statement: "NOTICE: You are advised to consult with an attorney before signing any documents or agreements concerning this matter. You have the right to cancel this agreement within 10 days after signing without obligation, except for certain described services and charges." The language of the disclosure statement shall be in plain and understandable English.

II. The disclosure statement shall include the following information:

(a) The name of the organization and whether it is for profit, and whether it is a partnership, corporation, or other type of organization.

(b) For all officers, trustees, investors, and owners with more than 5 percent ownership and for the facility manager:

(1) Name, address and amount of ownership.

(2) Responsibility and relationship to the facility.

(3) Previous experience with similar facilities.

(4) Previous business experience.

(5) Any felony convictions against such person in any jurisdiction.

(6) Any court orders or injunctive relief against such person.

(7) Relationships with other nursing homes or like communities.

(8) Previous bankruptcies or financial actions against such person.

(9) Relationship with any supplier or potential supplier of services.

(10) Supplies or materials of any kind contributed or sold to the provider.

(c) The provider's relationship with any religious, charitable, or nonprofit organization and the extent of such organization's financial responsibilities to the provider or to residents.

(d) Whether the provider claims to be nonprofit or tax exempt.

(e) The location and description of the facility and, if it is proposed or incomplete, the estimated completion date, status of construction, and any contingencies on that completion date.

(f) Those services to be provided by the facility under basic contract and those at extra cost.

(g) All locations where services are to be provided, if different from the main facility.

(h) All entrance fees and periodic payments that are required of residents and a description of all policies and conditions for refund or return of these fees and payments.

(i) When and how periodic payments may be changed by the facility.

(j) Provisions of the provider for reserve funding, escrows, and trusts and investment of these funds.

(k) Financial statements audited by a certified public accountant including, if the facility is in operation, a balance sheet and an income statement for the 2 complete and immediately preceding years.

(l) If the facility has not yet begun operating:

(1) All expected costs or obligations.

(2) Full description of all mortgages or long term financing and an analysis of the occupancy rates necessary to pay them together with an analysis showing the number of contracts necessary to make start-up feasible.

(3) Estimated entrance fee income prior to operation.

(4) Estimated start-up losses and reserves to be covered by entrance fees.

(5) Projection of estimated annual income from periodic payments.

(6) Resident mortality and morbidity assumptions.

(7) Analysis of facilities expected to compete with the proposed facility and a demographic analysis of the elderly population expected to support the facility.

(8) All periodic payments a resident will be expected to pay.

(9) Assumptions and bases for estimating occupancy rates.

(10) All expected subsidies, private or government, including Medicaid and Medicare, and the effect if these subsidies are not received.

(11) Projected annual operating expenses.

(12) Estimated capital and equipment replacement expenditures for the current year and the next 5 years. In specific cases, the commissioner may, if he deems necessary, require a longer period of projection of the estimated capital and operating expenses.

(13) All assets pledged as collateral.

(14) Annual payments on long term financing.

(15) Any other commitments over $25,000 to make payments to another party for any purpose.

III. The disclosure statement shall contain any other information deemed necessary by the commissioner.

IV. The cover page of the disclosure statement shall state, in a prominent location and type face, the date of the disclosure statement and that the issuance of a certificate of authority does not constitute approval, recommendation, or endorsement of the facility by the department, nor is it evidence of, nor does it attest to, the accuracy or completeness of the information set out in the disclosure statement.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:5 Revocation or Suspension of Certificate of Authority;  Liens. 

I. The commissioner may revoke, deny, or suspend a certificate upon notice and hearing with written findings of fact if he finds that any of the following conditions exist:

(a) Violation by a provider of any provisions of this chapter or any rule adopted pursuant to it.

(b) Failure to continue to meet the requirements of the certificate of authority.

(c) Lack of any qualifications necessary under this chapter for the certificate of authority.

(d) Failure to file a disclosure statement under RSA 420-D:4 or failure to disclose such to a prospective resident.

(e) Fraud or misrepresentation of a material fact in the disclosure statement.

(f) Failure to comply with a cease and desist order under RSA 420-D:24.

(g) Misappropriation, conversion, or wrongful withholding of money.

(h) A demonstrated lack of fitness or trustworthiness.

(i) Failure to make a new application for certificate of authority in accordance with RSA 420-D:13 when there is a sale, transfer of ownership, or partial ownership, or transfer of control.

(j) Such unsound financial condition or any other practice which may be hazardous or injurious to residents or to the general public.

(k) Failure to maintain a complete list of all entrance fees paid by each resident or prospective resident by the provider or his escrow agent.

(l) Failure to file an annual report in accordance with RSA 420-D:7.

II. If necessary to protect the interests of the residents, the commissioner shall file a lien in accordance with RSA 420-D:9 on the real and personal property of the provider and shall take any other action necessary to protect the residents of the facility.


Source. 1988, 44:2. 2010, 144:7, eff. Jan. 1, 2011.

    420-D:6 Appeal. 

Any person, corporation, partnership, or association aggrieved by the action of the commissioner in revoking, suspending, or refusing to grant or reissue a certificate has the right to a rehearing and appeal in accordance with the provisions of RSA 541.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:7 Annual Reports. 

I. Annually, on or before May 1, a provider certified under this chapter shall submit a report to the commissioner relative to the financial condition of the facility together with any other information required by the commissioner. The commissioner may require more frequent reports of any provider or facility if he or she deems it necessary for proper review. If the provider uses an annual period other than a calendar year, he or she may apply to the commissioner for permission to file on another date which must be within 120 days of the close of this annual period. The commissioner shall approve such a request if the annual period used is prescribed by an appropriate federal agency and shall approve requests that are for the convenience of the provider if it is practicable to do so. A provider shall not change the final date of his or her annual period without prior written approval of the commissioner.

II. The report required under this section shall be in such form as the commissioner shall prescribe and shall include but not be limited to the following information:

(a) The most recent disclosure statement of the facility as required under RSA 420-D:4.

(b) An annual financial statement with an explanation of the differences between previous financial estimates and actual figures for the year.

(c) An estimated financial statement for the new fiscal year with an estimate in case of all major changes expected during the year. The commissioner shall adopt rules under RSA 541-A relative to the definition of major changes. Reports containing the information under this subparagraph shall not be distributed to residents unless prior approval has been obtained from the commissioner.

(d) Financial statements audited by an independent certified public accountant, which shall contain for 2 or more annual periods, at a minimum, the following information:

(1) A balance sheet.

(2) A statement of income and expenses.

(3) A statement of equity or fund balances.

(4) A statement of changes in financial position.

(5) The accountant's opinion.

(6) All notes to the financial statements considered customary or necessary to full disclosure and adequate understanding of the financial statements, the financial condition of the facility, and the operation.

(7) Such other reasonable data, financial statements, and pertinent information as the commissioner may by rule prescribe.

III. The annual statement shall be sworn to in writing by the principal officer or officers of the provider as follows:

(a) If an individual owner, by him;

(b) If a limited partnership, by the general partner;

(c) If a partnership, by all the partners;

(d) If an unincorporated association, by all its members or by all its officers and directors;

(e) If a trust, by all its trustees and officers; or

(f) If a corporation, by the president and the secretary.

IV. Notwithstanding paragraph II, the commissioner shall not prescribe by rule or otherwise require submission of an actuarial report from any facility which does not offer a contract in which all or part of the risk of uncertain future health care costs is borne by the facility and not the resident.


Source. 1988, 44:2. 2010, 144:8, eff. Jan. 1, 2011. 2016, 111:5, eff. May 20, 2016; 150:1, eff. July 26, 2016. 2019, 113:8, eff. Aug. 20, 2019.

    420-D:8 Liquid Reserves. 

Liquid reserves of each facility subject to this chapter shall be maintained equal to 12 months' principal and interest payments plus that portion of 2 months' operating expenses which relates to life care residents. Other reserves or trust accounts under the exclusive control of the provider shall be considered in making this determination. The commissioner may adopt rules pursuant to RSA 541-A relative to the definition of liquid reserves. The commissioner may require liquid reserves to be placed in escrow and shall prescribe escrow conditions and shall approve the escrow agent. If the provider contracts with any resident to return any portion of the entrance fee to such resident or his estate, the commissioner may make a finding if necessary to protect the best interests of the resident that a reserve be established by the provider in accordance with rules adopted by the commissioner.


Source. 1988, 44:2, eff. Jan. 1, 1989.

    420-D:9 Lien on Behalf of Residents. 

The commissioner shall file a lien on all real and personal property of a provider if he deems it necessary to protect the interests of the residents. Notices of liens upon real property shall be filed in the registry of deeds of the county in which the real property subject to the liens is situated. The register of deeds shall receive, record, and index the same in accordance with RSA 478. The filing and service of the notice and demand of said lien shall constitute a lien upon the real estate, personal estate, property interest, right, or credit to which the notice and demand relates or which may be subsequently discovered. Such lien shall be effective for the period determined necessary by the commissioner and may be renewed if the circumstances warrant it. A lien shall only be foreclosed to protect the investment of residents, and the proceeds shall be distributed in a manner to satisfy any continuing care contracts in effect at that time.


Source. 1988, 44:2. 2010, 144:9, eff. Jan. 1, 2011. 2022, 42:15, eff. July 2, 2022.

    420-E:1 Definitions. 

In this chapter:

I. "Commissioner" means the insurance commissioner.

I-a. "
Claim involving urgent care
" means any claim for medical care or treatment with respect to which the application of the time periods for making non-urgent care determinations:

(a) Could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function; or

(b) In the opinion of a physician with knowledge of the claimant's medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care or treatment that is the subject of the claim.

II. "Department" means the insurance department.

III. "Health care provider" means any person, corporation, facility, or institution either licensed by this state or otherwise lawfully providing health care services, including, but not limited to, a physician, hospital or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist or psychologist, and any officer, employee or agent of such provider acting in the course and scope of his employment or agency related to or supportive of health care services.

III-a. "
Pre-service claim
" means any claim for a benefit under a health plan with respect to which the terms of the plan condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining medical care.

IV. "Utilization review" means a system for reviewing the appropriate and efficient allocation of hospital, medical or other health care services given to a patient or group of patients as to necessity, for the purpose of recommending or determining whether such services should be covered or provided by an insurer, nonprofit service organization, health maintenance organization, third-party administrator or employer. The terms include those programs or processes whether they apply prospectively or retrospectively to medical services. Utilization review services include, but are not limited to, the following: second opinion programs; prehospital admission certification; preinpatient service eligibility certification; and concurrent hospital review to determine appropriate length of stay. Utilization review shall not include claims review or decisions.


Source. 1992, 142:2. 1996, 188:12. 2001, 207:4, 5, eff. Jan. 1, 2002.

    420-E:2-a Medical Director. 

Every medical utilization review entity licensed by the department under this chapter shall employ a medical director licensed under RSA 329 or, in the case of a dental utilization review entity, a dentist licensed under RSA 317-A.


Source. 2000, 18:3. 2004, 187:5, eff. July 31, 2004.

    420-E:2 Licensure or Registration Required. 

I. Any person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or an employee of those exempt organizations, that performs medical utilization review services on behalf of commercial insurers, nonprofit service organizations, health maintenance organizations, third-party administrators or employers, shall apply for a license to be issued by the department and shall pay an application fee and an annual license fee. No person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or the employees of exempt organizations shall perform utilization review services or medical utilization review services unless the person, partnership, or corporation has received a license in accordance with this chapter.

II. [Repealed.]


Source. 1992, 142:2. 1993, 249:1. 1996, 188:13. 1997, 345:8, III. 1999, 249:4, eff. Sept. 7, 1999.

    420-E:3 Information Required. 

I. Each person, partnership or corporation licensed under this chapter shall, at the time of initial licensure and on or before April 1 of each succeeding year, provide the department with the following information:

(a) The process used by the entity to carry out its utilization review services, including the categories of health care personnel that perform utilization review activities and whether or not such individuals are licensed in this state.

(b) The process used by the entity for addressing beneficiary or provider complaints.

(c) The types of utilization review programs offered by the entity, including, but not limited to:

(1) Second opinion programs.

(2) Prehospital admission certification.

(3) Preinpatient service eligibility determination.

(4) Concurrent hospital review to determine appropriate length of stay.

(d) The process used by the entity to preserve beneficiary confidentiality of medical information.

II. Each person, partnership, or corporation licensed under this chapter shall adopt as the minimal acceptable standards for licensure either the Utilization Review Accreditation Commission (URAC) standards, the National Committee for Quality Assurance (NCQA) standards, or other similar standards acceptable to the commissioner, unless rules establishing stricter standards are adopted pursuant to the commissioner's authority under RSA 420-E:7, XII.


Source. 1992, 142:2. 1993, 249:2. 1999, 249:5, eff. Sept. 7, 1999.

    420-E:4-a Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits. 

I. Beginning July 1, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs may, when requiring prior authorization for a prescription drug, use and accept the prior authorization paper forms or electronic standard described in this section.

II. Beginning December 31, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs shall, when requiring prior authorization for a prescription drug, use and accept only the prior authorization paper forms or electronic standard described in this section.

III. On or before March 1, 2017, the commissioner shall adopt rules, pursuant to RSA 541-A, specifying the contents and format of the uniform prior authorization paper forms and the electronic prior authorization standard, consistent with the requirements of this section. In developing the paper forms and the electronic standard, the commissioner shall seek input from interested stakeholders, including but not limited to prescribers, pharmacists, carriers, and prescription benefits managers, and shall support adoption of nationally recognized standards for electronic prior authorization of prescription drugs, including those provided by the National Council for Prescription Drug Programs or an equivalent organization as available.

IV. The prior authorization paper forms adopted under this section shall not exceed 2 pages in length.

V. Nothing in this section shall require a carrier or pharmacy benefits manager to use electronic prior authorization. A carrier or pharmacy benefits manager shall not require use of electronic prior authorization when:

(a) A pharmacist or prescriber lacks broadband Internet access;

(b) A pharmacist or prescriber has low patient volume;

(c) A pharmacist or prescriber has opted-out for a certain medical condition or for a patient request;

(d) A pharmacist or prescriber lacks an electronic medical record system;

(e) The electronic prior authorization interface does not provide for the pre-population of prescriber and patient information; or

(f) The electronic prior authorization interface requires an additional cost to the prescriber.

VI. Nothing in this section shall prohibit the use of prior authorization for prescription drug benefits.

VII. This section shall apply to RSA 420-J and shall not apply to the Medicaid managed care program under RSA 126-A:5, XIX.


Source. 2016, 228:3, eff. June 9, 2016.

    420-E:4 Minimum Standards;  Licensure of Medical Utilization Review Entities. 

All licensees shall establish and maintain a utilization review procedure by which a claimant or claimant's representative may seek a claim benefit determination. The procedure shall meet the following minimum standards:

I. The licensee shall maintain a toll-free telephone number to ensure that a representative of the licensee shall be accessible by telephone to insureds, patients, and providers 7 days a week during normal working hours.

II. Claim benefit determinations shall be made by a licensed or certified health care provider.

III. Clinical review criteria considered or utilized in making claim benefit determinations shall be:

(a) Developed with input from appropriate actively practicing practitioners in the carrier or other licensed entity's service area;

(b) Updated at least biennially and as new treatments, applications, and technologies emerge;

(c) Developed in accordance with the standards of national accreditation entities:

(d) Based on current, nationally accepted standards of medical practice; and

(e) If practicable, evidence-based.

IV. Notification of claim benefit determinations shall be made within the following time periods:

(a) The determination of a claim involving urgent care shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 72 hours after receipt of the claim, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the licensee shall notify the claimant or claimant's representative within 24 hours of receipt of the claim and shall advise the claimant or claimant's representative of the specific information necessary to determine the claim. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the benefit determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(b) The determination of a claim involving urgent care and relating to the extension of an ongoing course of treatment and involving a question of medical necessity shall be made within 24 hours of receipt of the claim; provided, that the claim is made at least 24 hours prior to the expiration of the prescribed period of time or course of treatment.

(c) The determination of all other claims for preservice benefits shall be made within a reasonable time period appropriate to the medical circumstances, but in no event more than 15 days after receipt of the claim. This period may be extended one time by the licensee for up to 15 days; provided, that the licensee both determines that such an extension is necessary due to matters beyond the control of the licensee and notifies the claimant or claimant's representative, prior to the expiration of the initial 15-day period, of the circumstances requiring the extension of time and the date by which the licensee expects to render a decision. If such an extension is necessary due to a failure of the claimant or claimant's representative to provide sufficient information to determine whether, or to what extent, benefits are covered as payable, the notice of extension shall specifically describe the required additional information needed, and the claimant or claimant's representative shall be given at least 45 days from receipt of the notice within which to provide the specified information. Notification of the benefit determination following a request for additional information shall be made as soon as possible, but in no case later than 15 days after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(d) The determination of a post service claim shall be made within 30 days of the date of filing. In the event the claimant fails to provide sufficient information to determine the claim, the carrier shall notify the claimant within 15 days as to what additional information is required to process the claim and the claimant shall be given at least 45 days to provide the required information. The 30-day period for claim determination shall be tolled until such time as the claimant submits the required information.

V. The manner and content of notification of claim benefit determinations shall be as follows:

(a) The licensee shall notify the claimant or claimant's representative in writing or electronically of the claim determination.

(b) If the claim benefit determination is a claim denial, the notice shall include:

(1) The specific reason or reasons for the determination and shall refer to the specific provision of the policy or plan on which the determination is based.

(2) A statement of the claimant's right or the right of the claimant's representative to access the internal grievance process and the process for obtaining external review.

(3) If the claim denial is based upon a determination that the claim is experimental or investigational or not medically necessary or appropriate:

(A) The name and credentials of the carrier or other licensed entity, the medical director, including board status and the state or states where the person is currently licensed. If the person making the claim denial is not the medical director but a designee, then the credentials, board status, and state or states of current license shall also be provided for that person; and

(B) An explanation of the clinical rationale for the determination. This explanation shall recite the terms of the plan or the policy or of any clinical review criteria or any internal rule, guideline, protocol, or other similar provision that was relied upon in making the claim denial and how these provisions apply to the claimant's specific medical circumstances;

(4) If an internal rule, guideline, protocol, or other similar provision was relied upon in making the benefit determination, a statement that such rule, guideline, protocol, or other similar provision was relied upon in making the claim denial;

(5) If clinical review criteria were relied upon in making the benefit determination, a statement that such clinical review criteria were relied upon in making the claim denial. The recitation of terms of the clinical review criteria required under RSA 420-E:4, V(b)(3)(B) shall be accompanied by the following notice: "The clinical review criteria provided to you are used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract;"

(6) In the case of a denial of a benefit concerning a claim involving urgent care or in the case of a denial of a claim related to continuation of an ongoing course of treatment for a person who has received emergency services, but who has not been discharged from a facility, a description of the expedited review applicable to such a claim shall be included in the determination. For all other claim benefit determinations, a description of the grievance process shall be specifically described in the determination.

VI. A licensee shall file with the department a copy of the materials designed to inform patients of the requirements of the utilization plan and the responsibilities and rights of patients under the plan and an acknowledgment that all applicable state and federal laws to protect the confidentiality of individual medical records are followed.

VII. In any request for a benefit determination, the claimant may authorize a representative to pursue the claim or benefit determination by submitting a written statement to the licensee that acknowledges the representation.

VIII. No fees or costs shall be assessed against a claimant related to a request for claim benefit determination.


Source. 1992, 142:2. 1993, 249:3. 1996, 270:1. 2000, 18:16. 2001, 207:6. 2003, 276:8-10. 2006, 304:4, eff. Aug. 18, 2006.

    420-E:5 Listing. 

The commissioner shall compile and maintain a current listing of persons, partnerships or corporations licensed pursuant to this chapter. The list shall be available to the public.


Source. 1992, 142:2, eff. July 5, 1992.

    420-E:6 Periodic Reviews. 

The commissioner or designee may conduct periodic reviews of the operations of the entities licensed under this chapter to ensure that they continue to meet the minimum standards set in RSA 420-E:4 and any applicable rules adopted by the commissioner. The commissioner may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required in RSA 420-E:4, I.


Source. 1992, 142:2. 2001, 207:7, eff. Jan. 1, 2002.

    420-E:7 Rulemaking. 

The commissioner shall adopt rules, under RSA 541-A and after public hearing, relative to:

I. Procedures for application for license under RSA 420-E:2.

II. Initial application fees and annual license fees.

III. The time period for notification of determination as required under RSA 420-E:4, IV.

IV. Standards for telephone accessibility as required under RSA 420-E:4, I.

V. Manner for filing and other information for minimum standards as required under RSA 420-E:4.

VI. Manner and content of all forms required under this chapter.

VII. What shall constitute cause to take actions under RSA 420-E:6 and RSA 420-E:8.

VIII. Confidentiality of records and access to records of the provider and reviewer, as required under RSA 420-E:4.

IX. The scope of the review and the information which the reviewer is entitled to review and have access to from the provider.

X. Qualification of the reviewer, as required under RSA 420-E:4, II.

XI. Procedures for registration.

XII. Additional standards for licensure of medical utilization review entities under RSA 420-E:3, II.


Source. 1992, 142:2. 1993, 249:4. 2001, 207:8, 9. 2012, 171:24, eff. Aug. 10, 2012.

    420-E:8 Enforcement;  Administrative Fine;  Hearings. 

I. The commissioner may take appropriate action against a licensee which fails to meet the standards under this chapter or any rules adopted by the commissioner, or who fails to respond in a timely manner to corrective actions ordered by the commissioner. The commissioner may impose an administrative fine not to exceed $1,000 for each violation or may deny, suspend or revoke the license.

II. Before taking the actions authorized by this section to deny, suspend or revoke the license, the commissioner shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing under RSA 541-A. Rehearings and appeals shall be conducted in accordance with RSA 541.


Source. 1992, 142:2, eff. July 5, 1992.

    420-E:9 Rulings on Appropriateness of Medical Judgments Not Authorized. 

Nothing in this chapter requires or authorizes the commissioner to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents.


Source. 1992, 142:2, eff. July 5, 1992.

    420-F:1 Definitions;  Scope of Chapter. 

I. In this chapter:

(a) "Commissioner" means the New Hampshire insurance commissioner.

(b) "Contract holder" means any individual, proprietorship, partnership, corporation, association, union or other organization which contracts or may contract for dental care for oneself, employees, members, and their dependents.

(c) "Delta" means Delta Dental Plan of New Hampshire, Inc., formerly known as New Hampshire Dental Service Corporation.

(d) "Dental care" means dental services ordinarily provided by licensed dentists in accordance with accepted standards of the dental practice of the community at the time the service is rendered.

(e) "Participating dentist" means a provider who has entered into a contract with Delta to provide dental care.

(f) "Provider" means any person duly authorized and licensed to practice dentistry under the laws of the state in which the dental care is provided.

(g) "Public member" means a member of the general public who may or may not be eligible for benefits under a Delta service plan, who shall not be in a position to make the dental plan purchasing decision for a group or be associated with the dental profession. Family members of persons in a position to make group dental plan purchasing decisions and family members of persons associated with the dental profession may not serve as public members.

(gg) "Purchaser member" means an employer, association, union, or other entity which is a current Delta group contract holder.

(h) "Subscriber" means an individual entitled to receive dental care pursuant to a written agreement between Delta and a contract holder.

II. In accordance with 1961, 345, Delta was incorporated as New Hampshire Dental Service Corporation on July 26, 1966, and has operated since the date of its incorporation, as a voluntary corporation under RSA 292. Delta received recognition from the Internal Revenue Service as a section 501(c)(4) tax-exempt organization on February 21, 1973, and has operated as a tax-exempt organization since that date. The articles of agreement, by-laws and all contracts between Delta and its participating dentists and contract holders in effect on or before January 1, 1993, shall survive and be in full force and effect, except as modified by this chapter. Delta's principal place of business shall be in Concord, New Hampshire.

III. Delta shall be governed by this chapter and shall be exempt from this title, except for the provisions of RSA 400-A:16, RSA 400-A:37, RSA 400-A:39, RSA 402-C, RSA 404-F, RSA 415:18, XVI, relative to continuation of coverage, RSA 420-G:11, II, II-a and III, and 1961, 345; provided, however, if any of the provisions of 1961, 345 are inconsistent with this chapter the provisions of this chapter shall prevail. Delta and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

IV. Every organization doing business pursuant to this chapter shall be subject to the premium tax requirements of RSA 400-A:31 and RSA 400-A: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 dental benefit coverages from political subdivisions of the state of New Hampshire or from employees or retirees of such political subdivisions, either directly or indirectly. Nor shall any tax be levied on any revenues of such an organization that are derived from any business of the organization where the organization has assumed no insurance risk and is providing administrative services, only.


Source. 1992, 252:1. 1995, 256:4. 1997, 54:2. 1998, 85:2; 180:1, 2. 2000, 207:8. 2007, 289:37. 2010, 91:1, eff. July 24, 2010. 2018, 36:3, eff. May 15, 2018.

    420-F:10 Contingency Reserve Fund. 

Delta shall collect reasonable rates as described in RSA 420-F:6, designed to permit it to accumulate and maintain a contingency reserve fund which shall not be less than 8 percent of Delta's annual premium risk income.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:11 Examination. 

I. The commissioner shall make an examination of Delta as often as he or she deems it necessary, but not less frequently than once in every 5 years. All examinations shall be conducted at the expense of Delta.

II. Delta shall submit its books and records relating to its operations to such examinations and in every way facilitate them. For the purpose of examinations, the commissioner may issue subpoenas, administer oaths to, and examine the officers and agents of Delta.


Source. 1992, 252:1, eff. Jan. 1, 1993. 2018, 36:4, eff. May 15, 2018.

    420-F:12 Appeals. 

All orders and decisions of the commissioner concerning matters within his jurisdiction under this chapter shall be subject to rehearing and appeal as provided in RSA 541. RSA 541:18 and 19 shall apply to orders and decisions of the insurance commissioner affecting the rates of Delta.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:13 Administrative Services. 

Delta may contract to furnish administrative, marketing, and managerial services to any health related organization, agency, entity or plan.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:14 Nonliability of Corporation. 

Delta, its officers or employees, shall not be liable for injuries resulting from negligence, malfeasance, nonfeasance or malpractice on the part of any provider in the course of rendering any dental care.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:15 Not-for-Profit-Status. 

Delta is not organized and shall not be maintained or operated for private profit or benefit. The income or property of Delta from whatever source derived shall be applied solely toward the promotion of the purposes of Delta and no portion of such income or property shall be transferred to or inure to the profit or benefit of any provider, officer, director or employee of Delta or any individual, provided that nothing in this section shall prevent the payment in good faith of reasonable remuneration to any officer, director or employee of Delta, or to any other person, or to any participating dentist who has entered into contracts with Delta to furnish dental care, for any services rendered to Delta or to individuals pursuant to contracts with Delta for dental care.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:16 Relationship of Provider and Patient. 

Nothing in this chapter shall be deemed to alter the relationship of provider and patient. Delta shall not in any way influence the subscriber in the free choice of provider. Nothing in this chapter shall be deemed to abridge the right of any provider to decline patients in accordance with lawful standards and practices of such provider.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:17 Rulemaking Authority. 

The commissioner may adopt rules in accordance with RSA 541-A, which are reasonable and necessary to administer and enforce the provisions of this chapter.


Source. 1992, 252:1. 2002, 207:49, eff. July 15, 2002.

    420-F:18 Prohibited Practices. 

RSA 417 shall be construed to apply to Delta and the contracts which Delta issues, except to the extent that the commissioner determines that the nature of Delta, and the contracts which Delta issues, renders such provisions inappropriate.


Source. 1992, 252:1. 1997, 190:16, eff. Jan. 1, 1998.

    420-F:2-a Bylaws. 

Any bylaw developed by the board of directors or developed by the members shall require approval of both 
2/3 of the members of the board and a simple majority of all the members of Delta.


Source. 1998, 180:4, eff. July 1, 1998.

    420-F:2 Directors. 

I. The board of directors who shall manage the business and affairs of Delta shall be composed of 7 participating dentists, 4 public members, and 4 purchaser members.

II. A nominating committee composed of 2 participating dentists, one member of the general public, and 2 purchasers, none of whom are members of the board, selected by a majority vote of the entire board, shall develop recommendations for board nominees, as board vacancies occur, which nominees shall be approved to serve on the board by a majority vote of the entire board. The nominating committee may use an outside consultant in selecting new board members as vacancies occur.


Source. 1992, 252:1. 1998, 180:3, eff. July 1, 1998.

    420-F:3 Agent License. 

I. No person, for himself or in behalf of any person, shall sell or offer to sell any Delta benefit plan, as is provided for in this chapter, without being licensed by the commissioner pursuant to the provisions of RSA 402-J.

II. Upon written notice by Delta of its appointment of a person to act as its agent, the commissioner shall issue, if he is first satisfied that the appointee is a suitable person and intends to hold himself out in good faith as an agent and upon payment of the proper fee by the applicant, to the appointee a license to act as such agent.

III. A license previously issued may be renewed upon the application of Delta upon payment of the proper fee.

IV. The commissioner, at any time after granting such license, for cause shown and after notice and hearing, may determine such licensee to be unsuitable to act as such agent, and shall thereupon revoke such license and notify both Delta and the agent of such revocation.

V. Unless revoked by the commissioner, or unless Delta by written notice to the commissioner cancels the agent's authority to act for it, such license issued to an agent, or any renewal thereof, shall expire on June 14 of the second year after its issue.

VI. If a person acts or aids in any manner in the negotiation of Delta contracts, or solicits or receives any application for such contracts, without a license from the commissioner, or if the license granted to him or her or Delta for whom he or she acts as agent has been revoked, he or she shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person; but any contract issued on an application thus procured shall bind Delta if otherwise valid. This paragraph shall not apply to any clerical employee of Delta, or to any persons rendering their services without compensation.


Source. 1992, 252:1. 2000, 315:24. 2005, 206:9, eff. Jan. 1, 2006.

    420-F:4 Filing and Approval of Contracts. 

Delta shall not revise or modify any contract or issue a new contract to a contract holder until it shall have filed with the commissioner a copy of the form of such amendment, modification or contract, including all riders and endorsements, and until the commissioner's approval shall have been obtained. Any form of amendment, modification or contract not disapproved by the commissioner within 90 days after the filing, shall be deemed to have been approved as filed.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:5-a Dependent Coverage. 

I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

II. Nothing in this section shall be construed to require:

(a) Coverage for services provided to a dependent before the effective date of this section; or

(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.

III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.

IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:

(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or

(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).

VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days following the effective date of this section.

(b) Such notice shall include information regarding the required special open enrollment period.


Source. 2007, 352:5. 2009, 235:14. 2010, 243:12, eff. Sept. 23, 2010.

    420-F:5 Contracts With Contract Holders. 

Every contract between Delta and a contract holder shall be in writing, a copy of which shall be furnished to the contract holder and shall contain the following provisions:

I. A statement of the amount payable to Delta by the contract holder and the manner in which such amount is payable.

II. A statement of the nature and extent of the benefits to be provided, and if any benefits are to be limited or excepted, an enumeration of such limitations or exceptions shall be printed with the same prominence as the statement of benefits conferred.

III. A statement of the terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party.

IV. A statement that the contract includes endorsements and attached papers, if any, and that it comprises the entire contract.

V. A provision that no statement by the contract holder in its application for a contract shall void the contract or be used in any legal proceeding on the contract unless an exact copy of the application is included or attached to the contract.

VI. A statement of the grace period which will be allowed the contract holder for making any payment due under the contract. Such period shall be not less than 10 days.

VII. If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this paragraph. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this paragraph. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this paragraph commences.


Source. 1992, 252:1. 2007, 289:20, eff. Jan. 1, 2008.

    420-F:6 Rates and Contracts to be Approved. 

Delta shall file with the insurance commissioner a full schedule of the rates to be paid by contract holders and shall obtain the commissioner's approval prior to implementing any rate changes. The commissioner may refuse such approval if he finds the rates are excessive, inadequate, or discriminatory.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:7 Cancellation or Nonrenewal. 

