reglab/statecodes huggingface dataset:
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:14 - Non-Application to Certain Policies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:15 - Discrimination.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:16 - Approval by Commissioner.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:17 - Fraternal Benefit Societies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-b - Cancellation or Nonrenewal of Group Insurance Contracts.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-d - Coverage for Scalp Hair Prostheses.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-e - Coverage for Nonprescription Enteral Formulas.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-f - Coverage for Diabetes Services and Supplies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-g - Coverage for Dental Procedures; Medical or Hospital; Group.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-h - Coverage for Dental Procedures; Dental Offices.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-j - Off-Label Prescription Drugs.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-m - Retroactive Denials Prohibited; Exceptions.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-n - Coverage for Certain Prosthetic Devices.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-o - Group or Blanket Plan Prescription Drug Information Cards.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-p - Third-Party Payment of Covered, Court-Ordered Services.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-q - Coverage for Certified Midwives.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-r - Coverage for the Cost of Testing for Bone Marrow Donation.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-s - Coverage for Children's Early Intervention Services.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-t - Coverage for Obesity and Morbid Obesity; Group.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-u - Coverage for Hearing Aids.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-v - Reimbursement for Ambulance Service Providers.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-w - Naturopathy Providers; Payment for Equivalent Types of Services; Group.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-y - Oral Anti-Cancer Therapies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-z - Coverage for Early Refills of Prescription Eye Drops.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-aa - Coverage for Blood Lead Testing.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-bb - Coverage for Medically Necessary Dental Services.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-cc - Coverage for Perfluoroalkyls (PFAS) and Perfluorinated Compounds (PFCS) Blood Testing.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-dd - Coverage for Epinephrine Auto-Injectors.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:18-ee - Coverage for Long-Term Antibiotic Therapy Tick-Borne Illness.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:19 - Policies Under Franchise Plan.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:19-a - Student Insurance Policies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415 - Accident and Health Insurance › Section 415:19-b - Debt-Related Mortgage Disability and Mortgage Accidental Death Insurance.

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.