reglab/statecodes huggingface dataset:
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:8 - Reimbursement Insurance Policies.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:9 - Examination.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:10 - Penalties.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:10-a - Action Against an Obligor, Designee or Representative of an Obligor.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:11 - Rulemaking.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-C - Consumer Guaranty Contracts › Section 415-C:12 - Severability.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:1 - Purpose.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:2 - Scope.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:4 - Extraterritorial Jurisdiction-Group Long-Term Care Insurance.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:6 - Cancellation of Insurance; Conversion.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:7 - Right to Return; Free Look.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:9 - Incontestability Period.

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.
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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:10 - Nonforfeiture Benefits.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:11 - Approval and Disapproval of Forms.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:12 - Authority to Adopt Rules.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-D - Long-Term Care Insurance Act › Section 415-D:13 - Severability.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:1 - Definitions.

415-E:1 Definitions. –
In this chapter:
I. "Multiple-employer welfare arrangement" 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 employees of 2 or more employers, or to their beneficiaries. 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 the Employee Retirement Income Security Act of 1974, Public Law No. 93-406 (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.
II. "Commissioner" means the insurance commissioner of the state of New Hampshire.
III. "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.
IV. "Insolvency termination" means the termination of an arrangement where the fund balance as of the termination date is inadequate.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:2 - Applicability.

415-E:2 Applicability. –
I. No person shall, after April 1, 1992, operate a multiple-employer welfare arrangement unless such arrangement is approved by the commissioner. No person shall, after April 1, 1992, operate a multiple-employer welfare arrangement in existence prior to April 1, 1992, unless such arrangement has submitted for approval in compliance with RSA 415-E:4, or otherwise meets the special requirements of paragraph III of this section.
II. This chapter shall not apply to a multiple-employer welfare arrangement 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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:4 - Filing of Application.

415-E:4 Filing of Application. –
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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:5 - Fund Balance.

415-E:5 Fund Balance. –
Each multiple-employer welfare arrangement shall maintain a fund balance in excess of or equal to zero.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:6 - Financial Condition, Loss Reserves, Reinsurance, or Working Capital; Determination of Inadequacy.

415-E:6 Financial Condition, Loss Reserves, Reinsurance, or Working Capital;  Determination of Inadequacy. –
I. 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. 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.
II. 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.
III. 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 II.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:7 - Insolvency Protection.

415-E:7 Insolvency Protection. –
I. To assure the faithful performance of its obligations to its member employers and covered employees 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 25 percent of the preceding 12 months' health care claims expenditures or 5 percent of gross annual premiums for the succeeding year, whichever is greater; however, in no case shall the amount of the deposit exceed $100,000. 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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:8 - Policy Forms.

415-E:8 Policy Forms. –
I. No policy or contract form, application form, certificate, rider, endorsement, summary plan description, or other evidence of coverage shall be 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.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:9 - Employer Participants' Liability.

415-E:9 Employer Participants' Liability. –
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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:10 - Termination of Arrangement.

415-E:10 Termination of Arrangement. –
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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:12 - Place of Business; Maintenance of Records.

415-E:12 Place of Business;  Maintenance of Records. –
Each arrangement shall have and maintain its principal place of business in this state and 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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:13 - Suspension, Revocation of Approval.

415-E:13 Suspension, 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.
Source.
1991, 246:1. 1994, 214:6. 1997, 344:4, eff. July 1, 1997; 345:2, eff. Jan. 1, 1998.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:14 - Penalties.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:15 - Rehabilitation, Dissolution.

415-E:15 Rehabilitation, Dissolution. –
Any rehabilitation, liquidation, conservation, 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, or dissolution of insurers.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-E - Multiple-Employer Welfare Arrangements › Section 415-E:16 - Rulemaking.

415-E:16 Rulemaking. –
The commissioner may adopt such rules, pursuant to RSA 541-A, as he deems reasonable and necessary in order to carry out properly the functions and responsibilities assigned the insurance department under the laws of the state. This rulemaking authority shall expire on January 1, 1993, at which time this section, unless replaced by a later legislative enactment, shall be deemed repealed. Any rules adopted under this section shall be drafted in as narrow a manner as possible, consistent with the authority granted the department under the laws of this state.
Source.
1991, 246:1, eff. Jan. 1, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:1 - Definitions.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:2 - Applicability and Scope.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:4 - Loss Ratio Standards.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:5 - Disclosure Standards.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:6 - Notice of Free Examination.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:7 - Filing Requirements for Advertising.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:8 - Penalties.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-F - Medicare Supplemental Insurance › Section 415-F:9 - Premiums.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-H - Stop Loss Insurance › Section 415-H:1 - Purpose and Intent.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-H - Stop Loss Insurance › Section 415-H:2 - Definitions.

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.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 415-H - Stop Loss Insurance › Section 415-H:3 - Stop Loss Insurance Coverage Standards.

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.