I. No contract with a contract holder authorized under this chapter shall be cancelled by Delta, except for nonpayment of premium, unless the contract holder receives a notice of cancellation in accordance with this section. Notice of cancellation for breach of the contract by the contract holder shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 10 days prior to the effective date of the cancellation. Notice of cancellation for lack of participation shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta, at least 30 days prior to the effective date of the cancellation.

II. No contract with a contract holder authorized under this chapter shall be nonrenewed by Delta, except for nonpayment of premium, unless the contract holder receives either a notice of nonrenewal or an offer of renewal in accordance with this section. The notice of nonrenewal or offer of renewal shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 30 days prior to the renewal date of the contract.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:8 Investments. 

Delta shall invest its funds as provided for in RSA 411-A.


Source. 1992, 252:1, eff. Jan. 1, 1993.

    420-F:9 Financial Report and Examination. 

I. Delta shall file with the commissioner, on March 1, a report verified by an appropriate official of Delta, showing its financial condition on the last day of the preceding fiscal year.

II. Such report shall include:

(a) Delta's financial statements, including its balance sheet and statement of income and expenditures for the preceding year, certified by an independent public accountant;

(b) Such other financial information relating to Delta's performance as the commissioner may require.


Source. 1992, 252:1. 2001, 224:9, eff. Jan. 1, 2002.

    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 competition among health carriers on the basis of efficient claims handling, ability to manage health care services, consumer satisfaction, and low administrative costs.

III. To regulate underwriting and rating practices in the small employer and individual markets so as to promote access to affordable coverage for higher risk groups or individuals.


Source. 1997, 344:1. 1998, 340:7. 2001, 295:1, eff. July 1, 2002.

    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 information or documents as the commissioner shall adopt by rule as necessary to perform oversight function.

III. [Repealed.]

IV. [Repealed.]

V. The commissioner shall adopt such rules, under RSA 541-A, and issue such orders as may be necessary to carry out the commissioner's oversight responsibilities under this section.


Source. 2000, 2:2. 2010, 346:3, II, eff. July 20, 2010.

    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 be utilized without the express written consent of the association.

(b) Offer all eligible members, as defined under the applicable trust or other documents, coverage and rates on a guaranteed issue and renewable basis.

(c) Comply with the regulations concerning medical underwriting in RSA 420-G:5.

(d) Comply with the preexisting conditions provision of RSA 420-G:7.

II. Nothing in this chapter shall be interpreted to limit the size of employers who may participate in coverage with a qualified association trust.


Source. 1997, 344:1. 2003, 188:8. 2010, 346:10, eff. July 20, 2010. 2019, 346:413, eff. Dec. 1, 2021.

    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 each in the security of transferred health care data. The memorandum of understanding shall include a description of the data sets that will be included in the comprehensive health care information system, the criteria and procedures for the development of limited use data sets, the criteria and procedures to ensure that Health Insurance Portability and Accountability Act of 1996 (HIPAA)
 compliant limited use data sets are accessible, and a proposed time frame for the creation of a comprehensive health care information system. To the extent allowed by HIPAA, the data shall be available as a resource for insurers, employers, providers, purchasers of health care, and state agencies to continuously review health care utilization, expenditures, and performance in New Hampshire and to enhance the ability of New Hampshire consumers and employers to make informed and cost-effective health care choices. In presenting data for public access, comparative considerations shall be made regarding geography, demographics, general economic factors, and institutional size. Notwithstanding HIPAA or any other provision of law, the comprehensive health care information system shall not include or disclose any data that contains direct personal identifiers. For the purposes of this section, "
direct personal identifiers
" include information relating to an individual that contains primary or obvious identifiers.

II. The commissioner of the department of health and human services, with the approval of the commissioner of the insurance department, shall adopt rules, under RSA 541-A, as may be necessary to provide for the release of claims data from the comprehensive health care information system (CHIS).

III. The department shall make available to the public a public use data set for purposes of facilitating transparency in health care costs.


Source. 2003, 292:6. 2005, 248:19. 2015, 210:1, eff. Sept. 4, 2015. 2019, 233:6, eff. July 12, 2019.

    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 rates and practices are in full compliance with this chapter.

(b) The provisions concerning the health carrier's right to change premium rates and the factors which affect changes in premium rates.

(c) The provisions relating to renewability of health coverage.

(d) The provisions relating to any preexisting condition exclusions.

(e) The benefits and premiums available under all health insurance coverage for which the employer is qualified.

II. (a) All health carriers, licensed third party administrators, and any entity required to be registered with the commissioner pursuant to RSA 402-H, shall electronically provide:

(1) Their encrypted claims data to the department and to the department of health and human services in accordance with rules approved by the commissioner of health and humans services and adopted under RSA 420-G:14.

(2) To the department of health and human services, cross-matched claims data on requested policyholders, and subscriber information necessary for third party liability for benefits provided under RSA 167, filed in accordance with rules adopted under RSA 167:3-c.

(b) Notwithstanding RSA 91-A:10, the collection storage and release of health care data and statistical information that is subject to the federal requirements of the Health Information Privacy and Accountability Act (HIPAA)
 shall be governed exclusively by the rules adopted thereunder in 45 CFR Parts 160 and 164.

II-a. All health carriers and other health plans that collect the Health Employer Data and Information Set (HEDIS) shall annually submit the HEDIS information to the department.

III. All health carriers shall accept electronic claims submitted in Centers for Medicare and Medicaid Services (CMS) format for UB-92 or HCFA-1500 records, or as amended by CMS.

IV. The data submission requirements of paragraphs II and II-a shall apply with respect to claims data for all lives covered by a fully-insured health plan in any market in the state, by any self-funded plan for state or municipal employees, including any plan maintained under RSA 5-B, to any self-funded plan maintained by the university system of the state with respect to its employees or its students, and to any self-funded student health benefit plan maintained by an institution of higher education which provides 4-year bachelor's degree programs and graduate or professional degree programs.

V. In addition to those lives listed in paragraph IV, the data submission requirements of paragraphs II and II-a shall also apply to all health carriers, licensed third party administrators, and any entity required to be registered with the commissioner pursuant to RSA 402-H with respect to claims data for all lives covered by any other self-funded employer-sponsored plan, when the employer has opted in writing to the submission of the data. The carrier or administrator shall notify the employer of the employer's option to authorize submission of the data. The commissioner shall adopt rules under RSA 541-A specifying the form of such opt in, which shall include, but not be limited to, notice to the employer regarding why it is receiving the notification form, the privacy protections for the data submitted should the employer choose to opt in, and the transparency benefits, including benefits to employers, of broad inclusion of as many lives as possible in the database created under RSA 420-G:11-a. Nothing in this paragraph shall be construed to impose any reporting obligation on any self-funded employer or plan sponsor, or to impose any requirement with respect to the manner in which any such self-funded plan is administered. Nothing in this paragraph shall prevent a health carrier or third party administrator from communicating its views to an employer about the employer's decision whether to opt in to the submission of claims data.


Source. 1997, 344:1. 1999, 318:4. 2003, 145:3, 4; 292:3, 4, 7. 2006, 271:13, eff. Aug. 8, 2006. 2016, 250:2, eff. June 10, 2016.

    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 right in any manner.

II. Upon written request from any large employer, every health carrier, third-party administrator, pooled risk management program under RSA 5-B or any other type of multiple employer health plan shall provide that employer's loss information within 30 calendar days of receipt of the request. The loss information shall include all physician, hospital, prescription drug, and other covered medical claims specific to the employer's group plan incurred for the 12-month period paid through the 14 months which end within the 60-day period prior to the date of the request. An employer shall not be entitled by this section to more than 2 loss information requests in any 12-month period; however, nothing shall prohibit a carrier from fulfilling more frequent requests on a mutually agreed-upon basis.

III. If an employer requests loss information from an insurance agent or other authorized representative, including an administrator of a pooled risk management program or a multiple employer health plan, the agent or authorized representative shall transmit the request to the health carrier or carriers or third-party administrator within 4 working days.


Source. 2001, 120:2. 2003, 127:1; 188:9. 2004, 187:14, eff. July 31, 2004.

    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 with sound actuarial principles.

II. Each health carrier shall file each March 1, with the commissioner, an actuarial certification stating that the health carrier is in compliance with this section and that the rating methods of the health carrier are actuarially sound.

III. A health carrier shall make the information and documentation described in paragraph I available to the commissioner upon request.

IV. Each health carrier shall provide, at the time it gives a premium quote to a group, a rating disclosure form that identifies the health coverage plan rate and any adjustments to that rate resulting from the application of rating factors, including age, industry, and group size. The health carrier shall submit the rate disclosure form to the department for approval. Health carriers shall provide their insureds with renewal premium quotes at least 60 days prior to the expiration date of the policy.


Source. 1997, 344:1. 2006, 125:2, eff. July 14, 2006.

    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 or disapprove such rates within 30 days of receipt. The commissioner may disapprove rate filings if the commissioner finds such rates to be excessive, inadequate, or contrary to the intent of this chapter.


Source. 1997, 344:1, eff. July 1, 1997.

    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 in terms of scope and timeframe, and to limit this request to information the commissioner deems necessary to better understand the dynamics of the nongroup health insurance market and to assess the appropriateness of alternative sources of funding for the nongroup subsidy.

II. The commissioner shall request and health carriers shall supply information and data no later than June 30 of each year sufficient to report on the small employer health insurance market. Such information shall be reported for the market as a whole and by market segment. At the commissioner's discretion, such information may include, but not be limited to, information relating to premium rates and rating practices, the number of groups and individuals insured, availability of coverage and benefit plans, trend, loss ratios, administration costs, and profitability. The commissioner shall file a report of the information by December 31 of each year with the president of the senate, the speaker of the house of representatives, the chairperson of the house commerce committee, and the chairperson of the senate banks and insurance committee.

III. The commissioner shall request and health carriers shall supply information no later than June 30 of each year sufficient to report on the types of health coverage being purchased by individuals and employers by geographic area. The report shall include specific details regarding the type of coverage, including, but not limited to, co-pays, out-of-pocket maximums, network restrictions, and deductibles.

IV. The commissioner shall file the required reports by December 31 of each year with the senate president, the speaker of the house, and the chairpersons of the house and senate committees having jurisdiction over commerce issues.

V. The commissioner shall hold an annual public hearing concerning premium rates in the health insurance market and the factors, including health care costs and cost trends, that have contributed to rate increases during the prior year. The commissioner shall evaluate claims costs, administrative loads, and health carrier profits. The commissioner shall identify the factors that contribute to cost increases affecting health insurance premiums and health care services in New Hampshire. The commissioner shall identify variations in the price that health carriers pay for health care services and shall undertake further analysis to determine the cause of the observed price variations by utilizing the uniform hospital discharge data set, as described under RSA 126:25, the comprehensive health care information system as described in RSA 420-G:11-a, and other data sources as appropriate. In advance of holding the public hearing, the commissioner may require any health insurer or third party administrator to produce documents and information deemed necessary and relevant to evaluate the factors that contribute to cost growth in health care services, increased utilization of health care, and health insurance premium costs. The commissioner shall keep confidential all nonpublic documents and shall not disclose those documents without the consent of the health care provider or health care payer that produced the information or documents. The commissioner may compel a health insurance carrier or third party administrator to testify at the annual public hearing. The commissioner may also invite representatives of health care providers to provide relevant information.

VI. (a) The commissioner shall prepare an annual report concerning premium rates in the health insurance market and the factors that have contributed to rate variations during prior years. The annual report shall be designed to provide information which identifies and quantifies health care spending trends and the underlying factors that contributed to variations in health insurance premiums. The report may include, as appropriate, analysis of public policy options for increasing the efficiency of New Hampshire's health care financing and delivery system and controlling health care costs and premium variations. The report shall be based to the highest extent possible on the commissioner's analysis of information and data available to the commissioner, including the testimony at the public hearing, and any other information or documents submitted in connection with the public hearing.

(b) The commissioner shall submit the annual report to the governor, the president of the senate, and the speaker of the house of representatives on or before December 31 of each year.

VII. In conjunction with the annual public hearing required under paragraph V and the report required under paragraph VI, the commissioner shall consider any pertinent work of other legislative commissions and inquires focused on related matters.


Source. 1998, 340:16. 2003, 188:10. 2006, 125:3. 2007, 289:24. 2010, 240:1. 2014, 254:2, eff. July 22, 2014. 2019, 7:1, eff. July 9, 2019.

    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: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 enrollment period does not coincide with the open enrollment period in the individual market.

(3) Essential health benefits, in accordance with RSA 420-G:4-d, II and III.

(b) The commissioner may adopt further rules, pursuant to RSA 541-A, necessary to the proper administration of this chapter.

II. The commissioner, with the approval of the commissioner of the department of health and human services, shall adopt rules, under RSA 541-A, defining the content, format, and schedule for the filing of encrypted claims data and HEDIS information under RSA 420-G:11.


Source. 1997, 344:1. 2002, 207:50. 2003, 292:5, eff. July 18, 2003. 2019, 220:11, eff. Sept. 10, 2019.

    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 severable.


Source. 1997, 344:1, eff. July 1, 1997.

    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 or small employer market if the commissioner finds a health carrier to be in violation of RSA 420-G.

II. Be subject to an administrative fine not to exceed $2,500 for each violation. Repeated violations of the same chapter shall constitute separate fineable offenses.

III. Have its certificate of authority indefinitely suspended or revoked at the discretion of the commissioner.


Source. 1997, 344:1, eff. July 1, 1997.

    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 person's examination, including a review of the appropriate records and of the actuarial assumptions and methods used by the small employer health carrier in establishing premium rates for applicable health benefit plans.

I-a. "
Case characteristics
" means demographic or other relevant characteristics of a small employer group that may be considered by the health carrier in the determination of premium rates for that group.

II. "Commissioner" means the commissioner of insurance.

II-a. "
Composite billing
" means a method of calculating premium rates for small employer groups in which each enrolled employee's rate varies only by the enrolled employee's family composition.

III. "Creditable coverage" means any public or private health insurance or health benefit plan, whether insured or self-insured, unless that coverage consists solely of benefits excluded from the definitions of "health coverage" in paragraph IX or "individual health coverage" in paragraph XI. Notwithstanding the exclusion in paragraph IX, short-term, nonrenewable individual policies for medical, hospital, or major medical coverage issued pursuant to RSA 415:5, III or other law shall be considered "creditable coverage."

III-a. "
Date of enrollment
" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

IV. "Department" means the department of insurance.

V. "Eligible dependents" means those persons who may be included under a covered person's health coverage by the terms of the policy or plan and in accordance with this chapter.

VI. "Eligible employee" means an employee who meets the requirements for eligibility set forth by the employer, the health coverage plan and state law.

VI-a. "
Employee
" means "
employee
" as defined in the Employee Retirement Income Security Act of 1974, 29 U.S.C. section 1002(6).

VI-b. "
Essential health benefits
" means the categories of coverage identified in 42 U.S.C. section 18022(b)(1) and as further defined and implemented by the Secretary of the Department of Health and Human Services from time to time.

VII. "Exclusion period" means the length of time that must expire before a health carrier will cover medical treatment expense relating to a preexisting condition.

VII-a. "
Family composition
" means health plan membership type, including: enrollee only; enrollee and spouse; enrollee and children; enrollee, spouse, and children; and other similar membership types.

VIII. "Health carrier" means any entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to provide, deliver, arrange for, pay for or reimburse any of the costs of health services; including an insurance company, a health maintenance organization, a nonprofit health services corporation, or any other entity providing health coverage.

IX. "Health coverage" means any hospital or medical expense incurred policy or certificate, nonprofit health services corporation subscriber contract, or health maintenance organization subscriber contract and any other health insurance plan or health benefit plan. For the purposes of this chapter, health coverage does not include:

(a) Accident-only or disability income insurance.

(b) Coverage issued as a supplement to liability insurance.

(c) Liability insurance, including general liability insurance and automobile liability insurance.

(d) Workers' compensation or similar insurance.

(e) Automobile medical-payment insurance.

(f) Credit only insurance.

(g) Coverage for on-site medical clinics.

(h) Short-term, individual, nonrenewable medical, hospital, or major medical policies.

(i) Other similar insurance coverage, specified in rules, under which benefits for medical care are secondary or incidental to other insurance benefits.

(j) If offered separately:

(1) Limited scope dental or vision benefits.

(2) Long-term care, nursing home care, home health care, community-based care, or any combination thereof.

(3) Prescription drug benefits.

(4) Other similar, limited benefits as are specified in rules.

(k) If offered as independent, noncoordinated benefits:

(1) Specified disease or illness benefits.

(2) Hospital or surgical indemnity benefits.

(l) If offered as a separate insurance policy, Medicare supplemental health insurance, coverage supplemental to the coverage provided under chapter 55 of Title 10, United States Code, and similar supplemental coverage as specified in regulations.

IX-a. "
Health coverage plan rate
" means a rate that is uniquely determined for each of the coverages or health benefit plans a health carrier writes and that is derived from the market rate through the application of plan factors that reflect actuarially demonstrated differences in expected utilization and health care costs attributable to differences in the coverage design and/or the provider contracts that support the coverage and by including provisions for administrative costs and loads. The health coverage plan rate is periodically adjusted to reflect expected changes in the market rate, utilization, health care costs, administrative costs, and loads.

X. "Individual" means a person who is not eligible for health coverage through employment and that person's dependents.

XI. "Individual health coverage" means health coverage issued by a health carrier directly to an individual and not on a group or group remittance basis. For the purposes of this chapter, franchise insurance, as defined in RSA 415:19, shall be considered individual health coverage.

XII. (a) "
Large employer
" means an employer that employed on average at least 51 persons, on business days, during the previous calendar year.

(b) In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is a small or large employer shall be based on the average number of employees that it is reasonably expected such employer will employ on business days in the current calendar year.

XII-a. "
List billing
" means a method of calculating premium rates for small employer groups in which each enrolled employee's rate varies only by the enrolled employee's attained age and the enrolled employee's family composition.

XII-aa. "
Loss information
" means the aggregate claims experience and shall include, but not be limited to, the number of covered lives, the amount of premium received, the amount of total claims paid, and the claims loss ratio. "Loss information" shall not include any information or data pertaining to the medical diagnosis, treatment, or health status that identifies an individual covered under the group contract or policy. Catastrophic claim information shall be provided as long as the provision of this information would not compromise any covered individual's privacy.

XII-b. "
Loss ratio
" means the ratio between the amount of premium received and the amount of claims paid by the health carrier under the group insurance contract or policy.

XII-c. "
Market rate
" means a single rate reflecting the carrier's average cost of actual or anticipated claims for all health coverages or health benefit plans the carrier writes and maintains in a market, including the nongroup individual health insurance market and, separately, the small employer group health insurance market, and which is periodically adjusted by the carrier to reflect changes in actual or anticipated claims.

XIII. "Medical underwriting" means the use of health status related information to establish or modify health coverage premium rates.

XIII-a. "Modified experience rating" means a rating methodology to apply only to individual policies sold in the nongroup market, which modifies community rating to allow for limited consideration of health status, as detailed in RSA 420-G:4, I(a).

XIV. "
Preexisting condition
" means a condition, whether physical or mental, for which medical advice, diagnosis, care or treatment was recommended or received during the 3 months immediately preceding the enrollment date of health coverage.

XIV-a. [Repealed.]

XIV-b. "
Premium rate
" means the rates used by a carrier to calculate the premium. For group coverage, premium rates shall be expressed as a rate per enrolled employee.

XV. "
Qualified association trust or other entity
" means an association established trust or other entity in existence on January 1, 1995, and providing health coverage within the state of New Hampshire to at least 250 employees and/or the dependents of association members, which association:

(a) Was established and maintained for a primary purpose other than the provision of health coverage;

(b) Was in existence for at least 10 years prior to January 1, 1995; and

(c) Conducts regular meetings within the state of New Hampshire designed to further the interests of its members, and all members shall be given notice of such meetings at least 30 days prior to the date of any meeting.

XV-a. "
Rating period
" means the time period for which the premium rate charged by a health carrier to an individual or a small employer for a health benefit plan is in effect.

XVI. (a) "
Small employer
" means a business or organization which employed on average, one and up to 50 employees on business days during the previous calendar year. A small employer is subject to this chapter whether or not it becomes part of an association, multi-employer plan, trust, or any other entity cited in RSA 420-G:3 provided it meets this definition. However, with respect to coverage written under RSA 415-E to a bona fide pathway II association, whether self funded or fully insured, if such association has at least 250 New Hampshire covered lives and meets all applicable standards under RSA 415-E and all large group standards under this chapter, coverage offered by such association may be offered to sole proprietors or self-employed persons.

(b) In the case of an employer which was not in existence throughout the preceding calendar year, the determination of whether such employer is a small or large employer shall be based on the average number of employees that it is reasonably expected such employer will employ on business days in the current calendar year.

XVII. "Waiting period" means a period of time, determined by the employer, which must expire before an employee is eligible for health coverage as a condition of employment.


Source. 1997, 344:1. 1998, 340:8; 375:1. 2000, 2:1. 2001, 120:1. 2003, 188:1-4. 2005, 225:1-8; 248:14. 2007, 289:21, 22. 2010, 346:3, I, eff. July 20, 2010. 2019, 220:1, 2, eff. Sept. 10, 2019; 346:409, 412, eff. Dec. 1, 2021.

    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 administrator, claims paying agent or any other entity whether fully insured, partially insured, or self-funded which offers or provides health coverage for delivery in this state.

(a) This chapter shall not apply to pooled risk management programs which meet the standards established by RSA 5-B.

(b) This chapter shall not apply to student major medical expense coverage, except student major medical expense coverage shall be given credit and shall count as credit for previous health coverage as defined in RSA 420-G:7.

(c) Notwithstanding any other provision of this chapter, any multiple employer welfare arrangement which meets the requirements of RSA 415-E:2, III shall be exempt from the provisions of this chapter until January 1, 1998.

II. A qualified association trust or other entity, as defined by RSA 420-G:2, XV, shall comply with the requirements stated in RSA 420-G:10.

III. Notwithstanding any law to the contrary, the provisions of this chapter shall prevail with respect to the subject matter within this chapter.


Source. 1997, 344:1; 344:11. 2002, 207:10. 2010, 188:12, eff. Aug. 20, 2010. 2019, 220:13, eff. Sept. 10, 2019.

    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 of 26 U.S.C. section 125 and RSA 275:43-c.

II. [Repealed.]


Source. 2010, 204:2, eff. Aug. 21, 2010. 2019, 220:14, eff. Sept. 10, 2019.

    420-G:4-d Essential Health Benefits. 

I. All health coverage offered by health carriers to individuals or small employers shall include coverage for essential health benefits and provide essential health benefits in a plan substantially equivalent to New Hampshire's essential health benefit benchmark plan in effect for the plan year 2019.

II. If the federal government ceases to define essential health benefits, the commissioner shall define essential health benefits for New Hampshire by rulemaking pursuant to RSA 541-A. The New Hampshire essential health benefits shall include at least the following general categories and the items and services covered within the categories:

(a) Ambulatory patient services.

(b) Emergency services.

(c) Hospitalization.

(d) Maternity and newborn care.

(e) Mental health and substance use disorder services, including behavioral health treatment.

(f) Prescription drugs.

(g) Rehabilitative and habilitative services and devices.

(h) Laboratory services.

(i) Preventive and wellness services and chronic disease management.

(j) Pediatric services, including oral and vision care; provided, that health coverage that does not specifically include such pediatric services shall be deemed to have offered the essential health benefit under this subparagraph if the health carrier has obtained reasonable assurance that such pediatric services are provided to the purchaser of the health coverage.

III. In defining the essential health benefits under paragraph II, the commissioner shall:

(a) Ensure that such essential health benefit reflects an appropriate balance among the categories described in such subparagraph, so that benefits are not unduly weighted toward any category;

(b) Not define essential health benefits in a manner which would allow carriers to make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life;

(c) Consider the health care needs of diverse segments of the population, including women, children, persons with disabilities, and other groups;

(d) Ensure that health benefits established as essential are not subject to denial to individuals against their wishes on the basis of the individuals' age or expected length of life or of the individuals' present or predicted disability, degree of medical dependency, or quality of life;

(e) Ensure that a health plan shall not be treated as providing coverage for the essential health benefits unless the plan provides that:

(1) Coverage for emergency department services shall be provided without imposing any requirement under the plan for prior authorization of services or any limitation on coverage where the provider of services does not have a contractual relationship with the plan for the provision of services which is more restrictive than the requirements or limitations that apply to emergency department services received from providers who do have such a contractual relationship with the plan; and

(2) If such services are provided out-of-network, the cost-sharing requirement, such as a copayment amount or coinsurance rate is the same requirement which would apply if such services were provided in-network; and

(f) Ensure that the New Hampshire essential benefits are at least actuarially equivalent to the essential health benefits previously established by the federal government.

(g) Ensure essential health benefits are provided in a plan substantially equivalent to New Hampshire's essential health benefit benchmark plan in effect for plan year 2019.


Source. 2019, 220:4, eff. Sept. 10, 2019.

    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 a change in the group's case characteristics.

(b) Market rate shall be established by each health carrier for all of its health coverages offered to individuals and, separately, for all of its health coverages offered to small employers.

(c) Health carriers shall calculate health coverage plan rates for each of the coverages or health benefit plans written by that carrier. Variations in health coverage plan rates shall be solely attributable to variations in expected utilization or cost due to differences in coverage design and/or the provider contracts or other provider costs associated with specific coverages and shall not reflect differences due to the nature of the groups or eligible persons assumed to select particular health coverages.

(d)(1) In establishing the premium charged, health carriers providing coverage to individuals and small employers shall vary the premium rate with respect to the particular plan or coverage involved only by:

(A) Whether the plan or coverage covers an individual or family;

(B) Geographic rating area, except that the state shall constitute a single geographic rating area;

(C) Age, except that the maximum premium differential for age as determined by ratio shall be 3 to 1 for adults; and

(D) Tobacco use, except that the maximum differential rate due to tobacco use shall be 1.5 to 1.

(2) With respect to family coverage under an individual or small group health insurance policy, the rating variations permitted under subparagraphs (1)(A) and (D) shall be applied based on the portion of the premium that is attributable to each family member covered under the plan.

(3) Carriers shall adjust each health coverage plan or premium rate for age, based on the portion of the premium that is attributable to each family member covered under the plan or certificate, using the uniform age rating factors established by the commissioner pursuant to RSA 420-G:14, I(a)(2).

(e) [Repealed.]

(f) Each rating factor that a carrier chooses to utilize in the individual market shall be reflective of claim cost variations that correlate with that factor independently of claim cost variations that correlate with any of the other allowable factors.

(g) The same rating methodology shall apply to newly covered individuals and to individuals renewing at each annual renewal date, or to new small employers and small employers renewing at each annual renewal date or anniversary date. Rating methodology shall not be construed to include health carrier incentives to individual subscribers or members to participate in wellness and fitness programs provided such incentives are approved by the insurance department.

(h) The commissioner shall not approve any filing if such filing is excessive, inadequate, or contrary to the intent of this chapter.

II. (a) Health carriers providing health coverage to large employers may not require any person, as a condition of receiving health coverage or continued health coverage, to pay a premium or contribution that is greater than that of similarly situated persons based on any health status related factor of that person or that person's dependents.

(b) Nothing in subparagraph (a) shall be construed to restrict the amount that a health carrier may charge a large employer, nor to prevent a health carrier from establishing premium discounts or rebates or modifying copayments or deductibles in return for adherence to programs of health promotion and disease prevention.

III. [Repealed.]


Source. 1997, 344:1. 1998, 340:9, 10. 2001, 295:2; 296:1, 2. 2003, 188:5, 6, 15. 2005, 225:9, 10, 13, 15. 2013, 272:5, 6, eff. Jan. 1, 2014. 2019, 220:3, eff. Sept. 10, 2019.

    420-G:5 Medical Underwriting. 

I. Health carriers providing health coverage shall not perform medical underwriting, including the use of health statements or screenings or the use of prior claims history.

II. Regardless of claim experience, health status, or medical history, health carriers providing health coverage for individual or small employers shall not refuse to write or issue any of their available coverages or health benefit plans to any individual or small employer group that elects to be covered under that plan and agrees to make premium payments and meet the other requirements of the plan.

II-a. Health carriers shall not establish any annual or lifetime limits on the dollar value of essential health benefits for any individual, except annual or lifetime limits may be imposed on specific covered benefits that are not essential health benefits to the extent permitted under federal law as of January 1, 2019.

III. Health carriers providing health coverage for small employer groups shall not knowingly provide health coverage to groups where the employer has discriminated based on health status or claims history against any employee or potential employee or his or her dependents with respect to participation in an employer-sponsored health benefit plan.

IV. Health carriers shall not offer riders or endorsements to exclude certain illnesses or health conditions in order to avoid the purpose of this chapter.

V. Individual health insurance carriers shall be responsible for ascertaining the eligibility of any individual applicant or insured for high risk pool coverage. If a carrier determines that an individual meets any of the eligibility criteria set forth in RSA 404-G:5-e, the carrier shall give the individual written notice, with the declination of coverage, the coverage offering or upon a rate increase at renewal. The notice shall include information about available benefits and exclusions of high risk pool coverage and the name, address, and telephone number of the pool administrator or the administrator's designee.

VI. It shall constitute an unfair trade practice under RSA 417 for an insurer, insurance producer, or third party administrator to refer an individual employee to the pool, or arrange for an individual employee to apply to the pool, for the purpose of separating that employee from group health insurance coverage provided in connection with the employee's employment.

VII. Health carriers and health insurance producers shall ensure that persons seeking coverage through a small employer group who are required to complete a health statement have an option to convey the required information directly to the carrier or the producer through a secure means and bypassing the employer.

VIII. [Repealed.]


Source. 1997, 344:1. 1998, 340:11. 2001, 295:12. 2003, 188:7; 201:1, 2. 2004, 251:10, 11. 2005, 225:11. 2006, 125:1. 2009, 235:15. 2011, 189:7, eff. Aug. 13, 2011. 2019, 113:9, eff. Aug. 20, 2019; 220:5, eff. Sept. 10, 2019.

    420-G:6 Guaranteed Issue and Renewability. 

I. Health carriers shall not establish rules of eligibility, including continued eligibility, for health coverage in relation to the following health status related factors of any employee or dependent:

(a) Health status.

(b) Medical condition, including both physical and mental illness.

(c) Claims experience.

(d) Receipt of health care.

(e) Medical history.

(f) Genetic information.

(g) Evidence of insurability, including conditions arising out of domestic violence.

(h) Disability.

II. Paragraph I shall not be construed to require health carriers to provide particular benefits under the terms of such health coverage, or to prevent health carriers from limiting or restricting the amount, level, extent or nature of the benefits for similarly situated persons under the health coverage. Paragraph I shall also not be construed to require health carriers to issue health coverage to an individual with existing health coverage, except where the individual indicates an intent to replace the existing health coverage.

II-a. [Repealed.]

III. Health carriers shall actively market, issue, and renew all of the health coverages they sell in the individual and small employer market to all individuals and small employers in that market. Health carriers offering health coverage to small employers shall permit small employers to purchase health coverage at any point during the year, with the small employer's health coverage consisting of the 12-month period beginning with the small employer's effective date of coverage.

III-a. A health carrier shall not rescind health coverage issued to an individual or with respect to an individual covered under health coverage issued to a small or large employer, including a group to which the individual belongs or family coverage in which the individual is included, after the individual is covered under the plan, unless:

(a) The individual, or a person seeking coverage on behalf of the individual, performs an act, practice, or omission that constitutes fraud; or

(b) The individual makes an intentional misrepresentation of material fact, as prohibited by the terms of the plan or coverage.

III-b. For the purposes of subparagraph III-a(a), a person seeking coverage on behalf of an individual shall not include a producer, or an employee or authorized representative of the health carrier.

III-c. A health carrier in the individual, small group, or large group market shall provide individuals equal access to all health programs, coverage, or activities without discrimination on the basis of sex, sexual orientation, gender identity, race, creed, color, marital status, familial status, physical or mental disability, or national origin, as those terms are defined under RSA 354-A.

IV. [Repealed.]

V. Health coverages subject to this chapter shall be renewable to all individuals, regardless of age or eligibility for Medicare, or to employees and eligible dependents at the option of the small or large employer, except for the following reasons:

(a) Nonpayment of required premiums.

(b) Fraud or intentional misrepresentation on the part of an individual or an individual's representative, or on the part of an employer, employee, dependent, or an employee's representative.

(c) [Repealed.]

(d) Failure of an employer sponsoring group coverage to meet the minimum employee participation number or percentage requirement of the health coverage.

(e) The employer medically underwrites or otherwise violates a provision of this chapter.

(f) The health carrier is ceasing to offer health coverage in such market, in accordance with paragraph VII.

V-a. Health carriers shall not underwrite insureds at time of renewal.

VI. Where a health carrier decides to discontinue a particular type of health coverage offered in the individual, large employer or small employer market, the health carrier must:

(a) Provide at least 90-days notice of such discontinuation to each individual or employer with such health coverage and to all covered persons;

(b) Offer to each individual or employer with such health coverage, the option to purchase any other health coverage currently being offered by the health carrier in the relevant market;

(c) Act uniformly without regard to the claims experience of those employers, and without regard to any health status related factor of any covered person or any individual, employee, or eligible dependent who may become a covered person; and

(d) Make no adjustments in the health status factor applied to individuals moving from a discontinued product of that health carrier to another product of that health carrier if the individual was newly covered under the previous product within the last 5 years, or a health status factor adjustment was made with respect to that individual within the last 5 years.

VII. Where a health carrier decides to discontinue all of its health coverage in the individual market, small employer market, large employer market or any combination thereof, the health carrier must provide at least 180-days notice of such discontinuation to the commissioner, to each individual or employer with such health coverage and to all covered persons; and

(a) The health carrier may not renew any health coverages issued, or delivered for issuance, in such discontinued market or markets; and

(b) The health carrier may not provide health coverage in such discontinued market or markets during the 5-year period beginning on the date of the discontinuation of the last health coverage not so renewed except that the commissioner may waive or otherwise reduce the 5-year period in which the health carrier may not provide coverage in the discontinued market for good cause shown.

VIII. A health carrier may, at the time of coverage renewal, modify the health coverage it offers to:

(a) Large employers; and to

(b) Small employers and individuals, provided that such modification is in accordance with state law and applied uniformly among all small employers and/or individuals with such health coverage.

IX. A health carrier which has discontinued coverage in the individual market, the small employer market, or any combination thereof, in accordance with paragraph VII, shall continue to be liable for the payment of claims in accordance with the following:

(a) This section shall apply only to terminating carriers of insureds who obtain creditable replacement health coverage. This paragraph shall be effective with respect to all in-force policies, certificates, or other evidences of coverage as of the effective date of this paragraph.

(b) The terminating carrier shall continue to be liable for the payment of claims if the succeeding carrier's policy requires the satisfaction of any deductibles, individual or family stop-loss provisions limiting out-of-pocket payments, or waiting periods in its plan but only to the extent satisfaction or partial satisfaction of the same or similar provisions were included in the terminated plan providing similar benefits. In the case of deductible provisions and stop-loss provisions, the liability shall be for the same or overlapping benefit periods and shall be for expenses actually incurred and applied against the deductible and stop-loss provisions of the terminating carrier's plan but only to the extent those expenses are recognized under the terms of the succeeding carrier's plan and are subject to a similar stop-loss or deductible provision. The terminating company shall inform its insureds at the time of cancellation that this provision is applicable to them and that this is a requirement of New Hampshire statute. The provision should also appear in all policies or certificates where the provision about termination of the insurance company appears. Nothing in this subparagraph shall be deemed to prevent a succeeding carrier's plan from having stop-loss levels or deductible amounts that are higher than those specified in the terminating carrier's plan.

(c) Whenever a determination of the terminating carrier's benefits is required by the succeeding carrier, at the succeeding carrier's request the terminating carrier shall furnish, in a timely manner, but in no event later than 30 days, a statement of the benefits available or pertinent information, sufficient to permit verification of the terminating carrier's liability to the succeeding carrier. Any determination of the liability of the terminating plan shall be made in accordance with all the definitions, conditions, and covered expense provisions of the terminating plan rather than those of the succeeding plan. The benefit determination shall be made as if coverage had not been replaced by the succeeding carrier. The succeeding carrier shall notify the terminating carrier as to its liabilities pursuant to RSA 420-G:6, IX(b) and shall indemnify the insured for the same. Upon determination of any liability of the terminating plan, the terminating plan shall pay the succeeding plan in a timely manner, in no event later than 15 days, upon receipt of said claim information.


Source. 1997, 344:1. 1998, 158:1; 329:2; 340:12-14; 375:2-4. 2001, 295:3, 13. 2002, 1:1. 2005, 248:17. 2009, 235:16, eff. Sept. 14, 2009. 2019, 220:6, 7, eff. Sept. 10, 2019.

    420-G:7 Preexisting Condition Exclusion Periods. 

A health carrier shall not impose any preexisting condition exclusion with respect to coverage in the individual, small group, or large group market.


Source. 1997, 344:1. 2003, 188:11, 12. 2007, 289:23, eff. Jan. 1, 2008. 2019, 220:8, eff. Sept. 10, 2019.

    420-G:8 Open Enrollment. 

I. Each small employer group shall have an annual employee open enrollment period 60 days in length, occurring prior to the small employer group's anniversary date. During open enrollment, employees or eligible dependents may apply to the small employer for health coverage or make a change in their membership status becoming effective upon the small employer group's anniversary date, subject to providing the health carrier 30-days notice.

(a) A health carrier shall not refuse any small employer employees or eligible dependents applying for health coverage during the open enrollment period.

(b) Employees or eligible dependents coming on at the time of an open enrollment period shall have the same premiums as the rest of the small employer group shall have upon the new or renewal effective date.

II. A small employer employee who has met any employer imposed waiting period and is otherwise eligible for health coverage, who declines a small employer's health coverage plan during the initial offering or subsequent open enrollment period, shall be a late enrollee and shall not be allowed on the plan until the next open enrollment period.

III. A large employer employee, who has met any employer imposed waiting period and is otherwise eligible for health coverage, may enroll within 31 days of becoming eligible and shall not be required to submit evidence of insurability based on medical conditions. If a person does not enroll at this time, that person is a late enrollee. Each large employer group shall have an open enrollment period during which late enrollees may enroll and shall not be required to submit evidence of insurability based on medical conditions.

IV. Paragraphs II and III notwithstanding, an eligible employee or eligible dependent shall not be considered a late enrollee if:

(a) The person was covered under public or private health coverage at the time the person was able to enroll; and

(1) Has lost public or private health coverage as a result of termination of employment or eligibility, the termination of the other plan's coverage, death of a spouse, or divorce; and

(2) Requests enrollment within 30 days after termination of such health coverage; or

(b) Is employed by an employer that offers multiple health coverages and the person elects a different plan during an open enrollment period; or

(c) Was ordered by a court to provide health coverage for an ex-spouse or a minor child under a covered employee's plan and the request for enrollment is made within 30 days after issuance of such court order.

V. (a) If individual coverage offered by a health carrier or a large or small employer group's health coverage plan offers dependent coverage and the individual is enrolled in such coverage or the employee is enrolled or has met any applicable waiting period and is eligible to be enrolled, but for a failure to do so during a previous open enrollment period, a person who becomes a dependent of the individual or employee through marriage, birth, adoption or placement for adoption, and the employee if not otherwise enrolled, shall be provided with a special enrollment period.

(b) If an individual has minimum essential coverage through individual coverage offered by a health carrier or as an employee through a large or small employer group's health coverage plan, and the individual loses such coverage for any reason other than failure to pay premiums or a basis on which rescission is permitted pursuant to RSA 420-G:6, IV, the individual shall be provided with a special open enrollment period under any other individual health coverage or any large or small employer group health coverage plan for which the individual becomes eligible.

(c) The special enrollment period shall be at least 60 days in length and shall begin on the later of:

(1) The date dependent health coverage is made available; or

(2) The date of the marriage, birth, adoption, placement for adoption, or loss of minimum essential coverage, as the case may be.

(d) If the person seeks enrollment during such special enrollment period, the health coverage shall become effective:

(1) In the case of marriage or loss of minimum essential coverage, on or before the first day of the first month following the completed request for enrollment;

(2) In the case of birth, as of the date of birth; or

(3) In the case of adoption or placement for adoption, the date of such adoption or placement for adoption.


Source. 1997, 344:1. 2001, 296:3. 2003, 188:16. 2007, 289:39, eff. Jan. 1, 2008. 2019, 220:9, eff. Sept. 10, 2019.

    420-G:9 Minimum Participation Requirements. 

I. A health carrier may not require more than the minimum participation percentage of the employees eligible for health coverage in a small employer group to participate in the health carrier's health coverage plan. The minimum participation percentage shall be 75 percent when the health carrier's plan is the sole health coverage plan being sponsored by the employer group, and 37.5 percent when the health carrier's plan is not the sole health coverage plan being sponsored by the employer group.

II. For the purpose of calculating whether or not a small employer group's enrollment meets a carrier's minimum participation requirements:

(a) Any full-time or part-time employees who are covered as a dependent on another person's health coverage shall be excluded from the count.

(b) The total number of full-time employees and part-time employees who are otherwise eligible for health coverage shall be counted.

III. The minimum participation requirements shall be calculated on an employer-by-employer basis if the small employer is part of an association, trust, or other similar arrangement.

IV. In performing the computation to determine the actual enrollment necessary to meet the minimum participation requirement as a small employer group, the health carrier shall round any fractional number to the higher integer.

V. For the purpose of calculating whether or not a small employer group's enrollment meets a carrier's minimum participation requirements:

(a) Any full-time or part-time employee who is covered as a dependent on another person's health coverage or is enrolled in a governmental plan such as Medicare, Medicaid, or TRICARE shall be excluded from the count.

(b) Any full-time or part-time employee who has been found eligible for a premium tax credit and is enrolled in a qualified health plan (QHP) purchased through an exchange shall be excluded from the count.

(c) The total number of full-time employees and part-time employees who are otherwise eligible for health coverage shall be counted.

VI. The requirements under this section shall be the only participation requirements. Minimum employer contributions, or other criteria, shall not be permitted.


Source. 1997, 344:1. 1998, 340:15, eff. Aug. 25, 1998. 2019, 220:10, eff. Sept. 10, 2019.

    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 such third-party payors, or the payment schedule contained in such policies or plans.

II. Third-party payors should be required to provide such information regarding covered services in clear and simple terms with an easily understandable schedule of payment for services covered to current and potential beneficiaries, enrollees and subscribers.


Source. 1994, 359:1, eff. Jan. 1, 1997.

    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" or "insurer" means any life or health insurance company, fraternal benefit society, nonprofit health service corporation, nonprofit hospital service corporation, nonprofit medical service corporation, prepaid health plan, dental care plan, vision care plan, pharmaceutical plan, health maintenance organization, and all similar type organizations.

IV. "Policy" or "policy form" means any policy, contract, certificate, plan or agreement of life or health insurance, including credit life insurance and credit health insurance, delivered or issued for delivery in this state by any company subject to this chapter; any certificate, contract or policy issued by a fraternal benefit society; and any certificate issued pursuant to a group insurance policy delivered or issued for delivery in this state.


Source. 1994, 359:1, eff. Jan. 1, 1997.

    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. Any group policy covering a group of 1,000 or more lives at date of issue, other than a group credit life insurance policy or a group credit health insurance policy; however, this shall not exempt any certificate issued pursuant to a group policy delivered or issued for delivery in this state;

III. Any group annuity contract which serves as a funding vehicle for pension, profit sharing or deferred compensation plans;

IV. Any form used in connection with, as a conversion from, as an addition to, or in exchange pursuant to a contractual provision for, a policy delivered or issued for delivery on a form approved or permitted to be issued prior to the dates such forms must be approved under this chapter;

V. The renewal of a policy delivered or issued for delivery prior to the dates such forms must be approved under this chapter.


Source. 1994, 359:1, eff. Jan. 1, 1997.

    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 upon the subscriber's choice of primary care physician. The explanation of restrictions shall include a section regarding "referrals to other providers or other medical specialists" that shall urge enrollees, subscribers, certificate holders, and individual insureds to inquire about their primary care provider's referral group within the insurer's network. Such explanation shall include a general statement regarding the existence of physician hospital organizations within the insurer's network, to which primary care providers may be associated.

III. The nature of any payments required of the beneficiary, enrollee or subscriber such as copayments or deductibles.

IV. The nature of any limitations on payment by the insurer, including limitations based on the use of network or out-of-network health care providers.

V. The credentials of any health care provider the health care plan holds out as a specialist denoting board eligibility or board certification for such specialty.

VI. For companies or insurers providing health insurance through a managed care system of health care delivery or reimbursement, a description of the grievance procedures as required pursuant to RSA 420-J:5.

VII. For enrollees, subscribers, certificate holders, or individual insureds whose health insurance is provided through a managed care system of health care delivery and reimbursement, an explanation of a covered person's option to receive direct access to certain obstetrical-gynecological care, pursuant to RSA 420-J:6-a.


Source. 1994, 359:1. 1998, 216:1; 319:2. 2001, 207:16. 2002, 59:1, eff. June 25, 2002.

    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 minimum score of 40 on the Flesch reading ease test or an equivalent score on any other comparable test as provided in paragraph III;

(b) It is printed, except for specification pages, schedules and tables, in not less than 10 point type, one point leaded;

(c) The style, arrangement and overall appearance of the policy give no undue prominence to any portion of the text of the policy or to any endorsements or riders; and

(d) It contains a table of contents or an index of the principal sections of the policy, if the policy has more than 3,000 words printed on 3 or fewer pages of text, or if the policy has more than 3 pages regardless of the number of words.

II. For the purposes of this section, a Flesch reading ease test score shall be measured by the following method:

(a) For policy forms containing 10,000 words or less of text, the entire form shall be analyzed. For policy forms containing more than 10,000 words, the readability of two 200 word samples per page may be analyzed instead of the entire form. The samples shall be separated by at least 20 printed lines.

(b) The number of words and sentences in the text shall be counted and the total number of words divided by the total number of sentences. The figure obtained shall be multiplied by a factor of 1.015.

(c) The total number of syllables shall be counted and divided by the total number of words. The figure obtained shall be multiplied by a factor of 84.6.

(d) The sum of the figures computed under (b) and (c) subtracted from 206.835 equals the Flesch reading ease score for the policy form.

(e) For purposes of RSA 420-H:5, II(b), (c) and (d), the following procedures shall be used:

(1) A contraction, hyphenated word, or numbers and letters, when separated by spaces, shall be counted as one word;

(2) A unit of words ending with a period, semicolon, or colon, but excluding headings and captions, shall be counted as a sentence; and

(3) A syllable means a unit of spoken language consisting of one or more letters of a word as divided by an accepted dictionary. Where the dictionary shows 2 or more equally acceptable pronunciations of a word, the pronunciation containing fewer syllables may be used.

(f) The term "text" as used in this section shall include all printed matter except the following:

(1) The name and address of the insurer; the name, number or title of the policy; the table of contents or index; captions and subcaptions; specification pages, schedules or tables; and

(2) Any policy language which is drafted to conform to the requirements of any federal law, regulation or agency interpretation, any policy language required by any collectively bargained agreement, any medical terminology, any words which are defined in the policy, and any policy language required by law or regulation, provided, however, the insurer identifies the language or terminology excepted by this subparagraph and certifies, in writing, that the language or terminology is entitled to be excepted by this subparagraph.

III. Any other reading test may be approved by the commissioner for use as an alternative to the Flesch reading ease test if it is comparable in result to the Flesch reading ease test.

IV. Filings subject to this section shall be accompanied by a certificate stating that the filing meets the minimum reading ease score on the test used or stating that the score is lower than the minimum required but should be approved in accordance with RSA 420-H:6. To confirm the accuracy of any certification, the commissioner may require the submission of further information to verify the certification in question.

V. At the option of the insurer, riders, endorsements, applications and other forms made a part of the policy may be scored as separate forms or as part of the policy with which they may be used.


Source. 1994, 359:1. 2007, 289:25, eff. Jan. 1, 2008.

    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 policy form or type or class of policy forms; or

III. Is caused by certain policy language which is drafted to conform to the requirements of any state law, rule or agency interpretation.


Source. 1994, 359:1, eff. Jan. 1, 1997.

    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. 1994, 359:1, eff. Jan. 1, 1997.

    420-I:1 Definitions. 

In this chapter:

I. An "affiliate" of a specific person means any person directly or indirectly controlling, controlled by or under common control with such specific person.

II. "Exclusive arrangement" means any agreement, contract, combination or conspiracy, including, without limitation, acquisition, purchase, affiliation or consulting agreements with medical practitioners or group practices and contracts of employment, between a managed care insurer and any person or persons which has the purposes or effect of:

(a) Committing any person providing physician services to accept and treat as patients the subscribers to or participants in a managed care plan to the exclusion of persons who have coverage from any or all other managed care insurers;

(b) Providing reimbursement on sliding scales, capitation rates, payment schedules or other payment arrangements as a financial incentive for persons providing physician services to restrict treatment of persons who have coverage from some or all other managed care insurers; or

(c) Providing reimbursement on sliding scales, capitation rates, payment schedules or other payment arrangements which contain a financial disincentive for failing to restrict treatment of persons who have coverage through any or all other managed care insurers.

III. "
Managed care
" means any arrangement for the provision of physician services which is characterized by some measure of risk-sharing through capitated or other shared-risk compensation formulae, and which are characterized by the establishment and maintenance of a provider network available to subscribers or participants, and which provides incentives for subscribers or participants to use that network for covered services, and which ordinarily limit coverage or the extent of such coverage to physician services provided by that network. "
Managed care
" shall include any managed care products or services or similar products including but not limited to those governed by RSA 415, RSA 419, RSA 420, RSA 420-A, RSA 420-B, and RSA 420-C. "Managed care" shall not include direct primary care services which meet the requirements of RSA 329:1-e.

IV. "Managed care insurer" means a person offering or underwriting managed care and any affiliate thereof.

V. "Managed care plan" means any medical insurance plan offering or underwriting managed care.

VI. "Person" includes natural persons, trusts, corporations, limited liability companies, partnerships, limited partnerships, proprietorships, incorporated or unincorporated associations, and any other legal entity, and any and all of their affiliates.


Source. 1996, 134:2, eff. May 21, 1996. 2019, 330:4, eff. Oct. 15, 2019.

    420-I:2 Prohibition of Exclusive Arrangements. 

I. No managed care insurer may enter into any new exclusive arrangement or renew any exclusive arrangement with any person on or after the effective date of this act.

II. No managed care insurer shall maintain exclusive arrangements or engage in any act or practice that would result in exclusive arrangements with any person, except in accordance with paragraph III of this section, on or after June 30, 1997.

III. The provisions of paragraph II of this section shall not apply to physicians employed by a managed care insurer until June 30, 1999.


Source. 1996, 134:2, eff. May 21, 1996.

    420-I:3 Penalties. 

In addition to those actions authorized under RSA 420-B:13, the commissioner may impose a penalty on any managed care insurer of not more than $2,500 for each day such managed care insurer shall be a party to a contract, arrangement, conspiracy, act or practice declared unlawful under RSA 420-I:2.


Source. 1996, 134:2, eff. May 21, 1996.

    420-I:4 Reports to Insurance Commissioner. 

Each managed care insurer shall file a report in form and containing such information as the insurance commissioner prescribes when requested by the commissioner. Such report shall include the name of the managed care insurer, its affiliates, a description of each exclusive arrangement to which it is a party and, as applicable, the date on which exclusive arrangement has been or will be terminated.


Source. 1996, 134:2. 2000, 166:4, eff. July 22, 2000.

    420-I:5 Effect on Current Contracts. 

No person who is party to an exclusive arrangement on the effective date of this chapter shall renew or extend any such exclusive arrangement after the effective date of this act. No provision of any contract or agreement establishing an exclusive arrangement shall be effective after the earliest date on which any party to the arrangement may terminate the exclusive nature of the arrangement. All exclusive arrangements shall be unlawful on and after the date set out at RSA 420-I:2, II. Any exclusive arrangement entered into, extended or maintained in violation of this chapter shall be void and unenforceable.


Source. 1996, 134:2, eff. May 21, 1996.

    420-I:6 Limitation on Termination of Patient Relations. 

No exclusive arrangement between a managed care insurer and any person shall require a primary care physician to terminate any existing patient relationship with an individual who is covered by another managed care insurer. The physician shall continue to offer to provide services to existing patients for at least 5 years from the commencement date of this exclusive relationship or the effective date of the change of coverage, whichever is later. During such period, the physician will be reimbursed by the managed care insurer covering the patient at a rate which is not more than the highest rate paid by the insurer for similar services in the same service area.


Source. 1996, 134:2, eff. May 21, 1996.

    420-I:7 Provisions Severable. 

If any provision of this chapter or the application thereof to any person or circumstances is held to be invalid for any reason, such invalidity shall not affect any other provision or application of this chapter which may be effected without the invalid provision or application.


Source. 1996, 134:2, eff. May 21, 1996.

    420-J:1 Purpose and Intent. 

The purpose and intent of this chapter is to provide standards for certain fundamental operations of licensed entities providing health insurance through a managed care system of health care delivery and reimbursement. The establishment of these standards will ensure regulatory and quality consistency among the several and various licensees offering managed care type benefit plans and will enable consumers to make informed decisions in their relationships with managed care insurers. This chapter is intended to apply only to those insurers offering managed care plans. It is not intended to apply to traditional indemnity systems of reimbursement and fee-for-service forms of health care expense coverage. Health insurers which do not significantly limit covered persons' choices of providers shall not be subject to this chapter.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:10 Confidentiality of Insurer Records. 

I. Data or information pertaining to the diagnosis, treatment, or health of a covered person obtained from the person or from a provider by a health carrier is confidential and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this chapter and as allowed by any applicable state or federal law; or upon the express consent of the covered person; or pursuant to statute or court order for the production of evidence or the discovery thereof; or in the event of a claim or litigation between the covered person and the health carrier where the data or information is pertinent, regardless of whether the information is in the form of paper, is preserved on microfilm, or is stored in a computer retrievable form.

II. If any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant is disclosed pursuant to paragraph I, the health carrier making this required disclosure shall not be liable for the disclosure or any subsequent use or misuse of the data.

III. A health carrier shall be entitled to claim any statutory privileges against disclosure that the provider who furnished the information to the health carrier is entitled to claim.

IV. The records of the quality assessment program, and the information considered by any quality committee and the records of its actions and proceedings shall be confidential and not subject to subpoena or order to produce except in proceedings before the department or other appropriate state licensing or certifying agency, or in an appeal, if permitted, from the quality committee's findings or recommendations. This section shall not be construed to affect the confidentiality of any other proprietary record of a health carrier.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:11 Confidentiality of Insurance Department Records. 

All information, documents and copies thereof obtained by or disclosed to the commissioner or any other person in the course of an examination or investigation made pursuant to RSA 400-A:37, and, unless otherwise provided in this chapter, all information reported and maintained pursuant to this chapter shall be given confidential treatment and shall not be made public by the commissioner or any other person, except to insurance departments of other states, unless the commissioner after consultation with the affected parties, determines that the interest of policyholders, shareholders, or the public will be served by the publication thereof, in which event the commissioner may disclose all or any part thereof in such manner as the commissioner may deem appropriate.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:12 Rulemaking Authority. 

The commissioner may adopt such rules, under RSA 541-A, and issue such orders as may be necessary to carry out the purposes and provisions of this chapter.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:13 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 severable.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:14 Penalties. 

Any health carrier or other organization violating any of the provisions of this chapter may be subject to an administrative fine not to exceed $2,500 per violation. The commissioner may also suspend or revoke the certificate of authority or license of a health carrier or other organization for any violation of this chapter or the failure to comply with an order of the commissioner issued under this chapter.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:15 Definitions. 

In this subdivision:

I. "
ASAM criteria
" means the latest edition of the Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, developed by the American Society of Addiction Medicine.

II. "
Clinical stabilization services
" means 24-hour clinically-managed post-withdrawal management treatment for adults or adolescents which may include intensive education and counseling regarding the nature of addiction and its consequences, relapse prevention, outreach to families and significant others, and after-care planning, for individuals beginning to engage in recovery from addiction.

III. "
Short-term inpatient withdrawal management
" means 24-hour medically-supervised addiction treatment for adults or adolescents provided in medically-managed or medically-monitored inpatient facilities that provide evaluation and withdrawal management and which may include biopsychosocial assessment, individual and group counseling, psychological educational groups, and discharge planning.

IV. "
Substance use disorder services
" means health care services that are provided to a covered person as treatment for an addictive substance-related condition, not including treatment for any condition related to tobacco use.


Source. 2016, 2:11, eff. Jan. 1, 2017; 275:1, eff. Jan. 1, 2017 at 12:01 a.m.

    420-J:16 Levels of Care Criteria;  Attestation. 

I. Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, the health carrier providing such benefits shall rely upon ASAM criteria when determining medical necessity and developing utilization review standards for levels of care for substance use disorder services.

II. On January 1 of each year, each health carrier that provides coverage for substance use disorder services shall file with the commissioner an annual attestation of compliance with this subdivision.


Source. 2016, 2:11, eff. Jan. 1, 2017.

    420-J:17 Prior Authorization. 

I. Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, no prior authorization shall be required for the first 2 routine outpatient visits of an episode of care by an individual for assessment and care with respect to a substance use disorder.

II. Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, no prior authorization shall be required for short-term inpatient withdrawal management and clinical stabilization services for up to 24 hours, when prescribed by a clinician trained in the use and application of the ASAM criteria; provided, that the facility notifies the patient's health carrier as soon as practicable after admission of the patient. If the facility fails to notify the patient's health carrier as soon as practicable after admission of the patient, the facility shall be financially responsible for the costs of any services provided by the facility to the patient.

III. Alternatively, a carrier may require prior authorization for the services described in paragraph II, but only if the carrier has a medical clinician or licensed alcohol and drug counselor available on a 24-hour hotline to make the medical necessity determination and assist with placement at the appropriate level of care, and the carrier provides a prior authorization decision as soon as practicable after receipt from the treating clinician of the clinical rationale consistent with the ASAM criteria, but in no event more than 6 hours of receiving such information; provided that until such hotline determination is made, coverage for substance use disorder services shall be provided at an appropriate level of care consistent with the ASAM criteria, as defined in RSA 420-J:15, I.

IV. If an insurance policy does not require prior authorization for short-term inpatient withdrawal management services or clinical stabilization services, paragraphs II and III shall not apply.

V. Nothing in this section shall be construed to require coverage for services provided by a non-participating provider.


Source. 2016, 2:11, eff. Jan. 1, 2017; 275:2, eff. Jan. 1, 2017 at 12:01 a.m.

    420-J:18 Authorization for Medication-Assisted Treatment. 

Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, a health carrier shall:

I. Be required to offer at least one medication-assisted treatment therapy option approved by the federal Food and Drug Administration for treatment of substance use disorders without a requirement for prior authorization.

II. Not require a renewal of a prior authorization for a medication-assisted treatment therapy for treatment of substance use disorders more frequently than once every 12 months.


Source. 2017, 185:1, eff. Aug. 28, 2017. 2020, 39:52, eff. Sept. 27, 2020.

    420-J:19 Medication Synchronization. 

I. An individual or group health insurance plan or policy providing prescription drug coverage in New Hampshire, shall permit and apply a prorated, daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed by an in-network pharmacy for less than a 30-day supply if the prescriber and pharmacist determine the fill or refill to be in the best interest of the patient for the management or treatment of a chronic, long-term care condition and the patient requests or agrees to less than a 30-day supply for the purpose of synchronizing the patient's medications. For the purposes of this paragraph, the insured's or enrollee's maintenance prescription drugs to be synchronized shall meet all of the following requirements:

(a) They are covered by the policy, certificate, or contract described in this chapter.

(b) They are used for the management and treatment of a chronic, long-term care condition and have authorized refills that remain available to the insured or enrollee.

(c) Except as otherwise provided in this paragraph, they are not a controlled substance included in schedules II-V.

(d) They meet all utilization management requirements specific to the maintenance-prescription drugs at the time of the request to synchronize the insured's or enrollee's multiple, maintenance-prescription drugs.

(e) They are of a formulation that can be effectively split over required short-fill periods to achieve synchronization.

(f) They do not have quantity limits or dose-optimization criteria or requirements that will be violated when synchronizing the insured's or enrollee's multiple, maintenance-prescription drugs.

II. The plan or policy described in paragraph I shall apply a prorated, daily cost-sharing rate for maintenance-prescription drugs that are dispensed by an in-network pharmacy for the purpose of synchronizing the insured's or enrollee's multiple, maintenance-prescription drugs.

III. The plan or policy described in paragraph I shall not reimburse or pay any dispensing fee that is prorated. The insurer shall only pay or reimburse a dispensing fee that is based on each maintenance-prescription drug dispensed.

IV. A synchronization shall only occur once per year per maintenance-prescription drug.


Source. 2018, 103:2, eff. Jan. 1, 2019.

    420-J:2 Applicability and Scope. 

This chapter shall apply to all health carriers offering a managed care plan in this state.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-J:3-a Access to Enhanced 911 System. 

I. No health benefit plan issued or renewed after July 7, 2000 shall contain any provision which establishes or promotes an emergency medical response or transportation system that encourages or directs access by a covered person in competition with or in substitution of the state enhanced 911 system or other state, county, or local government emergency medical services system.

II. Notwithstanding paragraph I, a health carrier subject to this chapter may use transportation outside the enhanced 911 or other government emergency medical services system for services that are not in response to an emergency medical condition, as defined in RSA 420-J:3, XV.

III. No health benefit plan issued or renewed after July 7, 2000 shall contain any provision requiring a covered person to obtain prior authorization before accessing the enhanced 911 system or other state, county, or local government emergency medical services system for response and/or transportation for emergency services, as defined in RSA 420-J:3, XVI.

IV. No person who issues a health benefit plan subject to this chapter shall use false or misleading language in its enrollment sales materials or in any other materials provided to covered persons to discourage or prohibit covered persons from accessing the enhanced 911 system for response and/or transportation for emergency services.


Source. 2000, 104:2, eff. July 7, 2000.

    420-J:3-b Pre-certification Requirement. 

In the event that a person is covered by more than one plan that requires pre-certification, the member shall obtain pre-certification from the primary plan. Although the member shall not be required to obtain pre-certification from the secondary plan, the secondary plan shall not be required to treat such services as covered services if the services do not meet its certification criteria. The secondary plan shall not refuse payment for such services solely on the basis that the services were not pre-certified by the secondary plan.


Source. 2007, 289:26, eff. Jan. 1, 2008.

    420-J:3 Definitions. 

In this chapter:

I. "Adverse determination" means a determination by a health carrier or its designee utilization review entity that an admission, availability of care, continued stay or other health care service has been reviewed and, based upon the information provided, does not meet the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care or effectiveness, and the requested service is therefore denied, reduced, or terminated.

II. "Ambulatory review" means utilization review of health care services performed or provided in an outpatient setting.

III. "Appeals procedure" means a formal process whereby a covered person, a representative of a covered person, attending physician, facility or health care provider can contest an adverse determination rendered by the health carrier or its designee utilization review organization, which results in the denial, reduction or termination of a requested health care service.

III-a. "
Authorized representative
" means a person to whom a covered person has given consent to represent the covered person in an external review. Authorized representative may include the covered person's treating provider.

IV. "Case management" means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted or other health conditions.

V. "Certification" means a determination by a health carrier or its designee utilization review organization that an admission, availability of care, continued stay or other health care service has been reviewed and, based on the information provided, satisfies the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care, and effectiveness.

V-a. "
Claim denial
" means any of the following: a denial, reduction, or termination of, or a failure to provide or make payment (in whole or in part) for, a benefit, including any such denial, reduction, termination, or failure to provide or make payment that is based on a determination of a participant's or beneficiary's eligibility to participate in a plan, and including, with respect to group health plans, a denial, reduction, or termination of, or a failure to provide or make payment (in whole or in part) for, a benefit resulting from the application of any utilization review, as well as a failure to cover an item or service for which benefits are otherwise provided because it is determined to be experimental or investigational or not medically necessary or appropriate.

V-b. "
Claim involving urgent care
" means any claim for medical care or treatment with respect to which the application of the time periods for making non-urgent care determinations:

(a) Could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function; or

(b) In the opinion of a physician with knowledge of the claimant's medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care or treatment that is the subject of the claim.

V-c. "
Claimant's representative
" shall mean an individual authorized by a claimant in writing to pursue a claim or appeal on the claimant's behalf.

VI. "Clinical peer" means a physician or other health care professional who holds a non-restricted license in a state of the United States and in the same or similar specialty as typically manages the medical condition, procedure or treatment under review. A "clinical peer" includes a health care professional who has demonstrable expertise to review a case, whether or not the reviewing professional is in the same or a similar specialty as the health care professional who made the initial decision.

VII. "Clinical review criteria" means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by the health carrier to determine the necessity and appropriateness of health care services.

VIII. "Commissioner" means the insurance commissioner.

IX. "Concurrent hospital review" means utilization review conducted during a patient's inpatient stay or course of treatment.

X. "Consumer" means someone in the general public who may or may not be a covered person or a purchaser of health care including employers.

X-a. "
Contracted pharmacy
" or "
pharmacy
" means a pharmacy participating in the network of a pharmacy benefit manager through a direct contract or through a contract with a pharmacy services administration organization or group purchasing organization.

XI. "Covered benefits" or "benefits" means those health care services to which a covered person is entitled under the terms of a health benefit plan.

XII. "Covered person" means a policyholder, subscriber, enrollee, or other individual participating in a health benefit plan.

XIII. "Credentialing verification" is the process of obtaining and verifying information about a health care professional, and evaluating that health care professional, when that health care professional applies to become a participating provider in a managed care plan offered by a health carrier.

XIV. "Discharge planning" means the formal process for determining, prior to discharge from a facility, the coordination and management of the care that a patient receives following discharge from a facility.

XIV-a. "
Drug product reimbursement
" means the amount paid by a carrier or pharmacy benefit manager to a contracted pharmacy or pharmacist for the cost of the drug dispensed to a patient and does not include a dispensing or professional fee.

XV. "
Emergency medical condition
" means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical attention such that a prudent layperson with average knowledge of health and medicine could reasonably expect that failure to provide medical attention could result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or could place the person's health in serious jeopardy.

XVI. "
Emergency services
" means health care services that are provided to an enrollee, insured, or subscriber in a licensed hospital emergency facility by a provider after the sudden onset of a medical condition that manifests itself by symptoms of sufficient severity that a prudent layperson with average knowledge of health and medicine could reasonably expect that the absence of immediate medical attention could result in any of the following:

(a) Serious jeopardy to the patient's health.

(b) Serious impairment to bodily functions.

(c) Serious dysfunction of any bodily organ or part.

XVII. "Facility" means an institution providing health care services or a health care setting, including but not limited to hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, residential treatment centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings.

XVIII. "Grievance" means a written complaint submitted by or on behalf of a covered person regarding the:

(a) Availability, delivery, or quality of health care services, including a complaint regarding an adverse determination made pursuant to utilization review;

(b) Claims payment, handling, or reimbursement for health care services; or

(c) Matters pertaining to the contractual relationship between a covered person and a health carrier.

XIX. "Health benefit plan" means a policy, contract certificate or agreement entered into, offered or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.

XX. "Health care professional" means a physician or other health care practitioner licensed, accredited, or certified to perform specified health services consistent with state law.

XXI. "Health care provider" or "provider" means a health care professional or facility.

XXII. "Health care services" or "health services" means services for the diagnosis, prevention, treatment, cure or relief of a health condition, illness, injury or disease.

XXIII. "Health carrier" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including an insurance company, a health maintenance organization, a health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services.

XXIII-a. "
Independent review organization
" means an entity that employs or contracts with clinical peers to conduct independent external reviews of health carrier determinations.

XXIV. "Intermediary" means a person authorized to negotiate and execute provider contracts with health carriers on behalf of health care providers or on behalf of a network.

XXV. "Managed care plan" means a health benefit plan that either requires a covered person to use, or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with, or employed by the health carrier.

XXV-a. "
Medical director
" means a physician licensed under RSA 329 and employed by a health carrier or medical utilization review entity who is responsible for the utilization review techniques and methods of the health carrier or medical utilization review entity and their administration and implementation.

XXV-b. "
Medical necessity
" means health care services or products provided to an enrollee for the purpose of preventing, stabilizing, diagnosing, or treating an illness, injury, or disease or the symptoms of an illness, injury, or disease in a manner that is:

(a) Consistent with generally accepted standards of medical practice;

(b) Clinically appropriate in terms of type, frequency, extent, site, and duration;

(c) Demonstrated through scientific evidence to be effective in improving health outcomes;

(d) Representative of "best practices" in the medical profession; and

(e) Not primarily for the convenience of the enrollee or physician or other health care provider.

XXVI. "Network" means the group of participating providers providing services to a managed care plan.

XXVII. "Participating provider" means a provider who, under a contract with the health carrier or with its contractor or subcontractor, has agreed to provide health care services to covered persons with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly or indirectly from the health carrier.

XXVIII. "Person" means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, any similar entity or any combination of the foregoing.

XXVIII-a. "Pharmacy benefits manager" means "pharmacy benefits manager" as defined in RSA 402-N:1, VIII.

XXVIII-b. "
Pre-service claim
" means any claim for a benefit under a health plan with respect to which the terms of the plan condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining medical care. "
Pre-service claim
" shall not include a request for reimbursement made by a provider pursuant to the terms of an agreement between the provider and the health carrier.

XXVIII-aa. "
Post-service claim
" means any claim for a health benefit to which the terms of the plan do not condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining the medical care or disability benefit. "Post-service claim" shall not include a request for reimbursement made by a provider pursuant to the terms of an agreement between the provider and the health carrier.

XXIX. "Prospective review" means utilization review conducted prior to an admission or a course of treatment.

XXX. "Quality assessment" means the measurement and evaluation of the quality and outcomes of medical care provided to individuals, groups, or populations.

XXXI. "Quality improvement" means the effort to improve the processes and outcomes related to the provision of health care services within the health benefit plan.

XXXII. "Retrospective review" means a review of medical necessity conducted after services have been provided to a patient, but does not include a claims settlement process including an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, adjudication for payment, or whether a service is a covered benefit under the plan.

XXXIII. "Second opinion" means an opportunity or requirement to obtain a clinical evaluation by a provider other than the one originally making a recommendation for a proposed health service to assess the clinical necessity and appropriateness of the initial proposed health service.

XXXIV. "Utilization review" means a set of formal techniques designed to monitor the use of or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of health care services procedures, providers, or facilities. Techniques and methods may include ambulatory care review, case management, concurrent hospital review, discharge planning, prehospital admission certification, preinpatient service eligibility certification, prospective review, second opinion, or retrospective review.

XXXV. "Utilization review entity" means an entity, subject to licensure pursuant to RSA 420-E, that conducts utilization review, other than a health carrier performing review for its own health plans.


Source. 1997, 345:1; 345:10. 2000, 18:4, 11, 12. 2001, 207:10, 11, 14. 2003, 175:8. 2007, 33:1. 2014, 150:1, eff. Aug. 15, 2014. 2016, 177:1, 2, eff. Jan. 1, 2017. 2018, 356:6, 7, eff. July 1, 2018. 2019, 320:4, eff. Jan. 1, 2020.

    420-J:4-a Facility Credentialing. 

I. Health carriers shall credential qualified entities administering community mental health programs as defined under RSA 135-C:7, entities administering community substance use disorder treatment programs as defined under RSA 172:2-c, and community health centers as facilities when paneling and enrolling participating providers, consistent with health carriers' facility credentialing standards and practices, unless the entity requests professional level credentialing. Health carriers shall not be required to credential entities who do not meet the health carriers' facility credentialing eligibility standards. If an entity disagrees with the outcome of a health carrier's application of its facility credentialing standards and practices, the entity may request a formal hearing and review of the carrier's decision by the New Hampshire insurance department pursuant to RSA 400-A:17 and/or file a complaint with the New Hampshire insurance department's health care provider complaint process.

II. Nothing in this section shall be construed to require a health carrier to select or enroll a specific facility as a participating provider.


Source. 2021, 183:9, eff. Sept. 9, 2021.

    420-J:4 Credentialing Verification Procedures. 

I. A health carrier shall:

(a) Establish written policies and procedures for credentialing verification of all health care professionals with whom the health carrier contracts and apply these standards consistently.

(b) Verify the credentials of a health care professional. Prior to completion of credentialing verification the health carrier shall:

(1) Allow a health care provider who, at the time of submission of a clean and complete application, has a valid license from the respective state licensing board and has been credentialed by the hospital, if appropriate, to deliver health care services to covered persons when covering on-call for another health care provider who is credentialed by the carrier.

(2) Allow a health care provider to deliver health care services to covered persons when that health care provider has a valid license from the respective state licensing board and has been credentialed by the hospital, if appropriate, and who at the time of submission of a clean and complete application is credentialed by the health carrier in another state or is in the health carrier's New Hampshire network based on employment with a particular health care entity. When a health care provider relocates or opens an additional office and the carrier requires a site visit, documentation of the new site evaluation shall be required as part of the credentialing process. The medical director of the health carrier or other designated health care professional shall have responsibility for, and shall participate in, health care professional credentialing verification.

(c) Establish a credentialing verification committee consisting of licensed physicians and other health care professionals to review credentialing verification information and supporting documents and make decisions regarding credentialing verification.

(d) Make available for review by the applying health care professional upon written request all application and credentialing verification policies and procedures.

(e) Retain records and documents relating to a health care professional's credentialing verification process for 7 years.

(f) Keep confidential all information obtained in the credentialing verification process, except as otherwise provided by law.

(g) Notify a health care provider that a submitted credentialing application is incomplete, not later than 15 business days after receiving the credentialing application.

(h) Act upon and finalize the credentialing process within 30 calendar days for primary care physicians and 45 days for specialists of receipt of a clean and complete application. In this section, "clean and complete" means an application signed and appropriately dated by the health care provider, that includes all of the applicable information required in paragraph II and any affirmative responses on questions related to quality and clinical competence shall contain explanations satisfactory to the carrier.

(i) An applicant's rights under this section and under RSA 420-J:8-c shall terminate upon denial of the credentialing application by the health carrier or if the applicant decides not to contract with the health carrier.

II. A health carrier shall obtain verification of at least the following information about the applicant:

(a) Graduation from health care professional school.

(b) Completion of post graduate training (if applicable).

(c) The health care professional's license history in this and all other states.

(d) The health care professional's malpractice history.

(e) The health care professional's practice history.

(f) Current license, certificate of authority, or registration to practice a health care profession in New Hampshire.

(g) Current level of professional liability coverage (if applicable).

(h) Status of hospital privileges (if applicable).

(i) Specialty board certification status (if applicable).

(j) Current Drug Enforcement Agency (DEA) registration certificate (if applicable).

III. A health carrier shall thereafter obtain, at least every 3 years, verification of a participating provider's:

(a) Current license, certificate of authority or registration to practice a health care profession in New Hampshire.

(b) Current level of professional liability coverage (if applicable).

(c) Status of hospital privileges (if applicable).

(d) Current DEA registration certificate (if applicable).

(e) Specialty board certification status (if applicable).

IV. A health carrier shall require all participating providers to notify the health carrier of changes in the status of any items listed in this section at any time, and shall identify for participating providers the individual or department to whom they should report such changes.

V. Whenever a health carrier contracts to have another entity perform the credential verification functions required by this section or applicable rules, the commissioner shall hold the health carrier responsible for monitoring the activities of the entity with which it contracts and for ensuring that the requirements of this section and applicable rules are met.

VI. Nothing in this section shall be construed to require a health carrier to select a health care professional as a participating provider solely because the health care professional meets the health carrier's credentialing verification standards, or to prevent a health carrier from utilizing separate or additional criteria in selecting the health care professionals with whom it contracts.


Source. 1997, 345:1. 2002, 207:41. 2007, 98:1, eff. Aug. 10, 2007.

    420-J:5-a Right to External Review. 

I. A covered person shall have the right to independent external review of a determination by a health carrier or its designee utilization review entity when all of the following conditions apply:

(a) The subject of the request for external review is an adverse determination;

(b) The covered person has completed the internal review procedures provided by the carrier or other licensed entity pursuant to RSA 420-J:5, or the carrier or other entity has agreed to submit the determination to independent external review prior to completion of internal review, or the covered person has requested first or second level, standard or expedited review and has not received a decision from the carrier or other licensed entity within the required time frames;

(c)(1) The covered person or the covered person's authorized representative has submitted the request for external review in writing to the commissioner within 180 days of the date of the carrier or other licensed entity's denial decision provided pursuant to RSA 420-J:5, or if the carrier or other licensed entity has failed to make a first or second level, standard or expedited review decision that is past due, within 180 days of the date the decision was due;

(2) The covered person's or covered person's authorized representative's participation in any voluntary level of appeal offered by a carrier or other licensed entity pursuant to RSA 420-J:5, V(e)(2) shall not affect a covered person's ability to submit a request for external review. In the event that a covered person or covered person's authorized representative elects to proceed with a voluntary appeal, that person shall have 180 days from the date the decision is rendered on the voluntary appeal to submit a request for external review.

(d) The health carrier determination does not relate to any category of health care services that is excluded from the external review provisions of this chapter pursuant to paragraph II; and

(e) The request for external review is not based on a claim or allegation of provider malpractice, professional negligence, or other professional fault excluded from the external review provisions of this chapter pursuant to paragraph III.

II. Determinations relating to the following health care services shall not be reviewed under this chapter, but shall be reviewed pursuant to the review processes provided by applicable federal or state law:

(a) Health care services provided through Medicaid, the state Children's Health Insurance Program (Title XXI of the Social Security Act
), Medicare or services provided under these programs but through a contracted health carrier, except where those services are provided through private insurance coverage pursuant to the New Hampshire granite advantage health care program under RSA 126-AA in which case all provisions of this chapter shall apply.

(b) Health care services provided to inmates by the department of corrections.

(c) Health care services provided pursuant to a health plan not regulated by the state, such as self-funded plans administered by an administrative services organization or third-party administrator or federal employee benefit programs.

III. The external review procedures set forth in this chapter shall not be utilized to adjudicate claims or allegations of health care provider malpractice, professional negligence, or other professional fault against participating providers or medical directors.


Source. 2000, 18:13. 2001, 207:15. 2005, 248:21. 2012, 98:1. 2015, 64:1, eff. Aug. 1, 2015. 2018, 342:17, eff. Dec. 31, 2018.

    420-J:5-b Standard External Review. 

Standard external review shall be conducted as follows:

I. Within 7 business days after the date of receipt of a request for external review, the commissioner shall complete a preliminary review of the request to determine whether:

(a) The individual is or was a covered person under the health benefit plan;

(b) The determination that is the subject of the request for external review meets the conditions of eligibility for external review stated in RSA 420-J:5-a, I; and

(c) The covered person has provided all the information and forms required by the commissioner that are necessary to process a request for an external review.

II. Upon completion of the preliminary review pursuant to paragraph I, the commissioner shall immediately notify the covered person or the covered person's authorized representative in writing:

(a) Whether the request is complete; and

(b) Whether the request has been accepted for external review.

III. If the request is not complete, the commissioner shall inform the covered person or the covered person's authorized representative what information or documents are needed to make the request complete and to process the request. The covered person or the covered person's authorized representative shall submit such information or documentation within 10 days of being notified that the request was incomplete.

IV. If the request for external review is accepted, the commissioner shall:

(a) Include in the notice provided to the covered person pursuant to paragraph II a statement that if the covered person wishes to submit new or additional information or to present oral testimony via teleconference, such information shall be submitted, and the oral testimony shall be scheduled and presented, within 20 days of the date of issuance of the notice. However, the notice shall also explain that oral testimony shall be permitted only in cases when the commissioner determines, based on evidence provided by the covered person, that it would not be feasible or appropriate to present only written testimony.

(b) Immediately notify the health carrier in writing of the request for external review and its acceptance.

V. If the request for external review is not accepted, the commissioner shall inform the covered person or the covered person's authorized representative and the health carrier in writing of the reason for its non-acceptance.

VI. At the time a request for external review is accepted, the commissioner shall select and retain an independent review organization that is certified pursuant to RSA 420-J:5-d, I to conduct the external review. The commissioner shall not select the same independent review organization for each external review, but shall rotate among the certified independent review organizations, using all organizations equally. The commissioner may select and retain an independent review organization regardless of the rotation if the commissioner determines that the use of such independent review organization is necessary for the fair adjudication of the case in question.

VII. Within 10 days after the date of issuance of the notice provided pursuant to subparagraph IV(b), the health carrier or its designated utilization review organization shall provide to the selected independent review organization and to the covered person all information in its possession that is relevant to the adjudication of the matter in dispute, including but not limited to:

(a) The terms of agreement of the health benefit plan, including the evidence of coverage, benefit summary, or other similar document;

(b) All relevant medical records, including records submitted to the carrier by the covered person, the covered person's authorized representative, or the covered person's treating provider;

(c) A summary description of the applicable issues, including a statement of the health carrier's final determination;

(d) The clinical review criteria used and the clinical reasons for the determination;

(e) The relevant portions of the carrier's utilization management plan;

(f) Any communications between the covered person and the health carrier regarding the internal or external review; and

(g) All other documents, information, or criteria relied upon by the carrier in making its determination.

VIII. Failure by the health carrier or the covered person to provide the documents and information required in paragraph IV(a) or VII within the specified time frame shall not delay the conduct of the external review.

IX. The selected independent review organization shall review all of the information and documents received from the carrier pursuant to paragraph VII and any other information submitted by the covered person or the covered person's authorized representative or treating provider with the request for external review or pursuant to subparagraph IV(a) and any testimony provided . In addition to the information provided by the health carrier and the covered person or the covered person's authorized representative or treating provider, the independent review organization may consider any applicable, generally accepted clinical practice guidelines, studies or research, including those developed or conducted by the federal government, national or professional medical societies, boards, and associations. The independent review organization shall consider anew all previously determined facts, allow the introduction of new information, and make a decision that is not bound by decisions or conclusions made by the health carrier during internal review.

X. The selected independent review organization shall render a decision upholding or reversing the determination of the health carrier and notify the covered person or the covered person's authorized representative and the health carrier in writing within 20 days of the date that any new or additional information from the covered person is due pursuant to subparagraph IV(a). This notice shall include a written review decision that contains a statement of the nature of the grievance, references to evidence or documentation considered in making the decision, findings of fact, and the clinical and legal rationale for the decision, including, as applicable, clinical review criteria and rulings of law.


Source. 2000, 18:13, eff. Sept. 3, 2000.

    420-J:5-c Expedited External Review. 

Expedited external review shall be conducted as follows:

I. Expedited external review shall be available when the covered person's treating health care provider certifies to the commissioner that adherence to the time frames specified in RSA 420-J:5-b would seriously jeopardize the life or health of the covered person or would jeopardize the covered person's ability to regain maximum function.

II. Except to the extent that it is inconsistent with the provisions of this paragraph, all requirements for the conduct of standard external review specified in RSA 420-J:5-b shall apply to expedited external review. However, a person who meets the standard set forth in paragraph I for expedited external review, as well as the reviewability requirements set forth in RSA 420-J:5-b, I, may pursue expedited external review simultaneous with the internal review process in RSA 420-J:5.

III. At the time the commissioner receives a request for an expedited external review, the commissioner shall immediately make a determination whether the request meets the standard set forth in paragraph I for expedited external review, as well as the reviewability requirements set forth in RSA 420-J:5-b, I. If these conditions are met, the commissioner shall immediately notify the health carrier. If the request is not complete, the commissioner shall immediately contact the covered person or the covered person's authorized representative and attempt to obtain the information or documents that are needed to make the request complete.

IV. The commissioner shall select and retain an independent review organization that is certified pursuant to RSA 420-J:5-d, I to conduct the expedited external review.

V. The health carrier or its designated utilization review organization shall provide or transmit the documents and information specified in RSA 420-J:5-b, VII to the selected independent review organization by telephone, facsimile, or any other available expeditious method within one business day of receiving the commissioner's notice of the request for expedited external review pursuant to paragraph III.

VI. When handling a review on an expedited basis, the selected independent review organization shall make a decision and notify the carrier and the covered person as expeditiously as the covered person's medical condition requires, but in no event more than 72 hours after the expedited external review is requested.

VII. If the notice provided pursuant to paragraph VI was not in writing, within 2 business days after the date of providing that notice, the selected independent review organization shall:

(a) Provide written confirmation of the decision to the covered person or the covered person's authorized representative and the health carrier; and

(b) Include the information set forth in RSA 420-J:5-b, X.

VIII. An expedited external review shall not be provided for determinations made by the health carrier on a retrospective basis.

IX. A covered person shall not be held liable to either the health plan, the hospital, the physician, or the services provider for the cost of services in excess of the applicable copayment, coinsurance, or deductible incurred, pending the independent review organization's determination of an expedited external review.


Source. 2000, 18:13. 2012, 98:2, eff. July 28, 2012.

    420-J:5-d Certification of Independent Review Organizations. 

I. The certification of independent review organizations shall be conducted as follows:

(a) The commissioner shall certify independent review organizations eligible to be selected to conduct external reviews under this section to ensure that an independent review organization satisfies the minimum qualifications established under paragraph II.

(b) The commissioner shall develop an application form for initially certifying and recertifying independent review organizations to conduct external reviews.

(c) Independent review organizations wishing to be certified shall submit the application form and include all documentation and information necessary for the commissioner to determine whether the independent review organization satisfies the minimum qualifications established under paragraph II.

(d) The commissioner may determine that accreditation by a nationally recognized private accrediting entity with established and maintained standards for independent review organizations that meet or exceed the minimum qualifications established under paragraph II is sufficient for certification under this paragraph.

(e) The commissioner shall maintain and periodically update a list of certified independent review organizations.

(f) Whenever the commissioner determines that an independent review organization no longer satisfies the minimum qualifications established under paragraph II, the commissioner shall terminate the certification of the independent review organization and remove it from the list of certified independent review organizations that is maintained by the commissioner pursuant to subparagraph I(e).

II. To be certified under paragraph I to conduct external reviews, an independent review organization shall meet the following minimum qualifications:

(a) It shall develop and maintain written policies and procedures that govern all aspects of both the standard external review process and the expedited external review process.

(b) It shall establish and maintain a quality assurance program that:

(1) Ensures that external reviews are conducted within the specified time frames and required notices are provided in a timely manner;

(2) Ensures the selection of qualified and impartial clinical peer reviewers to conduct external reviews on behalf of the independent review organization with suitable matching of reviewers to specific cases;

(3) Ensures the confidentiality of medical and treatment records; and

(4) Ensures that any person employed by or under contract with the independent review organization adheres to the requirements of this section.

(c) It shall agree to maintain and provide to the commissioner such information as may be required to fulfill the provisions and purposes of this section.

(d) It shall assign clinical peer reviewers to conduct external reviews who are physicians or other appropriate health care providers and who:

(1) Are experts in the treatment of the covered person's medical condition that is the subject of the external review;

(2) Are knowledgeable about the recommended health care service or treatment through actual clinical experience;

(3) Hold a non-restricted license in a state of the United States and, for physicians, a current certification by a specialty board recognized by the American Board of Medical Specialties in the area or areas appropriate to the subject of the external review;

(4) Have no history of disciplinary actions or sanctions that have been taken or are pending by any hospital, governmental agency, or regulatory body; and

(5) Have agreed to disclose any potential conflict of interest.

(e) It shall be free of any conflict of interest. To meet this qualification, an independent review organization may not own or control or in any way be owned or controlled by a health carrier, a national, state, or local trade association of health carriers, or a national, state, or local trade association of health care providers. In addition, in order to qualify to conduct an external review of a specific case, neither the independent review organization selected to conduct the external review nor any clinical peer reviewer assigned by the independent organization to conduct the external review may have a material professional, familial or financial interest in any of the following:

(1) The health carrier that is the subject of the external review;

(2) Any officer, director, or management employee of the health carrier that is the subject of the external review;

(3) The health care provider or the health care provider's medical group or independent practice association recommending the health care service or treatment that is the subject of the external review;

(4) The facility or institution at which the recommended health care service or treatment would be provided;

(5) The developer or manufacturer of the principal drug, device, procedure, or other therapy being recommended for the covered person whose treatment is the subject of the external review; or

(6) The covered person or the covered person's authorized representative.

(f) Its charges for services provided shall be competitive and reasonable.

(g) It shall be accredited by a nationally recognized accreditation organization to perform external reviews.

(h) For the purpose of allowing in-state health care providers to act as clinical peer reviewers in the conduct of external reviews, the commissioner may determine, in specific cases, that an affiliation with a hospital, an institution, an academic medical center, or a health carrier provider network does not in and of itself constitute a conflict of interest which is sufficient to preclude that provider from acting as a clinical peer reviewer, so long as the affiliation is disclosed to the covered person or the covered person's authorized representative.

(i) The following organizations shall not be eligible for certification to conduct external reviews:

(1) Professional or trade associations of health care providers;

(2) Subsidiaries or affiliates of such provider associations;

(3) Health carrier or health plan associations; and

(4) Subsidiaries or affiliates of health plan or health carrier associations.


Source. 2000, 18:13. 2012, 98:3, eff. July 28, 2012.

    420-J:5-e General Provisions Regarding External Review. 

I. The health carrier against which a request for external review is filed shall pay the cost of the external review. Except under the circumstances described below in this paragraph, such costs shall not exceed $1,500. The commissioner shall notify the independent review organizations of the cost limitation for conducting an external review. The cost for an external review may exceed $1,500 if the commissioner determines an additional cost is necessary to ensure the fair adjudication of the case in question.

II. The external review decision of the independent review organization shall be binding on the health carrier and shall be enforceable by the commissioner pursuant to the penalty provisions of RSA 420-J:14. The external review decision of the independent review organization shall be binding on the covered person except to the extent the covered person has other remedies available under federal or state law. The external review process shall not be considered an adjudicative proceeding within the meaning of RSA 541-A, and the external review decision of the independent review organization shall not be subject to rehearing and appeal pursuant to RSA 541.

III. An independent review organization shall maintain all standards of confidentiality. The records and internal materials prepared for specific reviews by an independent review organization under this section shall be exempt from public disclosure under RSA 91-A.

IV. An external review organization acting in good faith shall have immunity from any civil or criminal liability or professional discipline as a result of acts or omissions with respect to any external review, unless the acts or omissions constitute willful and wanton misconduct.

V. The right to external review under this chapter shall not be construed to change the terms of coverage under a health benefit plan nor shall the health carrier retaliate against the covered person for exercising his or her right to an independent external review.

VI. When requested by the covered person, the commissioner shall provide consumer assistance in pursuing the internal grievance procedures under RSA 420-J:5 and the external review process under RSA 420-J:5-a-420-J:5-e.

VII. The commissioner shall report annually to the governor and the legislature on the number of grievances subjected to external review, the number of decisions resolved wholly or partially in favor of the covered person, and the number of decisions resolved wholly or partially in favor of the health carrier. Such reports shall also include a separate statement of the number of cases in which the external review was terminated as a result of a reversal by the health carrier of its adverse determination after the receipt of new or additional information from the covered person or the covered person's authorized representative and the number of cases in which the covered person and the health carrier agreed to resolve the dispute prior to a final determination by the independent review organization.

VIII. If, based on the evidence presented during the external review process, the commissioner determines that the health carrier's medical director, in the conduct of his or her duties, may have committed misconduct as set forth in RSA 329:17, VI, the commissioner shall document such findings and transmit them in a separate report to the board of medicine.


Source. 2000, 18:13, eff. Sept. 3, 2000.

    420-J:5 Grievance Procedures. 

Every carrier or other licensed entity shall establish and shall maintain a written procedure by which a claimant or a representative of the claimant, shall have a reasonable opportunity to appeal a claim denial to the carrier or other licensed entity, and under which there shall be a full and fair review of the claim denial. The written procedure filed with the insurance department shall include all forms used to process an appeal.

I. Full and fair review shall require that:

(a) The persons reviewing the grievance shall not be the same person or persons making the initial determination, and shall not be subordinate to or the supervisor of the person making the initial determination;

(b) For medical necessity appeals at least one person reviewing the appeal is a practitioner in the same or similar specialty who typically treats the medical condition, performs the procedure, or provides the treatment at issue in the appeal. A practitioner is considered of the same specialty if he or she has similar credentials and licensure as those who typically treat the condition or health problem in question in the appeal. A practitioner is considered of a similar specialty if he or she has experience treating the same problems as those in question in the appeal, in addition to expertise treating similar complications of those problems;

(c) The claimant shall have at least 180 days following receipt of a notification of a claim denial to appeal;

(d) The claimant shall have an opportunity to submit written comments, documents, records, and other information relating to the claim without regard to whether those documents or materials were considered in making the initial determination;

(e) The claimant shall be provided upon request, and without charge, reasonable access to, and copies of all documents, records, and other information relevant to or considered in making the initial adverse claim determination; and

(f) The review shall be a de novo proceeding and shall consider all information, documents, or other material submitted in connection with the appeal without regard to whether the information was considered in making the denial.

II. In the appeal of a claim denial that is based in whole or in part on a medical judgment:

(a) The review shall be conducted by or in consultation with a health care professional in the same or similar specialty who typically treats the medical condition, performs the procedure, or provides the treatment at issue in the appeal. A practitioner is considered of the same specialty if he or she has similar credentials and licensure as those who typically treat the condition or health problem in question in the appeal. A practitioner is considered of a similar specialty if he or she has experience treating the same problems as those in question in the appeal, in addition to expertise treating similar complications of those problems;

(b) The titles and qualifying credentials of the person conducting the review shall be included in the decision; and

(c) The identity and qualifications of any medical or vocational expert whose advice was considered, without regard to whether it was relied upon in making the initial claim denial, shall be made available to the claimant upon request.

III. In the appeal of a claim for urgent care, a claim involving a matter that would seriously jeopardize the life or health of a covered person or would jeopardize the covered person's ability to regain maximum function, or a claim concerning an admission, availability of care, continued stay or health care service for a person who has received emergency services, but who has not been discharged from a facility, an expedited appeal process shall be made available which shall provide for:

(a) The submission of information by the claimant to the carrier by telephone, facsimile, or other expeditious method; and

(b) The determination of the appeal not more than 72 hours after the submission of the request for appeal.

IV. Timing and Notification for Determination on Appeal

(a) In the case of nonexpedited appeal of a pre-service claim or post-service claim, the determination on appeal shall be made within a reasonable time appropriate to the medical circumstances, but in no event more than 30 days after receipt by the carrier or other licensed entity of the claimant's appeal.

(b) In the case of an expedited appeal related to an urgent care claim, a carrier or other entity shall make a decision and notify the covered person as expeditiously as the covered person's medical condition requires, but in no event more than 72 hours after the appeal is filed. If the expedited review involves ongoing urgent care services, the service shall be continued without liability to the covered person until the covered person has been notified of the determination. A carrier or other licensed entity shall provide written confirmation of its decision concerning an expedited review within 2 business days of providing notification of that decision, if the initial notification was not in writing.

(c) The period of time within which a decision shall be rendered on appeal shall begin to run at the time the appeal is filed in accordance with the appeal procedures of the carrier or other licensed entity, without regard to whether all the information necessary to make a determination on appeal is contained in the filing. In the event the claimant fails to submit information necessary to decide the appeal, the period for making the determination on appeal shall be tolled from the date the claimant is notified in writing of precisely what is required until the date the claimant responds to the request. The carrier or other licensed entity shall provide notification of incompleteness as soon as possible; but in no event more than 24 hours after the filing of the appeal in appeals involving urgent care. In the event that the claimant fails, within a 45-day period from the date of notification, to provide sufficient information, the carrier may deny the appeal on the basis of incompleteness. The appeal may be reopened upon receipt of the required information.

V. Manner and Content of Notification of Determination on Appeal. The carrier or other licensed entity shall provide a claimant with a written determination of the appeal.

(a) Where a decision is made to uphold, in whole or in part, the denial of benefits, the written determination of appeal shall include:

(1) The specific reason or reasons for the determination, including reference to the specific provision, rule, protocol, or guideline on which the determination is based;

(2) A statement that the rule, protocol, or guideline governing the appeal will be provided without charge to the claimant upon request;

(3) A statement describing all other dispute resolution options available to the claimant, including, but not limited to other options for internal review and options for external review and options for bringing a legal action;

(4) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits;

(5) If an internal rule, guideline, protocol, or other similar criterion was relied upon in making the claim denial, either the specific rule, guideline, protocol, or other similar criterion; or a statement that such rule, guideline, protocol, or other similar criterion was relied upon in making the claim denial and that a copy of the rule, guideline, protocol, or other similar criterion will be provided free of charge to the claimant upon request;

(6) If the claim denial is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the denial, applying the terms of the plan to the claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request;

(7) If the appeal involves an adverse determination, a copy of the notice of the right to external review that includes the specific requirements for filing an external review; and

(8) A statement describing the claimant's right to contact the insurance commissioner's office for assistance which shall include the toll-free telephone number and address of the commissioner.

(b) A carrier or other licensed entity that offers group health plans, employee benefit plans, or disability plans shall file annually with the commissioner, as part of its annual report required by RSA 420-J:5, V(g), a certificate of compliance stating that the carrier or other licensed entity has established and maintained, for each of its health benefit plans, grievance procedures that fully comply with the provisions of this chapter. Material modifications to the procedure shall be filed with the commissioner prior to becoming effective.

(c) A carrier or other licensed entity that offers group health plans, employee benefit plans, or disability plans shall maintain written records documenting all grievances and appeals received during a calendar year, a general description of the reason for the appeal or grievance, the name of the claimant, the dates of the appeal or grievance and the date of resolution.

(d) A carrier or other licensed entity that offers group health plans, employee benefit plans, or disability plans shall provide to consumers:

(1) A description of the internal grievance procedure required under RSA 420-J:5 for claim denials and other matters and a description of the process for obtaining external review under RSA 420-J:5-a-RSA 420-J:5-e. These descriptions shall be set forth in or attached to the policy, certificate, membership booklet, or other evidence of coverage provided to covered persons.

(2) A statement of a covered person's right to contact the commissioner's office for assistance at any time. The statement shall include the toll-free telephone number and address of the commissioner.

(3) A statement that the carrier or other licensed entity will provide assistance in preparing an appeal of an adverse benefit determination, and a toll-free telephone number to contact the carrier or other licensed entity.

(e)(1) If a carrier or other licensed entity provides 2 mandatory levels of appeal, the first level shall be completed within 15 days and the second level completed within the 30-day time period beginning from the initial date of filing the appeal or grievance. If a carrier or other licensed entity provides a single mandatory level of appeal, the single mandatory level shall be completed within the 30-day time period beginning from the initial date of filing the appeal. With respect to a mandatory second level of appeal involving a claim for continuation of services or urgent care, the carrier or other licensed entity shall make a decision and notify the claimant within 72 hours after the mandatory second level appeal is filed. For appeals involving post-service claims, the carrier shall make a decision and notify the claimant within 60 days of the date the completed appeal was filed.

(2) Subparagraph (e)(1) shall not prohibit a carrier or other licensed carrier from offering additional voluntary levels of appeal in addition to any mandatory levels of appeal offered, provided that:

(A) The claimant may elect to pursue any additional level of appeal under this subparagraph voluntarily;

(B) A carrier may not assert failure to exhaust administrative remedies where a claimant elects to pursue a claim through other venues rather than through the voluntary level of appeal;

(C) Any statute of limitations or time limits to pursue other remedies shall be tolled during the voluntary appeals process;

(D) Voluntary levels of appeal are available only after a claimant has completed required mandatory levels of appeal required under the plan or by regulation;

(E) The carrier provides a claimant with sufficient information to make an informed decision whether to submit the claim through any voluntary appeals process;

(F) No fees or costs are imposed on the claimant as part of any voluntary appeals process; and

(G) Any voluntary level of appeal requested by a claimant under this subparagraph shall be completed within 30 days from the date of the request for the voluntary appeal.

(f) Annual reports shall be made to the insurance commissioner regarding plan complaints, adverse determinations, claim denials, and prior authorization statistics in such form and containing such information as the commissioner may prescribe by rule or otherwise.

(g) If the claimant has filed an appeal and the carrier or other licensed entity has not issued a decision within the required time frames, the carrier or other licensed entity shall promptly provide the claimant with a statement of the claimant's right to file an external appeal as provided in RSA 420-J:5-a-RSA 420-J:5-e. The statement of appeal rights shall include a description of the process for obtaining external review of a determination, a copy of the written procedures governing external review, including the required time frames for requesting external review, and notice of the conditions under which expedited external review is available.

VI. In an appeal of a claim denial or other matter, the claimant may authorize a representative to pursue a claim or an appeal by submitting a written statement to the carrier or other licensed entity that acknowledges the representation.

VII. No fees or costs shall be assessed against a claimant related to a request for a grievance or appeal.


Source. 1997, 345:1. 2000, 18:6-10, 17. 2001, 207:12. 2003, 175:9, 10. 2005, 248:9, 10, 20. 2007, 289:27, 28, eff. Jan. 1, 2008.

    420-J:6-a Obstetrical-Gynecological Coverage. 

I. Health plans shall not require prior authorization by a covered person's primary care provider for coverage of the following services provided by participating providers who specialize in obstetrics and gynecology:

(a) Maternity care;

(b) An annual gynecological visit; and

(c) Follow-up care for obstetrical or gynecological conditions identified during such maternity care or annual gynecological visit.

II. Health plans may establish reasonable requirements for participating obstetricians and gynecologists to communicate with the covered person's primary care provider regarding the covered person's condition, treatment, and any need for follow-up care.


Source. 1998, 319:1, eff. Jan. 1, 1999.

    420-J:6-b Self-Referrals for Chiropractic Care. 

A health benefit plan under this chapter offering chiropractic benefits shall provide benefits to a covered person who utilizes services of a chiropractic provider (doctor of chiropractic) by self-referral for 12 visits under the following conditions:

I. Unless otherwise provided for by the health benefits plan, self-referral visits shall not apply to wellness care visits.

II. A covered person may utilize the services of a doctor of chiropractic as defined in RSA 316-A, without discrimination relative to access and fees, subject to the terms and conditions of the policy.

III. The health benefit plan shall fully disclose to the certificate holder in clear and understandable language the exact terms and conditions of each option that the certificate holder has purchased along with the co-payments or other cost-sharing features of each option.

IV. Within 10 working days of the first visit or consultation, the doctor of chiropractic shall send to the health benefit plan, or its designee, the chiropractic case findings. This shall be sufficient documentation for the initial 12 visits.

V. After 12 self-referral visits, a covered person who is continuing chiropractic care may be subject to utilization review from the health plan, or its designee, for the purpose of continued care. A provider of the same specialty shall be consulted when making any utilization review determination under this section.

VI. If the chiropractic provider recommends care beyond 12 visits, the participating doctor of chiropractic shall send to the insurer, or its designee, documentation containing information on the covered person's progress and necessity of care as well as a care plan for extended chiropractic care. The care recommendation shall be deemed authorized if the health benefit plan does not respond to the care recommendation within 7 business days. If the doctor of chiropractic fails to provide the required documentation, the insured or its covered person shall not be liable to the chiropractic provider for any unpaid fees.

VII. The covered person shall retain the right to choose chiropractic care on an elective, self-pay, fee-for-service basis; no entity regulated under this chapter shall prohibit a doctor of chiropractic from continuing care on an elective, self-pay, fee-for-service basis.

VIII. Nothing in this section is intended to limit the health plan's ability to credential providers or structuring with network providers.


Source. 2000, 14:1, eff. April 18, 2000.

    420-J:6-c Third-Party Payment of Covered, Court-Ordered Services. 

The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such services shall be subject to the same dollar limits, deductibles, co-payments and co-insurance factors and to the terms and conditions of the policy or certificate, including any managed care provisions. However, the claimant or claimant's representative shall have 48 hours from the commencement of a court-ordered service, placement, or program to seek any pre-authorization, pre-certification, or referral required under the terms of the policy. The determination of these preservice claims for court-ordered services for a minor shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 48 hours after receipt of the request and sufficient information, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the insurer shall notify the claimant or claimant's representative within 24 hours of receipt of the request and shall advise the claimant or claimant's representative of the specific information necessary to determine to what extent benefits are covered or payable. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the claim determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of:

I. The insurer's receipt of the specified additional information; or

II. The end of the period afforded the claimant or claimant's representative to provide the specified additional information.


Source. 2004, 117:4, eff. Aug. 15, 2004.

    420-J:6-d Coverage for Dependents. 

If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this section. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this section. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this section commences.


Source. 2007, 289:29, eff. Jan. 1, 2008.

    420-J:6-e Coverage for Medically Necessary Dental Services. 

Health carriers shall provide coverage for medically necessary dental services resulting from an accidental injury to sound natural teeth and gums when the course of treatment for the accidental injury is received or authorized within 3 months of the date of the injury. Treatment made necessary due to injury to the jaw and oral structures other than teeth shall be covered without time limit. Coverage under this section shall be subject to such other terms and conditions of the policy that may apply.


Source. 2019, 113:3, eff. Aug. 20, 2019.

    420-J:6 Utilization Review. 

I. Each health carrier which does not contract with a utilization review entity shall establish written procedures for carrying out its utilization review processes and shall file such procedures with the commissioner on or before April 1 of each year. Such carriers shall conform to the standards of either the Utilization Review Accreditation Commission or the National Committee for Quality Assurances and are subject to all applicable rules issued pursuant to RSA 420-E:7.

II. The written procedures shall describe the categories of health care personnel that perform utilization review activities and whether or not such individuals are licensed in this state, and shall address at a minimum, second opinion programs; prehospital admission certification; preinpatient service eligibility certification; and concurrent hospital review to determine appropriate length of stay; as well as the process used by the health carrier to preserve confidentiality of medical information.

III. Notification of claim denial shall be made within the following time periods:

(a) The determination of a claim involving urgent care shall be made as soon as possible, taking into account the medical exigencies, but in no event later than 72 hours after receipt of the claim, unless the claimant or claimant's representative fails to provide sufficient information to determine whether, or to what extent, benefits are covered or payable. In the case of such failure, the licensee shall notify the claimant or claimant's representative within 24 hours of receipt of the claim and shall advise the claimant or claimant's representative of the specific information necessary to determine the claim. The claimant or claimant's representative shall be afforded a reasonable amount of time, taking into account the circumstances, but not less than 48 hours, to provide the specified information. Thereafter, notification of the benefit determination shall be made as soon as possible, but in no case later than 48 hours after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(b) The determination of a claim involving urgent care and relating to the extension of an ongoing course of treatment and involving a question of medical necessity shall be made within 24 hours of receipt of the claim, provided that the claim is made at least 24 hours prior to the expiration of the prescribed period of time or course of treatment.

(c) The determination of all other claims for preservice benefits shall be made within a reasonable time period appropriate to the medical circumstances, but in no event more than 15 days after receipt of the claim. This period may be extended one time by the licensee for up to 15 days, provided that the licensee both determines that such an extension is necessary due to matters beyond the control of the licensee and notifies the claimant or claimant's representative, prior to the expiration of the initial 15-day period, of the circumstances requiring the extension of time and the date by which the licensee expects to render a decision. If such an extension is necessary due to a failure of the claimant or claimant's representative to provide sufficient information to determine whether, or to what extent, benefits are covered as payable, the notice of extension shall specifically describe the required additional information needed, and the claimant or claimant's representative shall be given at least 45 days from receipt of the notice within which to provide the specified information. Notification of the benefit determination following a request for additional information shall be made as soon as possible, but in no case later than 15 days after the earlier of (1) the licensee's receipt of the specified additional information, or (2) the end of the period afforded the claimant or claimant's representative to provide the specified additional information.

(d) The determination of a post service claim shall be made within 30 days of the date of filing. In the event the claimant fails to provide sufficient information to determine the claim, the carrier shall notify the claimant within 15 days as to what additional information is required to process the claim and the claimant shall be given at least 45 days to provide the required information. The 30-day period for claim determination shall be tolled until such time as the claimant submits the required information.

IV. All contracts with utilization review entities shall be available to the commissioner upon request.

V. Each health carrier that conducts utilization review shall employ a medical director who shall have responsibility for all utilization review techniques and methods and their administration and implementation. Nothing in this section shall be construed to preclude a medical director from consulting with or relying on the advice of a physician licensed in this state or any other state. Nothing in this section shall be construed as creating any civil liability to the medical director for the medical director's alleged negligent performance of the aforementioned responsibilities for utilization review.

VI. The clinical review criteria used by the health carrier or its designee utilization review entity shall be:

(a) Developed with input from appropriate actively practicing practitioners in the health carrier's service area;

(b) Updated at least biennially and as new treatments, applications, and technologies emerge;

(c) Developed in accordance with the standards of national accreditation entities;

(d) Based on current, nationally accepted standards of medical practice; and

(e) If practicable, evidence-based.


Source. 1997, 345:1. 2000, 18:5, 15. 2001, 207:13. 2003, 276:11, eff. July 1, 2003.

    420-J:7-a Repealed by 2007, 33:2, eff. July 13, 2007. 

    420-J:7-b Prescription Drugs. 

I. (a) Every health benefit plan that provides prescription drug benefits is required to provide prospective enrollees, and covered persons, a description of the prescription drug benefit plan. Among the specific items that shall be included in the description are:

(1) The procedure a covered person must follow to obtain drugs and medications that are subject to a plan list or plan formulary.

(2) A description of the drug formulary and the plan's exception process.

(3) A description of the extent to which a covered person will be reimbursed for the cost of a drug that is not on a plan list or formulary.

(b) Health carriers shall provide upon request additional information to covered persons related to specific drugs that are not on the formulary.

II. Every health benefit plan that provides prescription drug benefits shall maintain an expeditious exception process, not to exceed 48 hours, by which covered persons may obtain coverage for a medically necessary nonformulary prescription drug or for a nonformulary prescription drug that was available during the previous 12 months. The exception process shall begin when the prescribing provider has submitted a request with a clinical rationale for the exception to the health benefit plan. The exception process shall also begin when a covered person has submitted a non-clinical request for access to a drug approved by the federal Food and Drug Administration for treating a specific condition when such drug was available on the formulary during the previous 12 months. A prescription that requires an exception for coverage shall be considered approved if the exception process exceeds 48 hours.

II-a. No health benefit plan that provides prescription drug benefits and establishes the specific sequence in which prescription drugs for a medical condition are to be prescribed shall require failure on the same medication on more than one occasion for patients continuously enrolled in the plan. Nothing in this section shall be construed to prevent a health care provider from prescribing a medication to the same patient on more than one occasion, when he or she determines it is medically appropriate.

II-b. Every health benefit plan that provides prescription drug benefits and requires prior authorization for covered drugs in the formulary shall respond to a prior authorization request within 2 business days. The prior authorization process shall begin when the prescribing provider has submitted a request with a complete clinical rationale to the health carrier or pharmacy benefits manager. A prescription that requires a prior authorization for coverage shall be considered approved if the prior authorization process exceeds 2 business days.

III. Every health plan that provides prescription drug benefits shall provide written notice in a conspicuous font and size to covered persons affected by deletions to the plan list or plan formulary, provide an explanation of the exception process by which a covered person can access nonformulary medically necessary prescription drugs, and provide a toll-free telephone number through which a covered person can request additional information. For purposes of this paragraph, covered persons affected by deletions to the plan list or plan formulary shall include those covered persons for whom the health plan has provided coverage for the deleted prescription drugs during the 12-month period immediately prior to the deletion. Upon notification to covered persons, the health benefit plan shall allow at least 45 days before implementation of any formulary deletions; provided, however, that advance notice shall not be required if the federal Food and Drug Administration has determined that a prescription drug on the health benefit plan's formulary is unsafe. For purposes of this section, "
conspicuous font and size
" shall mean a font that is at least 12 point in size and in an easily legible font. If a covered person avails himself or herself of the exception process as outlined in 420-J:7-b, II, the medication shall be covered by the health plan until there is a resolution of the exception process.

IV. Every health benefit plan that provides prescription drug benefits shall maintain, as part of its records, all of the following information, which shall be made available to the commissioner upon request: the complete drug formulary or formularies of the plan, if the plan maintains a formulary, including a list of the prescription drugs on the formulary of the plan by major therapeutic category with an indication of whether any drugs are preferred over the other drugs.

IV-a. Every health benefit plan that provides prescription drug benefits shall provide notice of deletions to the plan list or plan formulary to all covered persons at least annually.

IV-b. Every health benefit plan that provides prescription drug coverage shall also provide notice of additions to the plan list or formulary to all covered persons at least annually. However, the requirements of this paragraph shall not apply to any health benefit plan that adds prescription drugs to its plan list or formulary upon approval by the federal Food and Drug Association.

IV-c. (a) Beginning July 1, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs may, when requiring prior authorization for a prescription drug, use and accept the prior authorization paper forms or electronic standard described in this paragraph.

(b) Beginning December 31, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs shall, when requiring prior authorization for a prescription drug, use and accept only the prior authorization paper forms or electronic standard described in this paragraph.

(c) On or before March 1, 2017, the commissioner shall adopt rules, pursuant to RSA 541-A, specifying the contents and format of the uniform prior authorization paper forms and the electronic prior authorization standard, consistent with the requirements of this paragraph. In developing the paper forms and the electronic standard, the commissioner shall seek input from interested stakeholders, including, but not limited to, prescribers, pharmacists, carriers, and prescription benefits managers, and shall support adoption of nationally recognized standards for electronic prior authorization of prescription drugs, including those provided by the National Council for Prescription Drug Programs or an equivalent organization as available.

(d) The prior authorization paper forms adopted under this paragraph shall not exceed 2 pages in length.

(e) Nothing in this paragraph shall require a carrier or pharmacy benefits manager to use electronic prior authorization. A carrier or pharmacy benefits manager shall not require use of electronic prior authorization when:

(1) A pharmacist or prescriber lacks broadband Internet access;

(2) A pharmacist or prescriber has low patient volume;

(3) A pharmacist or prescriber has opted-out for a certain medical condition or for a patient request;

(4) A pharmacist or prescriber lacks an electronic medical record system;

(5) The electronic prior authorization interface does not provide for the pre-population of prescriber and patient information; or

(6) The electronic prior authorization interface requires an additional cost to the prescriber.

(f) Nothing in this section shall prohibit the use of prior authorization for prescription drug benefits.

(g) This section shall apply to RSA 420-J and shall not apply to the Medicaid managed care program under RSA 126-A:5, XIX.

V. Every health benefit plan that provides coverage for prescription drugs or devices, or administers such a plan, or which contracts with an entity providing such prescription drug coverage, including but not limited to pharmacy benefit manager companies, shall issue to covered persons a card or other technology containing uniform prescription drug information. The uniform prescription drug information card or technology shall include all of the fields required by the health insurance provider for claims processing in a clear, readable, and understandable manner on the card or other technology issued and shall include, at a minimum, the following information:

(a) The name or trademark logo of the insurer and, if another company administers the prescription benefit, the name or trademark logo of the benefit administrator.

(b) The covered person's name and identification number.

(c) All of the electronic transaction routing information required by the insurer or its benefit administrator in order for the pharmacy to electronically process a prescription claim, including but not limited to the BIN number labeled as such or the Processor Control Number labeled as such, or both.

VI. All subscriber health insurance cards issued after January 1, 2004 shall contain the information required under paragraph V.

VII. A new uniform prescription drug information card, as required under paragraph V, shall be issued by health benefit plan upon enrollment of new members and when reissuing a new card to current members when there is a change in the covered person's pharmacy coverage that affects data contained on the card.

VIII. Every health benefit plan that provides prescription drug benefits shall allow its covered persons to purchase an up-to-90-day supply of covered prescription drugs on the covered person's health benefit plan formulary at one time at a pharmacy of the insured's choice within the insurer's network, provided that the insured can demonstrate that such drug has been taken by the insured for a continuous period of one year and provided that such drug is not subject to the health benefit plan's utilization management, prior authorization, or pre-certification requirements. Controlled substances as identified by the United States Drug Enforcement Administration are exempt from this paragraph. Nothing in this paragraph shall be construed to limit the health benefit plan's ability to establish co-payments, coinsurance deductibles, or other member cost shares. A retail pharmacy dispensing a 90-day supply of covered prescription drugs under this paragraph shall comply with any specified terms, conditions, and reimbursement rate which the health benefit plan may require for mail order pharmacies that fill 90-day prescriptions.

IX. (a) Every health benefit plan that provides prescription drug benefits shall allow its covered persons to obtain an emergency prescription for up to a 72-hour supply of covered prescription drugs on the covered person's health benefit plan formulary or a prescription drug that was deleted from the formulary within the last 90 days in the event a prescription requires prior authorization or an exception by an insurance carrier and the prior authorization or exception has neither been approved nor denied and a pharmacist has determined the medication is essential as provided in RSA 318:47-i. Such reimbursement shall be according to the payment rates of the provider contract. If authorization or exception is subsequently denied, the carrier shall reimburse the pharmacist for the prescription as given based on the pro-rated amount they would have otherwise received under the terms of the provider contract.

(b) The following drugs or classes of drugs, or their medical uses, may be excluded from coverage or otherwise restricted:

(1) Agents when used for anorexia, weight loss, or weight gain.

(2) Agents when used to promote fertility.

(3) Agents when used for cosmetic purposes or hair growth.

(4) Agents when used for the symptomatic relief of cough and colds.

(5) Agents when used to promote smoking cessation.

(6) Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations.

(7) Nonprescription drugs, except, in the case of pregnant women when recommended by or under the supervision of a physician, agents approved by the Food and Drug Administration under the over-the-counter monograph process for purposes of promoting, and when used to promote, tobacco cessation.

(8) Covered outpatient drugs which the manufacturer seeks to require as a condition of sale that associated tests or monitoring services be purchased exclusively from the manufacturer or its designee.

(9) Barbiturates.

(10) Benzodiazepines.

(11) Agents when used for the treatment of sexual or erectile dysfunction, unless such agents are used to treat a condition, other than sexual or erectile dysfunction, for which the agents have been approved by the Food and Drug Administration.

X. (a) A pharmacy benefits manager or insurer shall require a contracted pharmacy to charge an enrollee or insured person the pharmacy's usual and customary price of filling the prescription or the contracted copayment, whichever is less.

(b) Once it has settled a claim for filling a prescription for an enrollee or insured person and notified the pharmacy of the amount the pharmacy benefits manager or insurer shall pay to the pharmacy for that prescription, the pharmacy benefits manager or insurer shall not lower the amount to be paid to the pharmacy by the pharmacy benefits manager or the insurer for such settled claim; provided, however, that this paragraph shall not apply if the claim was submitted fraudulently or with inaccurate or misrepresented information.

(c) The commissioner shall adopt rules under RSA 541-A to implement this paragraph. Such rules shall include procedures for addressing complaints, provisions for enforcement, the receipt of complaints referred to the insurance department under RSA 318:47-h, III(b), and for reporting to the board of pharmacy on the status of complaints referred.

XI. Health carriers shall have access to or maintain within their data systems amounts paid to pharmacies and other health care providers for all prescription drugs on behalf of their covered members. Carriers shall have access to or maintain a record of any amounts due to the pharmacy from the covered member in the form of cost sharing, such as copayments, deductibles, or coinsurance. The health carrier shall be responsible for assuring timely access to this information even when the prescription drug benefit is administered by a pharmacy benefit manager or similar entity.

XII. A health carrier shall not, either directly or indirectly:

(a) Prohibit an in-network retail pharmacy from:

(1) Mailing or delivering a prescription drug to an enrollee as an ancillary service of the in-network retail pharmacy provided that confirmation of delivery is obtained.

(2) Charging a shipping or handling surcharge to an enrollee who requests that the in-network retail pharmacy mail or deliver a prescription drug to the enrollee as an ancillary service provided the enrollee receives a disclosure from the in-network retail pharmacy regarding any surcharge to be charged to the patient for the delivery of a prescription drug, including that the surcharge may not be reimbursable by the plan sponsor or health carrier.

(3) Offering the ancillary services described in subparagraph I(a) to an enrollee.

(b) Charge an enrollee who uses an in-network retail pharmacy that offers to mail or deliver a prescription drug to an enrollee as an ancillary service a surcharge for the delivery of a prescription drug or copayment that is higher than the surcharge or copayment the enrollee would pay if the enrollee used an in-network retail pharmacy that does not offer to mail or deliver a prescription drug to an enrollee as an ancillary service.

(c) For purposes of this section, a retail pharmacy shall not include a "mail-order pharmacy" as defined in RSA 318:1, VII-b.


Source. 1999, 286:1. 2003, 286:5. 2004, 187:15-17. 2007, 73:2. 2013, 257:30; 262:1. 2014, 2:1, eff. April 21, 2014; 120:2, eff. Aug. 15, 2014; 311:3, eff. Jan. 1, 2015. 2016, 221:6, eff. June 9, 2016; 228:2, eff. June 9, 2016. 2019, 137:1, eff. Aug. 24, 2019; 180:1, 2, eff. Sept. 8, 2019. 2020, 13:8, eff. Jan. 1, 2021. 2021, 149:2, eff. Sept. 21, 2021.

    420-J:7-c Disqualification of Certain Physicians Prohibited. 

A physician who is part of a health carrier's provider network on December 31, 2000, shall not be disqualified from participating in that network solely because such physician is not certified by a member board of the American Board of Medical Specialties.


Source. 2000, 248:1, eff. Aug. 8, 2000.

    420-J:7-d Continued Access to Care Subsequent to a Provider Contract Termination. 

The commissioner may extend the period of continued access to care subsequent to a provider contract termination provided for under RSA 420-J:8, XI for up to an additional 60-day period.


Source. 2003, 284:3, eff. July 1, 2003.

    420-J:7-e Notice of Consumer Rights. 

A health carrier shall, at least annually, in a conspicuous communication as approved by the commissioner which may be included as an insert in an annual mailing or by electronic communication, notify each covered person of his or her consumer rights under this chapter, including, but not limited to, appeal rights and the ability to access services out-of-network in the event covered services are not available in-network. A health carrier shall also notify covered persons of the right to access out-of-network services when the covered person contacts the health carrier directly requesting assistance finding clinically appropriate in-network care. A health carrier shall also provide notification to covered persons of their right to appeal whenever a covered person contacts the health carrier regarding a denial of coverage or when a health carrier verbally informs the covered person of the denial of coverage.


Source. 2017, 214:2, eff. Jan. 1, 2018.

    420-J:7 Network Adequacy. 

I. A health carrier shall maintain a network that is sufficient in numbers, types, and geographic location of providers to ensure that all services to covered persons will be accessible without unreasonable delay.

II. The commissioner shall adopt rules under RSA 541-A for a health carrier's network adequacy. Such rules shall establish, but not be limited to:

(a) Waiting times for appointments for non-emergency care.

(b) Choice of and access to providers for specialty care, specifically addressing the needs of the chronically ill, mentally ill, persons with substance use disorder, developmentally disabled or those with a life threatening illness.

(c) Standards for geographic accessibility, which shall include standards for access to the provision of durable medical equipment requiring a prescription. However, such standards shall not restrict an insurer's ability to provide prescriptions for durable medical equipment that are shipped to the patient by postal service or other common or private carrier, and shall not apply to durable medical equipment devices used exclusively for the administration of medication.

(d) Hours of operation for the carrier, including any entities performing prior approval or pre-authorization functions.

(e) Standards for addressing in-network access to hospital based providers, such as anesthesiologists, radiologists, pathologists, and emergency medicine physicians.

III. The health carrier shall keep, at its place of business, a detailed description of the health carrier's compliance with rules adopted pursuant to RSA 420-J:7, II as well as its procedures for monitoring network adequacy.

IV. Annually, the health carrier shall submit a report to the commissioner demonstrating compliance with the rules for network adequacy.

V. The commissioner shall provide a report annually on the findings associated with network adequacy review to the chairpersons of the house and senate committees having jurisdiction over insurance issues.


Source. 1997, 345:1. 2008, 311:1, eff. Aug. 31, 2008. 2017, 214:1, eff. Jan. 1, 2018. 2018, 356:3, 4, eff. July 1, 2018.

    420-J:8-a Prompt Payment Required. 

I. (a) Health carriers issuing health benefit plans subject to this chapter shall pay claims submitted by health care providers for services rendered in New Hampshire to covered persons within 30 calendar days upon receipt of a clean non-electronic claim or 15 calendar days upon receipt of a clean electronic claim.

(b) When the health carrier is denying or pending the claim, the carrier shall have 15 calendar days upon receipt of an electronic claim or 30 days upon receipt of a non-electronic claim to notify the health care provider or covered person of the reason for denying or pending the claim and what, if any, additional information is required to adjudicate the claim. Upon the health carrier's receipt of the requested additional information, the health carrier shall adjudicate the claim within 45 calendar days. If the required notice is not provided, the claim shall be treated as a clean claim and shall be adjudicated pursuant to subparagraph (a).

(c) Payment of a claim shall be considered to be made on the date a check was issued or electronically transferred. The health carrier shall mail checks no later than 5 business days after the date a check was issued. Failure to mail a check within 5 business days shall constitute a violation subject to enforcement under RSA 415:20.

(d) The health carrier's failure to comply with the time limits in this section shall not have the effect of requiring coverage for an otherwise non-covered claim. This section shall only apply to payments made on a claims basis and shall not apply to capitation or other forms of periodic payment.

II. In this section:

(a) "
Clean claim
" means a claim for payment of covered health care expenses that is submitted to a health carrier on the carrier's standard claim form using the most current published procedural codes, with all the required fields completed with correct and complete information in accordance with the carrier's published filing requirements.

(b) "
Electronic claim
" means the transmission of data for purposes of payment of covered health care services in an electronic data format specified by the health carrier and, if covered by the Health Insurance Portability and Accountability Act (HIPAA),
 is in such form and substance as to be in compliance with such act.

III. Any initial clean claim submission not paid within the time periods specified in subparagraph I(a) shall be deemed overdue. In that case:

(a) The health carrier shall pay the health care provider or the insured person the amount of the overdue claim plus an interest payment of 1.5 percent per month beginning from the date the payment was due; and

(b) The health care provider may recover from the carrier, upon a judicial finding of bad faith, reasonable attorney's fees for advising and representing a health care provider in a successful action against a carrier for payment of the claim.

IV. Exceptions to the requirements of this section are as follows:

(a) No health carrier shall be in violation of this section for a claim submitted by a health care provider if:

(1) Failure to comply is caused by a directive from a court or a federal or state agency;

(2) The health carrier is in liquidation or rehabilitation or is operating in compliance with a court-ordered plan of rehabilitation; or

(3) The carrier's compliance is rendered impossible due to matters beyond the carrier's control which are not caused by such carrier.

(b) No health carrier shall be in violation of this section for any claim submitted more than 90 days after the service was rendered.

(c) No health carrier shall be in violation of this section while the claim is pending due to a fraud investigation that has been reported to a state or federal agency, or an internal or external review determination pursuant to RSA 420-J:5 or RSA 420-J:5-a-e.

V. The commissioner may assess an administrative fine against any health carrier or may suspend or revoke the license or certificate of authority of any health carrier after determining that the health carrier has established a pattern of overdue payments and that the contemplated enforcement action would not promote the deterioration of the financial condition of an at-risk insurer. Such fine shall not exceed $300,000 per calendar year examined. Nothing in this paragraph shall be construed to alter the commissioner's authority to investigate or take action, including, but not limited to, action pursuant to RSA 415:20, in response to individual instances of noncompliance.


Source. 2000, 274:5; 314:5. 2005, 162:4. 2009, 235:17, eff. Sept. 14, 2009.

    420-J:8-b Retroactive Denials Prohibited;  Exceptions. 

I. In this section, "
retroactive denial of a previously paid claim
" means any attempt by a health carrier to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments currently owed to the provider, withholding or setting off against future payments, or reducing or affecting the future claim payments to the provider in any other manner.

II. No health carrier shall impose on any health care provider any retroactive denial of a previously paid claim or any part thereof unless:

(a) The carrier has provided the reason for the retroactive denial in writing to the health care provider; and

(b) The time which has elapsed since the date of payment of the challenged claim does not exceed 12 months. The retroactive denial of a previously paid claim may be permitted beyond 12 months from the date of payment only for the following reasons:

(1) The claim was submitted fraudulently;

(2) The claim payment was incorrect because the provider or the insured was already paid for the health care services identified in the claim;

(3) The health care services identified in the claim were not delivered by the physician/provider;

(4) The claim payment was for services covered by Title XVIII, Title XIX, or Title XXI of the Social Security Act;

(5) The claim payment is the subject of an adjustment with a different insurer, administrator, or payor and such adjustment is not affected by a contractual relationship, association, or affiliation involving claims payment, processing, or pricing; or

(6) The claim payment is the subject of legal action.

III. A health carrier shall notify a health care provider at least 15 days in advance of the imposition of any retroactive denials of previously paid claims. The health care provider shall have 6 months from the date of notification under this paragraph to determine whether the insured has other appropriate insurance, which was in effect on the date of service. Notwithstanding the contractual terms between the health carrier and provider, the health carrier shall allow for the submission of a claim that was previously denied by another insurer due to the insured's transfer or termination of coverage.


Source. 2002, 143:4. 2006, 104:4, eff. Aug. 7, 2006. 2018, 317:2, eff. Jan. 1, 2019.

    420-J:8-c Reimbursement for Providers Waiting for Health Carrier Credentialing Verification. 

I. Pursuant to RSA 420-J:4, I, health carriers issuing health benefit plans subject to this chapter shall pay claims for covered services rendered to covered persons by a health care provider who, at the time of submission of a clean and complete credentialing application, has a valid license from the respective state licensing board and has been credentialed by the hospital, if appropriate. The claim for covered services rendered by the provider applicant shall be paid at the same contracted rate as the credentialed provider:

(a) When covering on-call for another health care provider who is credentialed by the carrier and billed using the name of the credentialed provider; or

(b) Who, at the time of application, is credentialed by the health carrier in another state or is in the health carrier's New Hampshire network based on employment with a particular health care entity.

II. For purposes of RSA 420-J:4 and this section, a health care provider having a valid license shall include all:

(a) Mental health practitioners licensed under RSA 330-A and applicants for mental health practice licensure from other states who are permitted to practice in this state pursuant to RSA 330-A:26, II.

(b) Psychologists licensed under RSA 329-B and psychologists licensed in another jurisdiction issued a temporary license to practice under RSA 329-B:20, III.


Source. 2007, 98:2, eff. Aug. 10, 2007. 2019, 228:5, eff. Sept. 10, 2019.

    420-J:8-d Dependent Coverage. 

I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "
dependent child
" shall include a subscriber's child by blood or by law, who is under age 26.

I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.

II. Nothing in this section shall be construed to require:

(a) Coverage for services provided to a dependent before the effective date of this section; or

(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.

III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.

IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:

(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section;

(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.

V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).

VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:

(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and

(2) Within 30 days of the effective date of this section.

(b) Such notice shall include information regarding the required special open enrollment period.


Source. 2007, 352:6. 2009, 235:18. 2010, 243:13, eff. Sept. 23, 2010.

    420-J:8-e Reasonable Value of Health Care Services. 

In the event of a dispute between a health care provider and an insurance carrier relative to the reasonable value of a service under RSA 329:31-b or RSA 415-J:3, the commissioner shall have exclusive jurisdiction to determine if the fee is commercially reasonable. Either the provider or the insurance carrier may petition for a hearing under RSA 400-A:17. The petition shall include the appealing party's evidence and methodology for asserting that the fee is reasonable, and shall detail the efforts made by the parties to resolve the dispute prior to petitioning the commissioner for review. The department may require the parties to engage in mediation prior to rendering a decision.


Source. 2018, 356:2, eff. July 1, 2018. 2020, 27:35, eff. July 21, 2020.

    420-J:8-f Non-Covered Dental Services. 

I. No insurer, health care service contractor, health maintenance organization, dental insurer, or any other similar entity, including Delta Dental Plan of New Hampshire Inc., subject to regulation by the insurance department that covers dental services, and no contract or participating provider agreement with a dentist shall require, directly or indirectly, that a dentist who is a participating provider provide services to an enrolled participant at a fee set by, or at a fee subject to the approval of, the regulated entity unless the dental services are covered services.

II. No person providing third party administrator services shall make available for any customers a plan that sets dental fees for providers in its provider network for any services except covered services.

III. In this paragraph "
covered services
" means dental care service for which reimbursement is available under an enrollee's plan contract, or for which reimbursement would be available but for the application of contractual limitations such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or any other limitation.

IV. Fees for covered services shall be set in good faith and shall not be nominal.


Source. 2020, 39:14, eff. Jan. 1, 2021.

    420-J:8 Provider Contract Standards. 

I. Every contract between a health carrier and a participating provider shall set forth a hold harmless provision specifying protection for covered persons. This provision shall include language substantially as follows:

(a) Provider agrees that in no event, including but not limited to nonpayment by the health carrier or intermediary, insolvency of the health carrier or intermediary, or breach of this agreement, shall the provider bill, charge, collect a deposit from, seek payment or reimbursement from, or have recourse against a covered person or a person acting on behalf of the covered person (other than the health carrier or intermediary) for services provided pursuant to this agreement. This agreement does not prohibit the provider from collecting coinsurance, deductibles, or copayments, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to covered persons. Nor does this agreement prohibit a provider and a covered person from agreeing to continue services solely at the expense of the covered person, as long as the provider has clearly informed the covered person that the health carrier may not cover or continue to cover a specific service or services. Except as provided in this chapter, this agreement does not prohibit the provider from pursuing any available legal remedy.

(b) Provider further agrees that:

(1) This provision shall survive the termination of this agreement regardless of the cause giving rise to termination and shall be construed to be for the benefit of the covered person; and that

(2) This provision supersedes any oral or written contrary agreement now existing or hereafter entered into between provider and covered person or persons acting on their behalf.

(c) Any modifications, additions or deletions to the provisions of this section shall become effective on a date no earlier than 15 business days after the commissioner has received written notice of such proposed changes.

II. The execution of a contract by a health carrier shall not relieve the health carrier of its liability to any person with whom it has contracted for the provision of services, nor of its responsibility for the compliance with any law or rule.

III. The health carrier shall maintain provider and intermediary contracts at its principal place of business in this state, or the health carrier shall have access to all contracts and provide copies to facilitate regulatory review upon 15 business days prior written notice from the commissioner.

IV. No contract between a health carrier and a physician, for the purpose of delineating the rights and obligations of the parties within the provider network, shall limit the liability of the health carrier for any actions of the physician for which the health carrier might otherwise be liable.

V. No contract between a health carrier and a health care provider shall limit what information such health care provider may disclose to patients or to prospective patients regarding the provisions, terms, or requirements of the health carrier's products as they relate to the needs of such provider's patients except for trade secrets of significant competitive value.

VI. No contract shall use the term physician for the purpose of allowing a health carrier to avoid contracting with other health care professionals for health care services. A physician shall mean a person licensed to practice medicine under RSA 329. Nothing in this section shall be construed to require a health carrier to contract with a health care provider.

VII. A health carrier shall allow a participating provider 60 days from the postmarked date to review any proposed contract and any modifications to an existing contract, excluding those modifications that are expressly permitted under the existing contract.

VIII. (a) No contract between a health carrier and a participating provider shall contain any payment or reimbursement provision the terms of which creates an inducement for the provider to not provide medically necessary care to covered persons. Nothing in this section shall be construed to prohibit the use of payment arrangements between a health carrier and a participating provider or provider group which involve capitation, withholds or other arrangements.

(b) Prior to the execution of a health care provider contract, a health carrier shall furnish to the contracting entity, in writing or in electronic format, a complete copy of the proposed contract including all attachments and exhibits. The health carrier shall also make available to the contracting entity, in writing or in electronic format, the most current provider manual.

(c) The contracting entity may request that a health carrier disclose the fees applicable to specified procedure codes that pertain to the entity's practice or specialty or a method or process that allows the contracting entity to determine the fees pursuant to the terms of the contract. Upon request by the contracting entity, the insurer shall furnish, in writing or in an electronic format, the requested procedure codes within 30 calendar days from receipt of the request.

(d) No provider contract shall allow for a material change in the applicable fee schedule unless notice of such change is given at least 60 days in advance of the effective date.

(e) Provider contracts that include payment for mammography shall include distinct recognition of and additional payment for industry standard coding relating to mammography screening using 3-D tomosynthesis.

IX. The health carrier shall provide to covered persons, in the evidence of coverage, a description for the types of financial arrangements contained in its contracts with participating providers. Such descriptions shall be set forth in clear, understandable language.

X. Every contract between a health carrier and a participating provider shall provide that the health carrier may not remove a health care provider from its network or refuse to renew the health care provider with its network for participating in a covered person's internal grievance procedure or external review.

XI. Every contract entered into after July 1, 2003 between a health carrier and any physician or facility shall contain a provision that ensures that covered persons will have continued access to the provider in the event that the contract is terminated for any reason other than unprofessional behavior. The continued access to providers shall be made available for 60 days from the date of termination of the contract and shall be provided and paid for in accordance with the terms and conditions of the covered person's health benefit plan and the prior contract between a health carrier and a health care provider. Within 5 business days of the contract termination, the health carrier shall provide written notice to affected covered persons explaining their continued access rights.

XII. [Repealed.]

XIII. No health carrier shall interfere with a provider's right to legal representation during contract negotiations by restricting the provider's right to share confidential information with counsel or by refusing to negotiate directly with counsel selected by a provider as long as the provider receives assurance that counsel agrees to keep confidential the information exchanged during the course of negotiations to the same extent the provider is obligated to keep such information confidential.

XIV. Every contract or contract amendment entered into after the effective date of this paragraph between a health care carrier and any provider or facility shall contain a provision stating that no provider employed by a hospital or any affiliate is required or in any way obligated to refer patients to providers also employed or under contract with the hospital or any affiliate. Nothing in this paragraph shall be construed to prohibit health care carriers from providing coverage for only those services which are medically necessary and subject to the terms and conditions of the covered person's policy.

XV. (a) All contracts between a carrier or pharmacy benefit manager and a contracted pharmacy shall include:

(1) The sources used by the pharmacy benefit manager to calculate the drug product reimbursement paid for covered drugs available under the pharmacy health benefit plan administered by the carrier or pharmacy benefit manager.

(2) A process to appeal, investigate, and resolve disputes regarding the maximum allowable cost pricing. The process shall include the following provisions:

(A) A provision granting the contracted pharmacy or pharmacist at least 30 business days following the initial claim to file an appeal;

(B) A provision requiring the carrier or pharmacy benefit manager to investigate and resolve the appeal within 30 business days;

(C) A provision requiring that, if the appeal is denied, the carrier or pharmacy benefit manager shall:

(i) Provide the reason for the denial; and

(ii) Identify the national drug code of a drug product that may be purchased by contracted pharmacies at a price at or below the maximum allowable cost; and

(D) A provision requiring that, if an appeal is granted, the carrier or pharmacy benefits manager shall within 30 business days after granting the appeal:

(i) Make the change in the maximum allowable cost; and

(ii) Permit the challenging pharmacy or pharmacist to reverse and rebill the claim in question.

(b) For every drug for which the pharmacy benefit manager establishes a maximum allowable cost to determine the drug product reimbursement, the pharmacy benefit manager shall:

(1) Include in the contract with the pharmacy information identifying the national drug pricing compendia or sources used to obtain the drug price data.

(2) Make available to a contracted pharmacy the actual maximum allowable cost for each drug.

(3) Review and make necessary adjustments to the maximum allowable cost for every drug for which the price has changed at least every 14 days.

(c) [Repealed.]

(d) [Repealed.]

XVI. No contract between an insurance carrier or pharmacy benefit manager and a contracted pharmacy shall contain a provision prohibiting divulgence to a covered person or the insurance department relative to monetary matters which would prove beneficial in lowering costs to such covered person.


[Paragraph XVII repealed by 2021, 189:6 effective January 1, 2025.]



XVII. A pharmacy benefit manager shall not require accreditation of providers other than accreditation requirements as adopted by the New Hampshire pharmacy board or by another state or federal entity.


[Paragraph XVIII effective January 1, 2023.]



XVIII. Every contract entered into after September 1, 2022 between a health carrier and any health care provider shall contain a provision that requires the health care provider to notify the carrier when the health care provider is no longer accepting new patients. Notification shall take place no more than 30 days after the date the health care provider is no longer accepting new patients.


Source. 1997, 345:1. 1998, 377:3. 1999, 284:1. 2000, 18:14; 198:1. 2002, 207:11. 2003, 284:2, 9. 2005, 161:1. 2007, 195:1. 2009, 252:3, eff. Sept. 14, 2009. 2016, 177:3, eff. Jan. 1, 2017. 2017, 223:1, eff. July 11, 2017; 223:2, eff. May 1, 2018. 2018, 92:1, eff. May 25, 2018; 92:2, eff. June 30, 2020; 164:1, eff. Jan. 1, 2019. 2019, 226:1, eff. Sept. 10, 2019. 2021, 189:5, eff. Aug. 10, 2021. 2022, 84:1, eff. Jan. 1, 2023.

    420-J:9 Quality Assessment, Quality Improvement, and Reporting. 

I. A health carrier shall:

(a) Establish and maintain a written quality assessment program designed to collect and evaluate information regarding the quality of the health care processes used by the health carrier and the health outcomes of its covered persons.

(b) Establish and maintain a written quality improvement program structured to identify opportunities to improve care, practices that result in improved health care outcomes, problematic utilization patterns, and those providers who may be responsible for either exemplary or problematic patterns of utilization.

II. The quality improvement program shall at a minimum include: a statement of the objectives of the program; a description of how the health carrier will conduct its quality improvement program; the lines of authority and accountability including data collection responsibilities; evaluation tools; performance improvement activities; and an annual effectiveness review.

III. The chief medical officer or clinical director of the health carrier shall have primary responsibility for the quality assessment and quality improvement activities carried out by, or on behalf of, the health carrier and for ensuring that all requirements of this chapter relative to quality assessment and quality improvement are met.

IV. A health carrier shall:

(a) Assure that participating providers have an opportunity to participate in developing, implementing, and evaluating the quality assessment and quality improvement programs.

(b) Maintain at its principal office a copy of the quality assessment program and the quality improvement program which shall be available for inspection by the commissioner or designee at any time during the health carrier's regular business hours.

(c) Certify to the commissioner on or before March 1 of each year that its quality assessment program and its quality improvement program meet the requirements of this chapter and any applicable rules.

(d) Notify the commissioner on or before March 1 of each year of its accreditation by any external accrediting agencies and shall provide a contact person and a phone number for consumer phone calls.


Source. 1997, 345:1, eff. Jan. 1, 1998.

    420-K:1 Definitions. 

In this chapter:

I. "
Assessment
" means the liability of the member insurer to the reinsurance pool.

II. "
Board
" means the board of directors of the small employer health reinsurance pool.

III. "
Bona fide pathway II association coverage
" means coverage, whether self-funded or fully insured, that constitutes an employee welfare benefit plan sponsored by a bona fide pathway II association as defined in RSA 415-E:1.

IV. "
Commissioner
" means the insurance commissioner.

V. "Covered lives" shall include all persons who have health insurance via a health carrier and who are employees or dependents of employees of a small employer, including sole proprietors covered under bona fide pathway II association coverage.

VI. "
Health insurance
" means "health insurance" as defined in RSA 404-G:2, VII.

VII. "
Plan of operation
" means the plan of operation of the small employer health risk adjustment program, including articles, bylaws and operating rules, procedures and policies approved by the commissioner and adopted by the pool.

VIII. "
Small employer
" means "small employer" as defined in RSA 420-G:2, XVI.

IX. "
Small employer health carrier
" means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B that delivers, issues for delivery or maintains in force policies of health insurance in New Hampshire to any small employer. For purposes of this chapter, health carrier shall include any association, organization or arrangement offering or sponsoring bona fide pathway II association coverage.


Source. 2005, 225:12. 2008, 375:7, eff. July 1, 2008. 2019, 346:415, eff. Dec. 1, 2021.

    420-K:2 Establishment of the Risk Adjustment Program. 

I. There is established a nonprofit entity to be known as the "New Hampshire small employer health risk adjustment program." All small employer health carriers issuing or maintaining health insurance in this state shall be members of the program.

II. The commissioner shall give notice to all members of the program of the time and place for the initial organizational meeting. The members shall select the initial board at the organizational meeting and such initial board shall be subject to approval by the commissioner. The members shall elect each subsequent board at the annual meeting of members and each such subsequent board shall be subject to approval by the commissioner. The initial board and each subsequent board shall consist of at least 5 and not more than 9 representatives of members. There shall be no more than one board member on the initial board and each subsequent board representing any one member company. In determining voting rights at the organizational meeting and all subsequent meetings of members, each member shall be entitled to vote in person or by proxy. All such votes shall be proportional to the member's covered lives. To the extent possible, at least 2/3 of members of each board shall be small employer health carriers. The commissioner, or designee, shall be an ex-officio voting member of the board. In approving selection of each board, the commissioner shall assure that all members are fairly represented.

III. If the initial board is not elected at the organizational meeting, the commissioner shall appoint the initial board within 15 days of the organizational meeting.

IV. Within 60 days after the appointment of such initial board, the board shall submit to the commissioner a plan of operation and thereafter any amendments to the plan necessary or suitable to assure the fair, reasonable, and equitable administration of the program. The commissioner shall, after notice and hearing, approve the plan of operation provided he or she determines it to be suitable to assure the fair, reasonable, and equitable administration of the program. The plan of operation shall become effective upon approval in writing by the commissioner consistent with the date on which the coverage under this section shall be made available. If the board fails to submit a suitable plan of operation within 60 days after its appointment, or at any time thereafter fails to submit suitable amendments to the plan of operation, the commissioner shall, after notice and hearing, adopt and promulgate a plan of operation or amendments. The commissioner shall amend any plan adopted by him or her, as necessary at the time a plan of operation is submitted by the board and approved by the commissioner.

V. The board shall select risk adjustment program administrators through a competitive bidding process to administer the program. The board shall evaluate bids submitted based on criteria established by the board.

VI. The plan of operation shall establish procedures for:

(a) Handling and accounting of assets and moneys of the program, and for annual fiscal reporting to the commissioner.

(b) Filling vacancies on the board, subject to the approval of the commissioner.

(c) Selecting an administrator and setting forth the powers and duties of the administrator.

(d) Establishing risk adjustment parameters.

(e) Collecting assessments from all members to provide for risk adjustment payments by the program and for administrative expenses incurred or estimated to be incurred during the period for which the assessment is made.

(f) Any additional matters at the discretion of the board.


Source. 2005, 225:12. 2007, 289:32, eff. Sept. 1, 2007. 2019, 346:416, eff. Dec. 1, 2021.

    420-K:3 Powers of the Program. 

The program may:

I. Enter into contracts as are necessary or proper to carry out the provisions and purposes of this chapter, including the authority, with the approval of the commissioner, to enter into contracts with programs of other states for the joint performance of common functions, or with persons or other organizations for the performance of administrative functions.

II. Sue or be sued, including taking any legal actions necessary or proper for recovery of any assessments for, on behalf of, or against members.

III. Take such legal action as necessary to avoid the payment of improper claims against the program.

IV. Define the array of health coverage products for which risk adjustment will be applied in accordance with the requirements of this chapter.

V. Establish rules, conditions, and procedures pertaining to the risk adjustment mechanism, including implementation and measurement time frames and the permitted risk corridor where no transfer of risk adjustment funds shall take place.

VI. Establish appropriate rates, rate schedules, rate adjustments, rate classifications, and any other actuarial functions appropriate to the operation of the program.

VII. Assess members in accordance with the provisions of this chapter, and to make advance interim assessments as may be reasonable and necessary for organizational and interim operating expenses and to pay claims by the program. Any such interim assessments shall be credited as offsets against any regular assessments due following the close of the fiscal year.

VIII. Appoint from among the members appropriate legal, actuarial, and other committees as necessary to provide technical assistance in the operation of the program, policy, and other contract design, and any other function within the authority of the program.

IX. Borrow money to effectuate the purposes of the program. Any notes or other evidence of indebtedness of the program not in default shall be legal investments for insurers and may be carried as admitted assets.


Source. 2005, 225:12. 2007, 289:30, eff. Sept. 1, 2007. 2019, 346:417, eff. Dec. 1, 2021.

    420-K:4 Risk Adjustment Program. 

I. The board shall:

(a) Develop and monitor a measure of risk to be used in comparing populations covered by small employer health insurance coverage and bona fide pathway II association coverage. The population covered by qualified association trust coverage or by bona fide pathway I association coverage, whether self-funded or fully insured, shall not be a part of the risk adjustment program and, for the purposes of this chapter, shall not be considered to be small group coverage.

(b) Access from the New Hampshire comprehensive health care information system (CHIS), as described under RSA 420-G:11-a, member level information, including length of coverage, gender, age, and diagnosis, sufficient to measure and monitor risk for carriers issuing or administering small employer health insurance.

(c) Perform risk adjustment analysis which may include the use of data from the CHIS, including calculating New Hampshire specific relative weights as necessary, to analyze the difference in the medical care resources expected to be necessary to treat the 2 different populations, one covered in the small group insurance risk pool and the other covered by bona fide pathway II association coverage.

(d) Subject to the limitation in paragraph II, establish risk adjustment payments between carriers that are triggered whenever the average risk over any calendar year between bona fide pathway II association coverage and all other small group coverage differs by more than the maximum allowed amount, and that serve to create a net effect of reducing future expected risk score differences after payments to approximately the target amount. The commissioner shall establish the maximum allowed amount and the target amount by retaining actuarial experts. The standard that the actuarial experts shall use in recommending values for the maximum allowed amount and the target amount is that such amounts should be so determined as to prevent the pathway II association market from having an adverse impact on the availability and choice of coverage in the small group market and to prevent adverse selection against the small group market that is sufficient to cause the average premiums for small groups to increase at a rate that is significantly higher than the trend in claims costs.

(e) Provide a report to the insurance commissioner in a form and format acceptable to the commissioner.

II. The board shall not implement any adjustments until the number of lives covered by bona fide pathway II association coverage exceeds 2,000 member months for 3 consecutive months.


Source. 2005, 225:12, eff. July 1, 2005. 2019, 346:417, eff. Dec. 1, 2021.

    420-K:5 Eligibility, Coverage, and Rates. 

Beginning January 1, 2006 and ending June 30, 2008, members may reinsure with the pool health coverage provided to small employers as follows:

I. The pool shall reinsure the level of coverage provided up to, but not exceeding, the level of coverage provided in the standard health benefit plan or the actuarial equivalent thereof as defined and authorized by the board.

II. The pool shall not reimburse a ceding carrier with respect to claims of a reinsured employee or dependent until the carrier has incurred an initial level of claims for such employee or dependent of at least $5,000 in a calendar year for benefits covered by the standard health benefit plan. The amount of the deductible shall be periodically reviewed by the board and may be adjusted upward as determined by the board.

III. A member may reinsure an entire small employer group within a period of 60 days following the small employer's health insurance policy issue date.

IV. A member may reinsure an eligible employee or dependent of a small employer group:

(a) Within a period of 60 days following the small employer's health insurance policy issue date; or

(b) On the first plan anniversary after the coverage has been in effect for a period of 3 years, and every third plan anniversary thereafter; provided, that reinsurance pursuant to this subparagraph shall only be permitted with respect to eligible employees and their dependents of a small employer which has no more than 5 eligible employees as of the applicable anniversary.

V. A member may reinsure a newly eligible employee or dependent of a small employer group within a period of 60 days following the commencement of his or her coverage.

VI. Reinsurance coverage may be terminated for each reinsured employee or dependent on any plan anniversary.

VII. Reinsurance of newborn dependents shall be allowed only if the mother of any such dependent is reinsured as of the date of birth of such child, and all newborn dependents of reinsured persons shall be automatically reinsured as of their date of birth.

VIII. Notwithstanding the provisions of paragraphs III and IV:

(a) Coverage for eligible employees and their dependents provided under a group policy covering 2 or more small employers shall not be eligible for reinsurance when such coverage is discontinued and replaced by a group policy of another carrier covering 2 or more small employers, unless coverage for such eligible employees or dependents was reinsured by the prior carrier; and

(b) At the time coverage is assumed for such group by a succeeding carrier, such carrier shall notify the pool of its intention to provide coverage for such group and shall identify the employees and dependents whose coverage will continue to be reinsured. The time limitations for providing such notice shall be established by the pool.

IX. The board, as part of the plan of operation, shall establish a methodology for determining premium rates to be charged for reinsuring small employers and individuals. The methodology shall include a system for classification of small employers that reflects the way case characteristics are commonly used by small employer carriers in the state. Pool reinsurance premiums shall be established at the following percentages of the base reinsurance premium rate established by the pool for that classification of small employers with similar case characteristics:

(a) An entire small employer group consisting of 2 or more employees may be reinsured for a rate that is 150 percent of the applicable base reinsurance premium rate for the group established pursuant to RSA 420-K:4, II; and

(b) An eligible employee or dependent may be reinsured for a rate that is 500 percent of the applicable base reinsurance premium rate for the individual established pursuant to RSA 420-K:4, II.

X. On or before December 1, 2005, the board shall establish, subject to the approval of the commissioner, a standard reinsurance underwriting form for use by small employer carriers in ceding risks to the pool. The form may be amended from time to time as the board deems necessary, subject to the approval of the commissioner.

XI. Reinsurance coverage under this chapter shall terminate on December 31, 2008. Reinsurance shall be provided only for covered claims submitted within 2 years from the date the expenses on which the claim is based were incurred.

XII. A member who reinsured an eligible employee or dependent with an initial coverage date or anniversary date on or after January 1, 2008 may elect to terminate coverage for the eligible employee or dependent retroactive to the applicable initial coverage date or anniversary date occurring on or after January 1, 2008. These elections shall be made no later than July 1, 2008. The pool shall reimburse the member for the premium paid on behalf of the eligible employee or eligible dependent and the member shall reimburse the pool for any claims paid by the pool on behalf of the eligible employee or eligible dependent.


Source. 2005, 225:12, 14. 2008, 375:8, 9, eff. July 1, 2008.

    420-K:6 Assessments. 

I. Following the close of each fiscal year, the administrator shall determine the net premiums, the pool expenses of administration and the incurred losses for the year, taking into account investment income and other appropriate gains and losses.

(a) Each member's assessment for the reinsurance pool shall be based on its number of covered lives times a specified assessment rate. The board of directors shall specify the basis used to set the assessment rate. The board of directors shall establish a regular assessment rate, which shall be:

(1) Calculated on a calendar year basis based on the net losses from the audited financial statements of the prior fiscal year;

(2) Established no later than November 1 in the current fiscal year; and

(3) Anticipated to be sufficient to meet the pool's funding needs.

(b) In addition to the regular assessment rate, the board may establish a special assessment rate for organizational expenses and to pay claims reinsured by the pool. Notwithstanding RSA 420-G:4, a writer of health insurance may increase the premiums charged by the amount of the special assessment. Any assessment may appear as a separate line item on a policyholder's bill.

(1) The board shall only establish an interim assessment if the board determines that its funds are or will become insufficient to pay the reinsurance pool's expense or claims reinsured by the pool, in a timely manner.

(2) The regular assessment rate, and any special assessment rate, shall be subject to the approval of the commissioner. The commissioner shall approve the rate if he or she finds that the amount is required to fulfill the purpose of the reinsurance pool. For the purpose of making this determination, the commissioner may, at the expense of the pool, seek independent actuarial certification of the need for the proposed rate.

(c) The board shall impose and collect assessments on members of the pool.

(d) If the assessment exceeds the amount actually needed, the excess shall be held and invested and, with the earnings and interest thereon, be used to offset future net losses. Each covered life shall be included in the assessment on an aggregate basis and procedures shall be maintained to ensure that no covered life is counted more than once.

II. Provision shall be made in the plan of operation for the imposition of an interest penalty for late payment of assessments.

III. The board may defer, in whole or in part, the assessment of a member insurer if, in the opinion of the board, payment of the assessment would endanger the ability of the insurer to fulfill its contractual obligations. In the event an assessment against a member insurer is deferred in whole or in part, the amount by which such assessment is deferred may be assessed against the other members in a manner consistent with the basis for assessments set forth in this chapter. The member insurer receiving such deferral shall remain liable to the pool for the amount deferred. The board may attach appropriate conditions to any such deferral.

IV. The board shall have the authority to continue to impose and collect assessments pursuant to this section until the obligations of the pool have been satisfied in full. The board 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 such other related information as the commissioner may require. The commissioner shall annually review the report on association membership, covered lives, and the payment of assessments to ensure that all insurers that should be members of the association are participating in the association and that all association members have accurately reported covered lives and paid the proper assessment. The board shall remedy any problem identified by the commissioner with respect to membership in the association, reporting of covered lives, or payment of the assessment.


Source. 2005, 225:12. 2007, 289:31. 2008, 375:10, eff. July 1, 2008.

    420-K:7 Immunity and Indemnification. 

I. Neither the participation in the program as members, the establishment of rates, forms, or procedures, nor any other joint or collective action required by this chapter shall be the basis of any legal action against the program or any of its members.

II. Any person or member made a party to any action, suit, or proceeding because the person or member served on the board or on a committee or was an officer or employee of the program shall be held harmless and be indemnified by the program against all liability and costs, including the amounts of judgments, settlements, fines or penalties, and expenses and reasonable attorney's fees incurred in connection with the action, suit, or proceeding. The indemnification shall not be provided on any matter in which the person or member is finally adjudged in the action, suit, or proceeding to have committed a breach of duty involving gross negligence, dishonesty, willful misfeasance, or reckless disregard of the responsibilities of office. Costs and expenses of the indemnification shall be prorated and paid for by all members. The right of indemnification shall not be exclusive of other rights or defenses to which such person or the legal representative or successors of such person, may be entitled to as a matter of law. The commissioner may retain actuarial consultants necessary to carry out his or her responsibilities pursuant to this chapter and such expenses shall be paid by the program established in this chapter.


Source. 2005, 225:12. 2007, 289:33, eff. Sept. 1, 2007. 2019, 346:418, eff. Dec. 1, 2021.

    420-M:1 Purpose. 

The purpose of this chapter is to:

I. Increase the affordability, efficiency, and fairness of health insurance coverage for employers by setting standards for the licensure and oversight of purchasing alliances through which employers and their employees may purchase health coverage.

II. Allow employers and their employees to obtain better value in purchasing health insurance by consolidating purchasing responsibilities and resources, thereby increasing purchasing expertise and reducing the administrative cost of health plan contracting, enrollment, premium collection, and payment for multiple employers.

III. Foster competition based on value.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:10 Marketing Health Benefit Plans. 

I. The alliance shall establish marketing standards for use by participating carriers.

II. Any marketing, advertisement, or educational material for health coverage sold through the alliance shall be approved by the alliance prior to its use.

III. The alliance shall make approved marketing materials available to member employers in an efficient and standardized manner. These materials shall include, but not be limited to, an accurate summary of benefit plans, rates, cost, and accreditation information relating to the offerings of the participating carrier.

IV. This section shall not be construed to prohibit or to compel the alliance or a participating carrier from using the services of an agent or broker.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:11 Conflict of Interest. 

No officer or board member or director or contract administrator of a purchasing alliance or members of their households may be employed by, be a consultant for, be a member of the board of directors of, or be affiliated with, or otherwise be a representative of a carrier or other insurer. This section shall not preclude an officer or board member or director or contract administrator of a purchasing alliance from purchasing health coverage through the alliance.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:12 Purchasing Alliance Distinguished From Multiple Employer Welfare Arrangement. 

Purchasing alliances shall not be risk bearing entities, and shall not enter into a self-insured arrangement.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:13 Qualified Purchasing Alliance. 

A purchasing alliance that has a minimum of 500 enrollees may elect to obtain certification from the commissioner as a qualified purchasing alliance. To obtain certification, a purchasing alliance shall demonstrate:

I. That the purchasing alliance meets all requirements under RSA 415-E to operate as a bona fide pathway II association; and

II. That certification of the applicant as a qualified purchasing alliance will promote the purposes set out in RSA 420-M:1; and

III. That the purchasing alliance has the capacity to monitor and screen sole proprietor members purchasing pathway II association coverage to ensure that they meet all requirements to qualify as an "employee" under 29 C.F.R. section 2510.3-5(b) and meets the per month hourly work requirement contained in RSA 126-AA:2, III.


Source. 2010, 346:1. 2011, 155:2, eff. Aug. 7, 2011. 2019, 346:411, eff. Dec. 1, 2021.

    420-M:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Eligible dependents
" means "eligible dependents" as defined in RSA 420-G:2, V.

III. "
Eligible employee
" means "eligible employee" as defined in RSA 420-G:2, VI.

IV. "
Employee enrollee
" means an eligible employee, self-employed individual, or an eligible dependent of an eligible employee who is enrolled in a health benefit plan offered through an alliance by a participating carrier.

V. "
Health benefit plan
" means "health coverage" as defined in RSA 420-G:2, IX.

VI. "
Health carrier
" or "
carrier
" means "health carrier" as defined in RSA 420-G:2, VIII.

VII. "
Member employer
" means an employer who enrolls in an alliance.

VIII. "
Participating carrier
" means a carrier that contracts with the alliance.

IX. "
Purchasing alliance
" or "
alliance
" means a non-risk bearing corporation or other entity licensed pursuant to RSA 420-G:10-a that provides health insurance coverage to member employers and their employees.

X. "
Qualified purchasing alliance
" means a purchasing alliance that has obtained certification from the commissioner under RSA 420-M:13 as a qualified purchasing alliance with authority to sponsor fully-insured bona fide pathway II association coverage under RSA 415-E.

XI. "
Small employer
" means "small employer" as defined in RSA 420-G:2, XVI.


Source. 2010, 346:1, eff. July 20, 2010. 2019, 346:410, eff. Dec. 1, 2021.

    420-M:3 Jurisdiction of the Commissioner;  Penalties. 

I. The commissioner shall regulate the establishment and conduct of purchasing alliances.

II. No person or entity, other than a qualified association trust, shall market, sell, offer, or arrange the sale of one or more health benefit plans to 2 or more employers or their eligible employees without first being licensed by the commissioner pursuant to this chapter.

III. A person or entity, not licensed by the commissioner as a purchasing alliance and engaged in the purchase, sale, marketing, or distribution of health insurance or health care benefit plans shall not hold itself out as a health insurance purchasing alliance, health insurance purchasing cooperative, or a health insurance purchasing association.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:4 Purchasing Alliance Application and Licensing. 

To obtain authority to operate as a purchasing alliance, an application shall be completed and filed with the commissioner by an authorized representative of the corporation or other entity established to operate as a purchasing alliance. An application shall not be deemed filed until all information necessary to properly process the application has been received by the commissioner. Upon filing, the commissioner shall make a determination concerning the application and shall provide notice of the determination to the applicant. If approved, a copy of a license shall be provided to the purchasing alliance. The license shall serve as authorization to operate pursuant to this chapter.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:5 Preparation of a Business Plan and Other Required Documents. 

I. The application for a purchasing alliance shall include a business plan containing the following information:

(a) A detailed, written plan of operations explaining how the applicant intends to fulfill the purposes and requirements of this chapter;

(b) The specific steps that the alliance will use to increase affordability, efficiency, and fairness of health insurance coverage;

(c) The specific steps that the alliance will use to allow employers and their employees to obtain better value in purchasing health insurance;

(d) The scope of services to be offered and the resources and expertise to be used to implement and administer those services;

(e) A provision requiring that any coverage procured by the alliance shall require that the members of the alliance be notified directly by the insurer of cancellation due to nonpayment of premium;

(f) The personal biographical information and descriptions of the officers of the alliance;

(g) A written statement demonstrating that those involved in the operation of the alliance have the expertise and experience to effectively and professionally represent employers and their eligible employees; and

(h) An affirmative demonstration that financial controls are in place as a condition of licensure.

II. In addition to the business plan, each applicant shall file with the commissioner the following information or documents:

(a) A plan that affirmatively demonstrates that the alliance has the technical expertise and capacity to serve a significant group of employers and their eligible employees;

(b) A plan that demonstrates that the alliance has the technical capacity to provide service quality;

(c) The applicant's articles of incorporation, bylaws, or other formation and business operation documents;

(d) A list of officers and directors of the applicant and the contract administrator, if one is employed, and personal biographical information or firm descriptions for each;

(e) Evidence of security and prudence in the accounting, deposit, collection, handling, and transfer of moneys; and

(f) A description of the service area in which the alliance will be marketing and offering services.

III. Material changes in the operations or the business plan shall not take effect without approval from the commissioner.

IV. The commissioner shall conduct financial and performance audits or examinations of an alliance on a regular basis. The commissioner shall require audited financial statements from an alliance. The costs of examinations or audits shall be paid by the alliance.

V. A purchasing alliance shall submit an annual report no later than April 1 of each year that includes quarterly financial statements that show:

(a) The alliance is operating in a sound financial fashion;

(b) The alliance is not a risk-bearing entity; and

(c) The alliance is utilizing sound financial controls and money management.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:6 Revocation of License and Insolvency. 

I. The following intentional acts shall constitute grounds for denial, non-renewal, suspension, or revocation of an application or existing license, following notice and an opportunity for hearing:

(a) Failure to comply with the provisions of RSA 420-G;

(b) Failure to comply with the business plan filed and approved by the commissioner;

(c) Failure to maintain adequate financial controls;

(d) Failure to extend alliance health benefit plan coverage to eligible employees;

(e) Failure to comply with a lawful order of the commissioner;

(f) Engaging in an unfair or deceptive act or practice;

(g) Filing any necessary form, including the application form, with the commissioner that contains false or materially incorrect information or omissions; or

(h) Misappropriation, conversion, illegal withholding, or refusal to pay over upon proper demand any moneys that belong to a person or participating carrier and that have been entrusted to the alliance in its fiduciary capacity.

II. The commissioner shall require the removal and replacement of managerial or marketing staff or third party contractors if necessary to remedy compliance or performance problems.

III. In the event the alliance becomes insolvent, the commissioner shall place the alliance in receivership if necessary to protect the interests of alliance enrollees.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:7 Powers and Duties of Purchasing Alliances;  Restrictions on Purchasing Alliances. 

I. A purchasing alliance shall:

(a) Offer health benefit plans that are available to all member employers;

(b) Establish administrative and accounting procedures for operating the alliance, for providing services to member employers and enrollees, and for preparing an annual budget;

(c) Develop standard enrollment procedures for enrolling employers and their eligible employees and dependents;

(d) Establish procedures for open enrollment periods;

(e) Establish conditions of participation for small employers that conform to the requirements of RSA 420-G and include, but are not limited to, the following:

(1) Assurances that the member employer is an employer group and is not formed for the purpose of securing health benefits coverage; and

(2) Prepayment of premiums or other mechanisms to assure that payment will be made for coverage;

(f) Establish membership criteria that allow any employer to participate in the alliance or that limit participation in the alliance to employers that are members of or affiliated with an association, trade group, or other entity that has been in existence for at least 10 years and was established and maintained for purposes other than the provision of health coverage;

(g) Provide that each eligible employee is permitted to enroll in any health benefit plan offered by any participating carrier so long as the health benefit plan provides coverage where he or she works or lives;

(h) Establish conditions of participation for participating carriers;

(i) Develop and make available a list of objective criteria that shall be met by a participating carrier offering coverage to alliance members;

(j) Establish conditions of participation for agents or brokers;

(k) Provide to alliance members clear, standardized information on the health benefit plan including information on:

(1) Price;

(2) Benefits;

(3) Enrollee costs;

(4) Quality;

(5) Patient satisfaction;

(6) Enrollment; and

(7) Grievance procedures and rights and responsibilities;

(l) Transmit enrollment and eligibility information to participating carriers on a timely basis;

(m) Specify in contracts with participating carriers how all premiums shall be transmitted and the frequency of that transmission and how penalties and grace periods on late payments of premiums shall be calculated;

(n) Have a fiduciary duty with respect to all moneys received or owed to it to assure payments of its obligations and a full accounting to its members and the commissioner; and

(o) Submit to the commissioner quarterly financial statements, annual reports, and proposed material changes in the policy and/or operations or the business plan.

II. A purchasing alliance may:

(a) Receive, review, and act on grievances against participating carriers by member employers or enrollees;

(b) Require participating carriers to maintain health care data;

(c) Maintain a trust account or accounts for deposit of all moneys received and collected for the operation of the alliance;

(d) Establish procedures and mechanisms for billing and collection of premiums from member employers, including collection of any share of the premium paid by employee enrollees;

(e) Review information and recommendations from consumers, employers, participating carriers, or health care providers and other sources, and issue periodic reports or recommendations to the commissioner to improve the delivery of health services and the purchasing of health coverage;

(f) Develop model contracts that describe for potential contractors the requirements of the alliance and provide a copy of the contract to interested carriers;

(g) Place into its contracts between the alliance and member employers the following:

(1) A provision stating that, for administrative purposes, the alliance shall be the policyholder or contract holder of the health benefit plan on behalf of member employers, their eligible employees, and eligible dependents; and

(2) A provision stating that the participating carrier shall issue a certificate of coverage, or equivalent document, specifying the essential features of the health benefit plan's coverage to each enrolled eligible employee;

(h) Undertake any activity necessary to administer the alliance, including marketing and publicizing the alliance, and assuring that participating carriers, contractors, participating employers, and enrollees are in compliance with alliance requirements;

(i) Establish contracts with participating carriers to provide health coverage to alliance members;

(j) Establish contracts with employer members;

(k) Contract with qualified, independent third parties for services necessary to carry out the powers and duties of the alliance;

(l) Appoint advisory committees, as necessary, to provide technical assistance in the operation of the program and in carrying out the purposes of this chapter;

(m) Assess member employers a fee for costs incurred or anticipated in connection with the operation of the alliance;

(n) Require as a condition of membership that employers include a minimum percentage of employees in coverage purchased through the alliance;

(o) Reject or allow a carrier to reject an employer from membership or drop or allow a carrier to drop a member employer if the member fails to pay premiums or engages in fraud or material misrepresentation in connection with a health benefit plan purchased through the alliance;

(p) Contract with licensed insurance agents or brokers to market and service coverage made available through the alliance to its members. Compensation for agents and brokers shall not vary based on the actual or expected health status or medical utilization of the group to which coverage is sold;

(q) Define a set of standardized requirements that the alliance shall use to purchase insurance from a carrier;

(r) Require that member employers and their eligible employees continue to pay administrative fees that are part of the contract with the alliance if a member employer or enrollee cancels prior to completion of a contract period or membership period established by the alliance;

(s) Negotiate the premium rates charged for coverage offered through the alliance and, for small employer members, ensure that rates are consistent with the rating restrictions contained in RSA 420-G;

(t) Request such information from participating carriers as is necessary to carry out the powers and duties of this chapter;

(u) Sue or be sued, including taking action necessary for securing legal remedies on behalf of the alliance, member employers, or enrollees;

(v) Apply for loans or loan guarantees from the New Hampshire business finance authority for the purpose of funding startup costs;

(w) Receive and accept loans, grants, funds, or anything of value from a public or private entity including:

(1) Employer premiums;

(2) Employer participation fees;

(3) Employer late fees;

(4) Employer reinstatement fees;

(5) Agent and broker fees paid by the employer;

(6) Interest earned on accounts;

(7) Funds paid by the participating carriers for a pooled marketing effort;

(8) Public sector and private sector grants, gifts, loans, or donations; or

(9) Other lawful sources;

(x) Receive and accept contributions of property, labor, or any other thing of value;

(y) Expend funds to pay:

(1) Participating carriers under their contracts;

(2) Third parties for services provided under contract;

(3) Employer billing adjustments;

(4) Agent and broker fees;

(5) The alliance's administrative expenses; and

(6) All other expenditures duly authorized by the board;

(z) Exercise all powers reasonably necessary to carry out the powers granted and duties imposed under this chapter; and

(aa) Enter into all other contracts as are necessary to carry out the powers and duties of the alliance.

III. A purchasing alliance shall not:

(a) Purchase health care services directly, assume risk for the cost or provision of health care services, or otherwise contract with health care providers for the provision of health care services to enrollees.

(b) Exclude from membership in the alliance an employer, eligible employee, or eligible dependent of an eligible employee who meets the alliance's membership criteria and who agrees to pay fees for membership and the premium for health coverage through the alliance and who abides by the bylaws and rules of the alliance.

(c) As a condition of membership, require an employer, eligible employee, or eligible dependent to subscribe to limited health coverage or non-health coverage related products or services.

(d) Engage in any act or practice that results in the selection of member employers and enrollees based on industry type, experience, gender, family status, education, health status, income, employer size, or other factors related to the risk profile of the group.

(e) Require or take any action inconsistent or in conflict with state laws or regulations.


Source. 2010, 346:1. 2011, 155:1, eff. Aug. 7, 2011.

    420-M:8 Contracts With Participating Carriers. 

The contracts entered into by the alliance shall:

I. Establish performance standards for specific contractual elements;

II. Set liquidated damages for breach of the contract;

III. Require the insurer to notify the member employers of cancellation of the policy;

IV. Require the member employers in the event of cancellation to arrange for continuation coverage for their employees to the extent provided under federal and state law; and

V. Contain a provision stating that if after timely receipt of the premium payment from the employer, the alliance fails to make the premium payment to the insurer, with the result that coverage is terminated, that the alliance shall be liable for benefits to the same extent as the insurer or carrier would have been liable if coverage had not been terminated.


Source. 2010, 346:1, eff. July 20, 2010.

    420-M:9 Requirements for Participating Carriers. 

I. To qualify as a participating carrier, a carrier shall demonstrate the following characteristics:

(a) That it is licensed and in good standing with the insurance department;

(b) That it has the ability to administer health coverage, to provide adequate service, and to comply with all contractual requirements of the alliance;

(c) That it has the ability to provide enrollees with access to covered services;

(d) That it has the ability to provide coverage for enrollees in any service area in which the carrier plans to participate through the alliance;

(e) That it has the ability to arrange and pay for quality health care services;

(f) That it has the ability to provide standard data required by the alliance, in a manner prescribed by the alliance, including information on:

(1) Plan performance;

(2) Enrollee satisfaction;

(3) Provider payment and incentive structures; and

(4) Such other data requirements prescribed by the alliance;

(g) That it has the ability to meet quality of care standards established by government and industry authorities; and

(h) That it is financially strong and has competent management.

II. Participating carriers that contract with or employ health care providers shall have the ability to accomplish the following in a manner satisfactory to the alliance:

(a) Review and report on the cost and quality of care covered;

(b) Review and report on the appropriateness of care covered; and

(c) Provide accessible health care services.

III. Each participating carrier shall:

(a) Meet the standards established by the alliance pursuant to this chapter;

(b) Provide data and information as required by the alliance;

(c) Comply with all laws and rules regarding underwriting, rating, claims handling, sales, solicitation, licensing, fair marketing, unfair trade practices, the provisions of this chapter, and other applicable state statutes;

(d) Enroll and terminate individuals in the manner specified by the alliance; and

(e) Comply with other requirements established by the alliance pursuant to this chapter.

IV. Nothing in this chapter shall prohibit participating carriers from contracting with particular health care providers or types, classes, or categories of health care providers, or setting reimbursement methodology.

V. In the event that the participating carrier elects to terminate its contract with the alliance, the participating carrier shall:

(a) Provide advance notice of its decision to the alliance; and

(b) Provide notice of the decision at least 180 days prior to the non-renewal of health coverage to the member employers and employee enrollees.


Source. 2010, 346:1, eff. July 20, 2010.

    420-N:1 Purpose and Scope. 

The intent of this chapter is to preserve the state's status as the primary regulator of the business of insurance within New Hampshire and the constitutional integrity and sovereignty of the state of New Hampshire under the Tenth Amendment to the United States Constitution and part I, article 7 of the New Hampshire constitution and the insurance commissioner's administration of the insurance reforms required under the Patient Protection and Affordable Care Act of 2009, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, including any federal regulations, interpretations, standards, or guidance issued thereunder (hereinafter "the Act").


Source. 2011, 264:1. 2012, 231:1, eff. June 18, 2012. 2017, 221:5, eff. July 10, 2017; 221:9, eff. July 1, 2020. 2022, 323:20, eff. Sept. 6, 2022.

    420-N:10 Repealed by 2020, 37:52, eff. Sept. 27, 2020. 

    420-N:2 Definitions. 

In this chapter:

I. "
Act
" means the Patient Protection and Affordable Care Act of 2009, Public Law 111-148, as amended by the Health Care and Education Reconciliation Act of 2010, Public Law 111-152, including any federal regulations, interpretations, standards, or guidance issued thereunder.

II. "
Commissioner
" means the insurance commissioner.

III. [Repealed.]


Source. 2011, 264:1, eff. July 1, 2011. 2017, 221:6, eff. July 10, 2017; 221:10, eff. July 1, 2020. 2022, 323:1, V(b), eff. Sept. 6, 2022.

    420-N:3 Repealed by 2022, 323:1, V(a), eff. Sept. 6, 2022. 

    420-N:4 Repealed by 2022, 323:1, V(c), eff. Sept. 6, 2022. 

    420-N:5-a Repealed by 2014, 201:2, eff. Jan. 1, 2019. 

    420-N:5 Authority of the Commissioner. 

The commissioner shall have authority to:

I. Make, adopt, and amend rules and regulations pursuant to RSA 541-A for, or as an aid to, the administration of any provision of the Act relating to insurance;

II. Apply for any public or private grant funds available under the Act;

III. Apply for any waiver available under any specific provision of the Act;

IV. Adopt and apply standards consistent with the Act for form and rate review of insurance products and any other regulatory oversight functions performed by the department; and

V. Enforce the consumer protections and market reforms set forth in the Act that relate to insurance. This shall not include the medical assistance program under RSA 167.


Source. 2011, 264:1, eff. July 1, 2011. 2022, 323:21, eff. Sept. 6, 2022.

    420-N:6-a Waiver. 

If such action is supported by the recommendations of actuarial experts retained by the department as being consistent with the purposes of RSA 404-G:1, I, the commissioner shall, at the earliest practicable date, submit an application on behalf of the state to the United States Secretary of the Treasury, and if required, to the United States Secretary of Health and Human Services, to waive certain provisions of the Act, as provided in section 1332 of the Act, or any other applicable waiver provision in order to create a risk sharing or reinsurance mechanism for the individual market under RSA 404-G which is eligible to draw down federal pass-through funding to support such mechanism. The commissioner shall publish and accept public comment on the 1332 waiver application and the plan of operation for the individual market mechanism prior to approving such plans. The commissioner shall implement any federally approved waiver, including but not limited to overseeing the implementation of a revised plan of operations under RSA 404-G:12.


Source. 2017, 221:7, eff. July 10, 2017. 2019, 346:421, eff. July 1, 2019. 2022, 323:22, eff. Sept. 6, 2022.

    420-N:6 Repealed by 2012, 231:3, I, eff. June 18, 2012. 

    420-N:7 Prohibition on State-Based Health Exchange;  Guidelines for Interaction With Federally-Facilitated Health Exchange. 

I. No New Hampshire state agency, department, or political subdivision shall plan, create, participate in or enable a state-based exchange for health insurance under the Act, or contract with any private entity to do so.

II. State agencies or departments may interact with the federal government with respect to the creation of a federally-facilitated exchange for New Hampshire.

III. Subject to the requirements of this chapter, state agencies or departments may operate specific functions of a federally-facilitated exchange consistent with this subdivision to enable the continuation of traditional areas of state regulation and authority.

IV. State agency activities relating to any federally-facilitated exchange for New Hampshire shall be consistent with the following objectives:

(a) Promoting preservation of the private, commercial delivery of health coverage through carriers and producers to the greatest degree possible under the Act and minimizing interference with the operation of commercial markets.

(b) Minimizing overhead and administrative expenses.

(c) Promoting competition and consumer choice, for example by advocating for allowing all health and dental plans that meet the minimum requirements necessary to be certified as qualified plans under the Act to be offered in the exchange.

(d) Preserving to the greatest extent possible the state's insurance regulatory authority and the state's flexibility in determining Medicaid eligibility standards and program design and operation.


Source. 2012, 231:2, eff. June 18, 2012. 2022, 323:23, eff. Sept. 6, 2022.

    420-N:8 Federally-Facilitated Exchange;  Authority of the Commissioner. 

I. In the event a federally-facilitated exchange is established for New Hampshire, the commissioner shall retain authority with respect to insurance products sold in New Hampshire on the federally-facilitated exchange to the maximum extent possible by law as provided in title XXXVII, including but not limited to producer and insurer licensing, form and rate approval, reinsurance and other risk-sharing mechanisms, network adequacy, industry assessments, internal grievance standards, external review, and unfair trade practices.

II. Any person who sells, solicits, or negotiates insurance within the meaning of RSA 402-J:3 through a federally-facilitated exchange shall be licensed as a producer under RSA 402-J; provided, that nothing in this subdivision shall prohibit the sale of health coverage by an exchange or health carrier directly to the consumer without the use of a producer. This paragraph shall not be interpreted to require that all navigators as defined under the Act be licensed as producers, but rather that any individual who in fact performs a producer function be licensed, whether or not that person is employed by a navigator.

III. The commissioner may establish standards and training requirements for navigators on a federally-facilitated exchange consistent with section 1311(i) of the Act and regulations implemented under the Act, including provisions to ensure that any private or public entity that is selected as a navigator avoids conflicts of interest and is appropriately qualified to engage in navigator activities.

IV. The commissioner shall, consistent with the requirements of the Act, allow producers to enroll individuals, employers, or employees in qualified health plans offered through a federally-facilitated exchange in this state, including enrollment using Internet websites.

V. The commissioner may adopt rules, pursuant to RSA 541-A, as necessary to perform the duties specified in this section and to protect against adverse selection by creating a level playing field between a federally-facilitated exchange and the commercial health insurance market.


Source. 2012, 231:2, eff. June 18, 2012. 2022, 323:24, eff. Sept. 6, 2022.

    420-N:9 Federally-Facilitated Exchange;  Authority of the Health and Human Services Commissioner. 

I. The commissioner of health and human services shall have authority to establish New Hampshire eligibility standards, enrollment procedures, and outreach mechanisms for persons who are enrolled through a federally-facilitated exchange in this state in the Medicaid program under title XIX of the Social Security Act or the Children's Health Insurance Program (CHIP) under title XXI of the Social Security Act.

II. The commissioner of health and human services may establish navigator guidelines for New Hampshire consistent with section 1311(i) of the Act, and regulations implemented under the Act, to ensure that navigators are qualified to reach and assist the Medicaid-eligible and other populations served by a federally-facilitated exchange in New Hampshire.

III. The commissioner of health and human services may adopt rules, pursuant to RSA 541-A, as necessary to fulfill the purposes of this subdivision.


Source. 2012, 231:2, eff. June 18, 2012. 2022, 323:25, eff. Sept. 6, 2022.

    420-O:1 Purpose and Scope. 

I. The purpose of this chapter is to set forth standards and procedures for not-for-profit private and public institutions of higher education which provide 4 year bachelor's degree programs and graduate or professional degree programs, and which have a history of providing for the health insurance needs of their students by implementing self-funded student health benefit plans, to obtain authorization to continue this practice.

II. This chapter shall apply only to self-funded student health benefit plans, not to fully-insured student major medical expense coverage, which is governed by RSA 415:19-a and other applicable provisions of Title XXXVII. Nothing in this chapter shall be construed to prohibit an educational institution from purchasing fully-insured student health coverage offered pursuant to RSA 415:19-a.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:10 Termination of Plan. 

I. In any case in which an institution determines that there is a reason to believe that the student health plan will terminate, the institution shall so inform the commissioner at least 60 days prior thereto, and shall file a sworn statement with the commissioner concerning all current and future liabilities under its discontinued plan. The institution also shall submit a plan for the superintendent's approval for winding up the plan's affairs in an orderly manner designed to result in timely payment of all benefits, in such form and manner as the commissioner may prescribe.

II. Any funds of the institution, as they pertain to the student health plan, shall be accounted for separate and apart from all other assets, liabilities, income, and expenses of the institution until all plan benefits and other plan obligations have been satisfied. Until such time, the institution shall continue to maintain and fund the reserve funds required to be established under RSA 420-O:5. If at any time the commissioner determines that additional funds shall be deposited in the reserve funds, then the institution shall make the deposit within 5 days of the commissioner's determination.

III. If, after 24 months, or such longer period as deemed necessary by the commissioner, all plan benefits and other plan obligations have been satisfied, the institution, upon approval by the commissioner, shall no longer be required to maintain assets within the plan's reserve funds.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:11 Administrative Rules. 

The commissioner may adopt rules under RSA 541-A necessary to implement the provisions of this chapter and to ensure that the plans established under this chapter are in the best interests of the students, students' spouses, students' children, and other persons chiefly dependent upon the students for support and maintenance.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:12 Penalties. 

Any institution of higher education that violates this chapter shall be subject to the penalties set forth in RSA 400-A:15 or such other section of the insurance code as may be applicable, including but not limited to RSA 420-J and RSA 417.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:2 Definitions. 

In this chapter:

I. "
Commissioner
" means the insurance commissioner.

II. "
Plan document
" means evidence of coverage furnished to a student that sets forth all benefits and terms and conditions, with regard to a student health plan.

III. "
Qualified actuary
" means an actuary who is a member in good standing of the American Academy of Actuaries or Society of Actuaries, with experience in establishing rates for self-insured trusts providing health benefits or other similar experience.

IV. "
Institution of higher education
" or "
institution
" means an educational institution in New Hampshire that:

(a) Admits as regular students only persons having a certificate of graduation from a school providing secondary education, or the recognized equivalent of such a certificate, or persons who have completed a secondary school education in a home school setting that is treated as a home school or private school under the laws of this state;

(b) Is legally authorized within New Hampshire to provide a program of education beyond secondary education;

(c) Provides an educational program for which the institution awards a bachelor's degree, graduate degree, or professional degree;

(d) Is a public or other nonprofit institution;

(e) Is accredited by a nationally recognized accrediting agency or association; and

(f) Has a history of providing for the health insurance needs of its students through a self-funded student health benefit plan.

V. "
Student
" means a person enrolled in a degree program in an institution of higher education and may include a postdoctoral fellow.

VI. "
Student health plan
" or "
plan
" means any self-funded plan established or maintained by an institution of higher education for the purpose of providing medical, surgical, or hospital services to a student, the student's spouse or domestic partner, the student's child or children, or other persons chiefly dependent upon the student for support and maintenance.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:3 Certificate of Authority. 

I. An institution of higher education shall not establish, maintain, or otherwise participate in a student health plan in this state unless the institution obtains and maintains a certificate of authority from the commissioner pursuant to this chapter.

II. To obtain a certificate of authority, an institution shall file an application on such form as the commissioner may prescribe, and shall provide to the satisfaction of the commissioner the following:

(a) A copy of the student contract, including a table of the premium rates charged or proposed to be charged.

(b) A report indicating the benefit provisions, premium rates or premium equivalents, and incurred medical losses associated with the institution's students under the insurance policy or self-funded plan insuring the institution's students, for the 3 years prior to the date of the application.

(c) The most recent certified independently-audited financial statement for the institution.

(d) A report prepared by a qualified actuary that supports the proposed premiums for the plan.

(e) A copy of all agreements between the institution and any plan administrator, with regard to the student health plan.

(f) A balance sheet, including actuarially determined claims liabilities, and statement of revenue and expenses, including reasonably projected expenses, medical losses, and premiums to be charged to students for the plan during the first 3 years.

(g) A narrative description of the:

(1) Accounting methodology that the institution will utilize, including a description of the separate accounts for revenues and expenses, including medical and hospital expenses and administration expenses, reserves for claims and expenses thereon, including incurred-but-not-reported, unearned premium reserves, contingent reserves, and any asset accounts, including cash, premiums receivable, and investments, relevant to the plan. The accounts may be established within the institution's general accounting ledger system; provided the general ledger accounts are clearly identifiable as pertaining to the plan, including any such accounts allocated to the plan;

(2) Billing and claim payment procedures, including the names and contact information for those persons charged with handling accounting and claims issues; and

(3) Any compensation the institution will receive in connection with the plan.

(h) A copy of any stop-loss insurance policy issued or proposed to be issued by an insurer authorized to do the business of accident and health insurance in this state.

(i) Evidence of the student health plan's recognition as minimum essential coverage by the United States Department of Health and Human Services pursuant to 45 C.F.R. section 156.604.

(j) Such other information as the commissioner may require.

III. To maintain a certificate of authority, an institution shall:

(a) Have on a continuous basis within its own organization adequate resources and competent personnel to administer the student health plan or, in order to provide such administrative services, in whole or part, have contracted with a person or entity to serve as a plan administrator; provided that any such contracted plan administrator shall be in good standing under RSA 402-H or any other requirements of Title XXXVII applicable to administration of the plan.

(b) Establish and maintain premium equivalents sufficient to meet its contractual obligations and to satisfy the reserve requirements set forth in RSA 420-O:5.

(c) Comply with consumer protection requirements under Title XXXVII, including, but not limited to, RSA 420-J, and rules adopted thereunder, RSA 417, and the department's claims processing rules, including the requirements for claims review, network adequacy, dispute resolution, and appeal procedures.

(d) Provide covered students with a copy of the plan document annually.

(e) Maintain recognition of the student health plan as minimum essential coverage in accordance with 45 C.F.R. section 156.604.

(f) File all plan documents, including the plan document, premium equivalents, and any changes in contracts or stop-loss coverage with the commissioner annually at least 60 days prior to the start of the plan year, and receive the commissioner's approval in accordance with Title XXXVII prior to the coverage start date.

(g) File an annual report with the commissioner in accordance with RSA 420-O:6.

IV. Upon compliance by the institution with the requirements under paragraph II, and demonstration of capacity to comply with the requirements of paragraph III, the commissioner may issue a certificate of authority to an applicant. Every certificate of authority shall contain the name of the certified entity and its home office address. The commissioner shall refuse to grant a certificate of authority to an applicant that fails to meet the requirements of this section. The commissioner may refuse to issue any certificate of authority if, in the commissioner's judgment, the refusal will best promote the interests of the people of this state.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:4 Minimum Loss Ratio;  Reporting. 

I. A plan under this chapter shall have an expected loss ratio of not less than 85 percent. In reviewing a rate filing or application by a plan, the commissioner may modify the expected minimum loss ratio requirement if the commissioner determines the modification to be in the interests of the people of this state or if the commissioner determines that a modification is necessary to maintain plan solvency.

II. No later than 120 days after the close of a plan's fiscal year, a plan shall annually report the actual loss ratio for the previous plan fiscal year in a format acceptable to the commissioner. If the expected loss ratio is not met, the commissioner may direct the plan to take corrective action. Mandatory uniform student administrative health fees paid by the students irrespective of whether the student is a plan member to an institution shall not be deemed to be included in the premiums paid by students for health benefit coverage under a plan.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:5 Reserves. 

I. An institution shall establish reserves with the amounts necessary to satisfy all contractual obligations and liabilities of the plan, including:

(a) Funds for the payment of claims and expenses thereon reported but not yet paid, and claims and expenses thereon incurred but not yet reported, which shall not be less than an amount equal to 25 percent of expected incurred claims and expenses thereon for the current plan year, unless a qualified actuary has demonstrated to the commissioner's satisfaction that a lesser amount shall be adequate.

(b) Funds for unearned premium equivalents, computed pro-rata on the basis of the unexpired portion of the policy period.

(c) Contingency funds, established and maintained for the sole purpose of satisfying unexpected obligations of the plan in the event of termination of the plan.

II. The reserve statement shall be prepared by a qualified actuary. If at any time the reserve funds required to be established pursuant to this section fall below the required minimum amounts, then the institution shall immediately notify the commissioner of such impairment. The institution shall cure the impairment within 5 business days.

III. The plan's assets, liabilities, income, and expenses shall be accounted for separate and apart from all other assets, liabilities, income, and expenses of the institution.

IV. The requirements for funding of the plan's reserves shall be calculated using generally accepted accounting principles. Only those expenses that relate to the plan shall be included in calculating the requirements for funding of the plan's reserve funds. Expenses allocated to the plan shall be allocated on an equitable basis in conformity with generally accepted accounting principles consistently applied. The books, accounts, and records of the plan shall be maintained to clearly and accurately disclose the nature and details of all expenses to support the reasonableness of such expenses.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:6 Annual Report. 

I. Within 120 days of the close of its fiscal year, an institution of higher education operating under a certificate of authority issued under this chapter shall file with the commissioner a report that contains:

(a) An annual financial statement, verified by the oath of the chief financial officer and at least one of the institution's principal officers with direct knowledge of the operations of the student health plan, showing the financial condition of the plan during the most recent fiscal year, in accordance with law and generally accepted accounting principles, in a form prescribed by the commissioner.

(b) The identity of the qualified actuary utilized by the institution or plan and the amount paid to the qualified actuary by the institution or plan during its most recent fiscal year.

(c) The identities of all vendors involved in plan administration during its most recent fiscal year.

(d) The name and contact information of the person or entity appointed by the institution to administer the student health plan.

(e) A pro-forma statement of projected revenue and expenses for health benefits anticipated by the plan for the next 12-month period of the plan's operation, provided on a fiscal year basis.

(f) A detailed report of the operations and condition of the plan's reserve funds.

(g) Such other information as the commissioner may require.

II. The annual financial statement shall show the financial results of the student health plan operations and a description as to how the institution meets the reserve requirements in RSA 420-O:5, I, the method used to calculate the reserves, and the change in the reserves from the beginning of the plan's fiscal year to the end of the plan's fiscal year. In addition, the annual financial statement shall detail the assets comprising the reserve fund to demonstrate compliance with RSA 420-O:5, I.

III. An institution that fails to file any report or statement required by this chapter, or fails to reply within 30 days to a written inquiry by the commissioner in connection therewith shall, in addition to other penalties provided by this title, be subject, upon due notice and opportunity to be heard, to a penalty of up to $1,000 per day of delay, not to exceed $25,000 in the aggregate, for each such failure.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:7 Examination. 

The commissioner may, pursuant to RSA 400-A:37, make an examination into the affairs of any institution, with regard to a student health plan issued by the institution, as often as the commissioner deems it expedient for the protection of the interests of the people of New Hampshire. The expenses of every examination of the affairs of an institution, with regard to a student health plan established or maintained by the institution, shall be borne and paid by the institution so examined. The expenses of examination shall include reimbursement for the compensation paid for the services of persons employed by the commissioner or by the commissioner's authority to make such examination, and for the necessary traveling and living expenses of the person or persons making the examination.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:8 Investigations;  Subpoenas. 

The commissioner may make such investigations as he or she deems necessary both within and outside the state in accordance with the provisions of RSA 400-A:16 and RSA 400-A:20-22.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-O:9 Suspension or Revocation of Certificate of Authority. 

I. The commissioner may suspend or revoke a certificate of authority issued to an institution under this chapter upon a finding, after notice and hearing, that the institution has failed to comply with any requirement imposed on it under this chapter or necessary to maintain minimum essential coverage status and that in the commissioner's judgment such suspension or revocation is reasonably necessary to protect the interests of the people of this state, including:

(a) For any cause that would be a basis for denial of an initial application for such a certificate;

(b) Failure to maintain the reserves required by RSA 420-O:5; or

(c) The commissioner finds that the institution has refused to produce its accounts, records, and files for examination or has refused to cooperate or give information with respect to the affairs of the student health plan or to perform any other legal obligation relating to such an examination or investigation when required by the commissioner.

II. Any certificate of authority suspended or revoked under this section shall be surrendered to the commissioner, and the institution shall notify all participating students of that decision in such form and manner as the commissioner may prescribe, but not later than 10 days after receipt of notice of the commissioner's decision requiring suspension or revocation. In addition, the institution shall submit a plan for the commissioner's approval for winding up the plan's affairs in an orderly manner designed to result in timely payment of all benefits, in such form and manner as the commissioner may prescribe.

III. All final decisions to suspend or revoke the certificate of authority with regard to an institution shall be public.


Source. 2016, 257:1, eff. Jan. 1, 2017.

    420-P:1 Title. 

This chapter shall be known and may be cited as the "Insurance Data Security Law."


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:10 Safe Harbor for HIPAA Compliance. 

A licensee that is in possession of protected health information subject to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and that has established and maintains programs and procedures regarding information privacy, security, and breach notification that are prescribed by HIPAA and by Parts 160 and 164 of Title 45 of the Code of Federal Regulations established pursuant to HIPAA, shall be considered to meet the requirements of this chapter with respect to such protected health information, provided that the licensee is compliant with the HIPAA privacy, security, and breach notification requirements and submits a written statement certifying such compliance. Furthermore, to the extent a licensee maintains other nonpublic information concerning a consumer in the same manner as protected health information, it shall be considered to meet the requirements of this chapter with respect to such nonpublic information, provided the licensee submits a written statement that it does maintain and protect other nonpublic information as it does protected health information. However, any licensee subject to this HIPAA safe harbor shall continue to be subject to, and shall comply with, the commissioner notification requirements of RSA 420-P:6, I and II. For purposes of this section, the definition of "protected health information" shall be as set forth in HIPAA and the regulations promulgated thereunder and shall be considered to be a subset of nonpublic information, as defined in RSA 420-P:3, XI.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:11 Safe Harbor for New York Regulatory Compliance. 

A licensee that is in compliance with N.Y. Comp. Codes R. __ampersand__ Regs. Title 23, section 500, Cybersecurity Requirements for Financial Services Companies, effective March 1, 2017, shall be considered to meet the requirements of this chapter, provided that the licensee submits a written statement to the commissioner certifying such compliance. However, any licensee subject to this New York Regulatory Safe Harbor shall continue to be subject to, and shall comply with, the investigation requirements of RSA 420-P:5, the commissioner notification requirements of RSA 420-P:6, I and II, and the consumer notification requirements of RSA 420-P:6, III.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:12 Penalties. 

A licensee which violates this chapter may be penalized in accordance with RSA 400-A:15, III.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:13 Rulemaking. 

The commissioner may adopt rules pursuant to RSA 541-A as necessary to carry out the provisions of this chapter.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:14 Severability. 

If any provision of this chapter, or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of this chapter which can be given effect without the invalid provision or application, and to this end the provisions of the chapter are declared to be severable.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:2 Purpose and Scope. 

I. This chapter establishes the exclusive state standards applicable to licensees for data security, the investigation of a cybersecurity event, as defined in RSA 420-P:3, IV, and notification to the commissioner.

II. This chapter shall not be construed to create or imply a private cause of action for violation of its provisions nor shall it be construed to curtail a private cause of action which would otherwise exist in the absence of this chapter.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:3 Definitions. 

In this chapter:

I. "
Authorized individual
" means an individual known to and screened by the licensee and determined to be necessary and appropriate to have access to the nonpublic information held by the licensee and its information systems.

II. "
Commissioner
" means the insurance commissioner.

III. "
Consumer
" means an individual, including, but not limited to, an applicant, policyholder, insured, beneficiary, claimant, and certificate holder, who is a resident of this state and whose nonpublic information is in a licensee's possession, custody, or control.

IV. "
Cybersecurity event
" means an event resulting in unauthorized access to, disruption or misuse of, an information system or nonpublic information stored on such information system. The term shall not include the unauthorized acquisition of encrypted nonpublic information if the encryption, process, or key is not also acquired, released, or used without authorization. A cybersecurity event shall not include an event with regard to which the licensee has determined that the nonpublic information accessed by an unauthorized person has not been used or released and has been returned or destroyed.

V. "
Department
" means the insurance department.

VI. "
Encrypted
" means the transformation of data into a form which results in a low probability of assigning meaning without the use of a protective process or key.

VII. "
Information security program
" means the administrative, technical, and physical safeguards that a licensee uses to access, collect, distribute, process, protect, store, use, transmit, dispose of, or otherwise handle nonpublic information.

VIII. "
Information system
" means a discrete set of electronic information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of electronic nonpublic information, as well as any specialized system such as industrial/process controls systems, telephone switching and private branch exchange systems, and environmental control systems.

IX. "
Licensee
" means any person licensed, authorized to operate, or registered, or required to be licensed, authorized, or registered pursuant to the insurance laws of this state but shall not include a purchasing group or a risk retention group chartered and licensed in a state other than this state or a person that is acting as an assuming insurer that is domiciled in another state or jurisdiction.

X. "
Multi-factor authentication
" means authentication through verification of at least 2 of the following types of authentication factors:

(a) Knowledge factors, such as a password;

(b) Possession factors, such as a token or text message on a mobile phone; or

(c) Inherence factors, such as a biometric characteristic.

XI. "
Nonpublic information
" means information that is not publicly available information and is:

(a) Any information concerning a consumer which because of name, number, personal mark, or other identifier can be used to identify such consumer, in combination with any one or more of the following data elements:

(1) Social Security number.

(2) Driver's license number or non-driver identification card number.

(3) Financial account number, credit or debit card number.

(4) Any security code, access code, or password that would permit access to a consumer's financial account.

(5) Biometric records.

(b) Any information or data, except age or gender, in any form or medium created by or derived from a health care provider or a consumer, that can be used to identify a particular consumer, and that relates to:

(1) The past, present, or future physical, mental or behavioral health or condition of any consumer or a member of the consumer's family;

(2) The provision of health care to any consumer; or

(3) Payment for the provision of health care to any consumer.

XII. "
Person
" means any individual or any non-governmental entity, including but not limited to any non- governmental partnership, corporation, branch, agency, or association.

XIII. "
Program
" means information security program.

XIV. "
Publicly available information
" means any information that a licensee has a reasonable basis to believe is lawfully made available to the general public from: federal, state, or local government records; widely distributed media; or disclosures to the general public that are required to be made by federal, state, or local law. For the purposes of this paragraph, a licensee has a reasonable basis to believe that information is lawfully made available to the general public if the licensee has taken steps to determine:

(a) That the information is of the type that is available to the general public; and

(b) Whether a consumer can direct that the information not be made available to the general public and, if so, that such consumer has not done so.

XV. "
Risk assessment
" means the risk assessment that each licensee is required to conduct under RSA 420-P:4, III.

XVI. "
State
" means the state of New Hampshire.

XVII. "
Third-party service provider
" means a person, not otherwise defined as a licensee, that contracts with a licensee to maintain, process, store or otherwise is permitted access to nonpublic information through its provision of services to the licensee.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:4 Information Security Program. 

I. Implementation of the program shall be commensurate with the size and complexity of the licensee, the nature and scope of the licensee's activities, including its use of third-party service providers, and the sensitivity of the nonpublic information used by the licensee or in the licensee's possession, custody, or control. Each licensee shall develop, implement, and maintain a comprehensive written information security program based on the licensee's risk assessment and that contains administrative, technical, and physical safeguards for the protection of nonpublic information and the licensee's information system.

II. The objectives of a licensee's program shall be designed to:

(a) Protect the security and confidentiality of nonpublic information and the security of the information system.

(b) Protect against any threats or hazards to the security or integrity of nonpublic information and the information system.

(c) Protect against unauthorized access to or use of nonpublic information, and minimize the likelihood of harm to any consumer.

(d) Define and periodically reevaluate a schedule for retention of nonpublic information and a mechanism for its destruction when no longer needed.

III. While performing risk assessment the licensee shall:

(a) Designate one or more employees, an affiliate, or an outside vendor designated to act on behalf of the licensee who is responsible for the program.

(b) Identify reasonably foreseeable internal or external threats that could result in unauthorized access, transmission, disclosure, misuse, alteration or destruction of nonpublic information, including the security of information systems and nonpublic information that are accessible to, or held by, third-party service providers.

(c) Assess the likelihood and potential damage of these threats, taking into consideration the sensitivity of the nonpublic information.

(d) Assess the sufficiency of policies, procedures, information systems and other safeguards in place to manage these threats, including consideration of threats in each relevant area of the licensee's operations, including:

(1) Employee training and management;

(2) Information systems, including network and software design, as well as information classification, governance, processing, storage, transmission, and disposal; and

(3) Detecting, preventing, and responding to attacks, intrusions, or other systems failures.

(e) Implement information safeguards to manage the threats identified in its ongoing assessment, and no less than annually, assess the effectiveness of the safeguards' key controls, systems, and procedures.

IV. Based on its risk assessment and to manage its risk, the licensee shall:

(a) Design its program to mitigate the identified risks, commensurate with the size and complexity of the licensee, the nature and scope of the licensee's activities, including its use of third-party service providers, and the sensitivity of the nonpublic information used by the licensee or in the licensee's possession, custody, or control.

(b) Determine which security measures listed below are appropriate and implement such security measures:

(1) Place access controls on information systems, including controls to authenticate and permit access only to authorized individuals to protect against the unauthorized acquisition of nonpublic information.

(2) Identify and manage the data, personnel, devices, systems, and facilities that enable the organization to achieve business purposes in accordance with their relative importance to business objectives and the organization's risk strategy.

(3) Restrict physical access to nonpublic information to authorized individuals only.

(4) Protect by encryption or other appropriate means, all nonpublic information while being transmitted over an external network and all nonpublic information stored on a laptop computer or other portable computing or storage device or media.

(5) Adopt secure development practices for in-house developed applications utilized by the licensee.

(6) Modify the information system in accordance with the licensee's information security program.

(7) Utilize effective controls, which may include multi-factor authentication procedures for any individual accessing nonpublic information.

(8) Regularly test and monitor systems and procedures to detect actual and attempted attacks on, or intrusions into, information systems.

(9) Include audit trails within the information security program designed to detect and respond to cybersecurity events and designed to reconstruct material financial transactions sufficient to support normal operations and obligations of the licensee.

(10) Implement measures to protect against destruction, loss, or damage of nonpublic information due to environmental hazards, such as fire and water damage or other catastrophes or technological failures.

(11) Develop, implement, and maintain procedures for the secure disposal of nonpublic information in any format.

(c) Include cybersecurity risks in the licensee's enterprise risk management process.

(d) Stay informed regarding emerging threats or vulnerabilities and utilize reasonable security measures when sharing information relative to the character of the sharing and the type of information shared.

(e) Provide its personnel with cybersecurity awareness training that is updated as necessary to reflect risks identified by the licensee in the risk assessment.

V. If the licensee has a board of directors, the board or an appropriate committee of the board shall, at a minimum:

(a) Require the licensee's executive management or its delegates to develop, implement, and maintain the licensee's information security program.

(b) Require the licensee's executive management or its delegates to report in writing at least annually, the following information:

(1) The overall status of the information security program and the licensee's compliance with this chapter; and

(2) Material matters related to the information security program, addressing issues such as risk assessment, risk management and control decisions, third-party service provider arrangements, results of testing, cybersecurity events or violations and management's responses thereto, and recommendations for changes in the program.

(c) If executive management delegates any of its responsibilities under RSA 420-P:4, it shall oversee the development, implementation and maintenance of the licensee's program prepared by the delegates and shall receive a report from the delegates complying with the requirements of the report to the board of directors.

VI. (a) With regard to oversight of third-party service providers, a licensee shall exercise due diligence in selecting its third-party service provider; and

(b) A licensee shall require a third-party service provider to implement appropriate administrative, technical, and physical measures to protect and secure the information systems and nonpublic information that are accessible to, or held by, the third-party service provider.

VII. The licensee shall monitor, evaluate and adjust, as appropriate, the information security program consistent with any relevant changes in technology, the sensitivity of its nonpublic information, internal or external threats to information, and the licensee's own changing business arrangements, such as mergers and acquisitions, alliances and joint ventures, outsourcing arrangements and changes to information systems.

VIII. (a) As part of its program, each licensee shall establish a written incident response plan designed to promptly respond to, and recover from, any cybersecurity event that compromises the confidentiality, integrity or availability of nonpublic information in its possession, the licensee's information systems, or the continuing functionality of any aspect of the licensee's business or operations.

(b) Such incident response plan shall address the following areas:

(1) The internal process for responding to a cybersecurity event;

(2) The goals of the incident response plan;

(3) The definition of clear roles, responsibilities, and levels of decision-making authority;

(4) External and internal communications and information sharing;

(5) Identification of requirements for the remediation of any identified weaknesses in information systems and associated controls;

(6) Documentation and reporting regarding cybersecurity events and related incident response activities; and

(7) The evaluation and revision as necessary of the incident response plan following a cybersecurity event.

IX. Annually, each insurer domiciled in this state shall submit to the commissioner, a written statement by March 1, certifying that the insurer is in compliance with the requirements set forth in this section. Each insurer shall maintain for examination by the department all records, schedules and data supporting this certificate for a period of 5 years. To the extent an insurer has identified areas, systems, or processes that require material improvement, updating, or redesign, the insurer shall document the identification and the remedial efforts planned and underway to address such areas, systems or processes. Such documentation shall be available for inspection by the commissioner.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:5 Investigation of a Cybersecurity Event. 

I. If the licensee learns that a cybersecurity event has or may have occurred, the licensee or an outside vendor and/or service provider designated to act on behalf of the licensee, shall conduct a prompt investigation.

II. During the investigation, the licensee, or an outside vendor and/or service provider designated to act on behalf of the licensee, shall, at a minimum determine as much of the following information as possible:

(a) Whether a cybersecurity event has occurred.

(b) The nature and scope of the cybersecurity event.

(c) Identify any nonpublic information that may have been involved in the cybersecurity event.

(d) Perform or oversee reasonable measures to restore the security of the information systems compromised in the cybersecurity event in order to prevent further unauthorized acquisition, release, or use of nonpublic information in the licensee's possession, custody, or control.

III. If the licensee learns that a cybersecurity event has or may have occurred in a system maintained by a third-party service provider, the licensee shall complete the steps listed in paragraph II above or confirm and document that the third-party service provider has completed those steps.

IV. The licensee shall maintain records concerning all cybersecurity events for a period of at least 5 years from the date of the cybersecurity event and shall produce those records upon demand of the commissioner.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:6 Notification of a Cybersecurity Event. 

I. Each licensee shall notify the commissioner within 3 business days of a determination that a cybersecurity event has occurred when either of the following criteria has been met:

(a) New Hampshire is the licensee's state of domicile, in the case of an insurer, or this state is the licensee's home state, in the case of a producer, as those terms are defined in RSA 402-J, and the cybersecurity event has a reasonable likelihood of materially harming a consumer residing in this state or reasonable likelihood of materially harming any material part of the normal operations of the licensee; or

(b) The licensee reasonably believes that the nonpublic information involves 250 or more consumers residing in New Hampshire and that the cybersecurity event:

(1) Impacts the licensee, in which case notice shall be provided to any government body, self-regulatory agency, or any other supervisory body pursuant to any state or federal law; or

(2) Has a reasonable likelihood of materially harming:

(A) Any consumer residing in this state; or

(B) Any material part of the normal operations of the licensee.

II. The licensee shall provide as much of the following information as possible. The licensee shall provide the information in electronic form as directed by the commissioner. The licensee shall have a continuing obligation to update and supplement initial and subsequent notifications to the commissioner regarding material changes to previously provided information relating to the cybersecurity event.

(a) Date of the cybersecurity event.

(b) Description of how the information was exposed, lost, stolen, or breached, including the specific roles and responsibilities of third-party service providers, if any.

(c) How the cybersecurity event was discovered.

(d) Whether any lost, stolen, or breached information has been recovered and, if so, how this was done.

(e) The identity of the source of the cybersecurity event.

(f) Whether the licensee has filed a police report or has notified any regulatory, government, or law enforcement agencies and, if so, when such notification was provided.

(g) Description of the specific types of information acquired without authorization. Specific types of information means particular data elements including, for example, types of medical information, types of financial information, or types of information allowing identification of the consumer.

(h) The period during which the information system was compromised by the cybersecurity event.

(i) The number of total consumers in this state affected by the cybersecurity event. The licensee shall provide the best estimate in the initial report to the commissioner and update this estimate with each subsequent report to the commissioner pursuant to this section.

(j) The results of any internal review identifying a lapse in either automated controls or internal procedures, or confirming that all automated controls or internal procedures were followed.

(k) Description of efforts being undertaken to remediate the situation which permitted the cybersecurity event to occur.

(l) A copy of the licensee's privacy policy and a statement outlining the steps the licensee will take to investigate and notify consumers affected by the cybersecurity event.

(m) Name of a contact person who is both familiar with the cybersecurity event and authorized to act for the licensee.

III. A licensee shall notify consumers by complying with RSA 359-C:20, I(a) and (c), II-IV, and VI, and providing a copy of the notice sent to consumers under that statute to the commissioner, when a licensee is required to notify the commissioner under paragraph I.

IV. (a) In the case of a cybersecurity event in a system maintained by a third-party service provider, of which the licensee has become aware, the licensee shall treat such event as it would under paragraph I, unless the third-party service provider provides the notice required under paragraph I to the commissioner.

(b) The computation of licensee's deadlines shall begin on the day after the third-party service provider notifies the licensee of the cybersecurity event or the licensee otherwise has actual knowledge of the cybersecurity event, whichever is sooner.

(c) Nothing in this chapter shall prevent or abrogate an agreement between a licensee and another licensee, a third-party service provider or any other party to fulfill any of the investigation requirements imposed under RSA 420-P:5 or notice requirements imposed under RSA 420-P:6.

V. (a)(1) As to notice of cybersecurity events of reinsurers to insurers, in the case of a cybersecurity event involving nonpublic information that is used by the licensee that is acting as an assuming insurer or in the possession, custody, or control of a licensee that is acting as an assuming insurer and that does not have a direct contractual relationship with the affected consumers, the assuming insurer shall notify its affected ceding insurers and the commissioner of its state of domicile within 3 business days of making the determination that a cybersecurity event has occurred.

(2) The ceding insurers that have a direct contractual relationship with affected consumers shall fulfill the consumer notification requirements imposed under RSA 359-C:20, I(a) and (c), II-IV, and VI, and any other notification requirements relating to a cybersecurity event imposed under this section.

(b)(1) In the case of a cybersecurity event involving nonpublic information that is in the possession, custody, or control of a third-party service provider of a licensee that is an assuming insurer, the assuming insurer shall notify its affected ceding insurers and the commissioner of its state of domicile within 3 business days of receiving notice from its third-party service provider that a cybersecurity event has occurred.

(2) The ceding insurers that have a direct contractual relationship with affected consumers shall fulfill the consumer notification requirements imposed under RSA 359-C:20, I(a) and (c), II-IV, and VI, and any other notification requirements relating to a cybersecurity event imposed under this section.

(c) Any licensee acting as assuming insurer shall have no other notice obligations relating to a cybersecurity event or other data breach under this section or any other law of this state.

VI. As to notice of cybersecurity events from insurers to producers of record, in the case of a cybersecurity event involving nonpublic information that is in the possession, custody, or control of a licensee that is an insurer or its third-party service provider and for which a consumer accessed the insurer's services through an independent insurance producer, the insurer shall notify the producers of record of all affected consumers as soon as practicable as directed by the commissioner. The insurer is excused from this obligation for those instances in which it does not have the current producer of record information for any individual consumer.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:7 Power of Commissioner. 

I. The commissioner shall have power to examine and investigate the affairs of any licensee to determine whether the licensee has been or is engaged in any conduct in violation of this chapter. This power is in addition to the powers which the commissioner has under RSA 400-A:16 and RSA 400-A:37. Any such investigation shall be conducted pursuant to RSA 400-A:16 and any examination shall be conducted pursuant to 400-A:37.

II. Whenever the commissioner has reason to believe that a licensee has been or is engaged in conduct in this state which violates this chapter, the commissioner may take action that is necessary or appropriate to enforce the provisions of this chapter.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:8 Confidentiality. 

I. Any documents, materials, or other information in the control or possession of the department that are furnished by a licensee or an employee or agent thereof acting on behalf of licensee pursuant to RSA 420-P:4, IX, RSA 420-P:6, II(b), (c), (d), (e), (h), (j), and (k), or that are obtained by the commissioner in an investigation or examination pursuant to RSA 420-P:7 shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action. However, the commissioner may use the documents, materials or other information in the furtherance of any regulatory or legal action brought as a part of the commissioner's duties. The commissioner shall not otherwise make the documents, materials, or other information public without the prior written consent of the licensee.

II. Neither the commissioner nor any person who received documents, materials, or other information while acting under the authority of the commissioner shall be permitted or required to testify in any private civil action concerning any confidential documents, materials, or information subject to this section.

III. In order to assist in the performance of the commissioner's duties under this chapter, the commissioner:

(a) May share documents, materials, or other information, including the confidential and privileged documents, materials, or information subject to paragraph I, with other state, federal, and international regulatory agencies, with the National Association of Insurance Commissioners, its affiliates or subsidiaries, and with state, federal, and international law enforcement authorities, provided that the recipient agrees in writing to maintain the confidentiality and privileged status of the document, material, or other information.

(b) May receive documents, materials, or information, including otherwise confidential and privileged documents, materials, or information, from the National Association of Insurance Commissioners, its affiliates or subsidiaries and from regulatory and law enforcement officials of other foreign or domestic jurisdictions, and shall maintain as confidential or privileged any document, material, or information received with notice or the understanding that it is confidential or privileged under the laws of the jurisdiction that is the source of the document, material, or information.

(c) May share documents, materials, or other information subject to paragraph I, above, with a third-party consultant or vendor provided the consultant agrees in writing to maintain the confidentiality and privileged status of the document, material, or other information.

(d) May enter into agreements governing sharing and use of information consistent with this section.

IV. Nothing in this chapter shall prohibit the commissioner from releasing final, adjudicated actions that are open to public inspection, pursuant to RSA 91-A, to a database or other clearinghouse service maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries.

V. Documents, materials, or other information in the possession or control of the National Association of Insurance Commissioners or a third-party consultant or vendor pursuant to this chapter shall be confidential by law and privileged, shall not be subject to RSA 91-A, shall not be subject to subpoena, and shall not be subject to discovery or admissible in evidence in any private civil action.

VI. No waiver of any applicable privilege or claim of confidentiality in the documents, materials, or information shall occur as a result of disclosure to the commissioner under this section or as a result of sharing as authorized in paragraph III.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-P:9 Exceptions. 

I. The following exceptions shall apply to this chapter:

(a) A licensee with fewer than 20 employees, including any independent contractors, shall be exempt from RSA 420-P:4.

(b) An employee, agent, representative, or designee of a licensee, who is also a licensee, shall be exempt from RSA 420-P:4 and need not develop its own program to the extent that the employee, agent, representative, or designee is covered by the information security program of the other licensee.

(c) A continuing care retirement community, as defined by RSA 420-D, shall be exempt from RSA 420-P:4.

(d) A life settlement provider, as defined by RSA 408-D, shall be exempt from RSA 420-P:4.

(e) A licensee that is a bank or a credit union, as defined in RSA 383-A:2-201, that has established and maintains programs and procedures regarding administrative, technical, and physical safeguards for customer information that are prescribed by section 501(b) of the Gramm-Leach-Bliley Act, 15 U.S.C. section 6801 et seq. and by section 216 of the Fair and Accurate Credit Transaction Act of 2003, and that is subject to examination by its federal regulatory authorities, shall be exempt from RSA 420-P:4, and those provisions of this chapter that apply to a bank or credit union apply only to the extent that it involves insurance. Notification to affected consumers for security breaches relating to insurance business shall be made consistent with the requirements of the Gramm-Leach-Bliley Act. Notification to the commissioner shall be made consistent with that received by federal regulatory authorities.

(f) A motor vehicle retail seller or a motor vehicle sales finance company, as defined in RSA 361-A, shall be exempt from RSA 420-P:4, and those provisions of this chapter that apply to a motor vehicle retail seller or a motor vehicle sales finance company apply only to the extent that it involves insurance. Notification to affected consumers for security breaches relating to the insurance business shall be made consistent with the requirements of the Gramm-Leach Bliley Act. Notification to the commissioner shall be made consistent with that received by federal regulatory authorities.

(g) A vendor, as defined under RSA 402-K:1, shall be exempt from this chapter.

II. A licensee which ceases to qualify for an exception under this section shall have 180 days to comply with RSA 420-P:4.


Source. 2019, 309:1, eff. Jan. 1, 2020.

    420-Q:1 Purpose and Scope. 

The purpose of this chapter is to set forth standards and procedures for electronic delivery of insurance documents and notices in a manner that will promote efficient delivery while maintaining consumer protection.


Source. 2021, 57:5, eff. July 24, 2021.

    420-Q:2 Delivery Standards and Procedures. 

I. Subject to the requirements of this section, any notice to a party or any other document required by law in an insurance transaction or that is to serve as evidence of insurance coverage may be delivered, stored, and presented by electronic means if the electronic means meet the requirements of the RSA 294-E.

II. Delivery of a notice or document in accordance with this section shall be considered equivalent to and have the same effect as any delivery method required by law, including delivery by first class mail, first class mail with postage prepaid, certified mail, certificate of mail, or certificate of mailing.

III. A notice or document may be delivered by electronic means by an insurer to a party pursuant to this section if the following applies:

(a) The party has affirmatively consented electronically, or confirmed consent electronically, in a manner that reasonably demonstrates that the party can access information in the electronic form that will be used for notices or documents delivered by electronic means to which the party has given consent, and the party has not withdrawn the consent.

(b) The party, before giving consent, is provided with a clear and conspicuous statement informing the party of all of the following:

(1) The hardware and software requirements for access to and retention of a notice or document delivered by electronic means.

(2) The types of notices and documents to which the party's consent would apply.

(3) The right of the party to withdraw consent to have a notice or document delivered by electronic means, at any time, and any conditions or consequences imposed in the event consent is withdrawn.

(4) The procedures a party must follow to withdraw consent to have a notice or document delivered by electronic means and to update the party's electronic mail address.

(5) The right of a party to have a notice or document delivered, upon request, in paper form.

IV. An insurer shall take all measures reasonably calculated to ensure that delivery by electronic means results in receipt of the notice or document by the party.


Source. 2021, 57:5, eff. July 24, 2021.