reglab/statecodes huggingface dataset:
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:9 - Lien on Behalf of Residents.

420-D:9 Lien on Behalf of Residents. –
The commissioner shall file a lien on all real and personal property of a provider if he deems it necessary to protect the interests of the residents. Notices of liens upon real property shall be filed in the registry of deeds of the county in which the real property subject to the liens is situated. The register of deeds shall receive, record, and index the same in accordance with RSA 478. The filing and service of the notice and demand of said lien shall constitute a lien upon the real estate, personal estate, property interest, right, or credit to which the notice and demand relates or which may be subsequently discovered. Such lien shall be effective for the period determined necessary by the commissioner and may be renewed if the circumstances warrant it. A lien shall only be foreclosed to protect the investment of residents, and the proceeds shall be distributed in a manner to satisfy any continuing care contracts in effect at that time.
Source.
1988, 44:2. 2010, 144:9, eff. Jan. 1, 2011. 2022, 42:15, eff. July 2, 2022.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:11 - Pledging Assets.

420-D:11 Pledging Assets. –
Only unencumbered assets of a facility may be pledged as collateral for another facility.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:13 - Transfer or Sale of Interest.

420-D:13 Transfer or Sale of Interest. –
I. Any provider who plans to sell or otherwise transfer control, whether partial or entire, or an interest in the management or assets of a continuing care community certified under this chapter shall notify the commissioner of the proposed change. The notification shall specify the amount of interest involved in the transfer, the type of transfer, and to whom. The commissioner may refuse to approve such transfer until full disclosure has been made, to his satisfaction, of the terms and conditions of the transfer and he has determined that such transfer is in the best interests of the residents and the state of New Hampshire.
II. If the commissioner determines that management control or more than 50 percent of the assets of the facility have been or are about to be transferred to another party, he shall cancel the existing certificate of authority and require that an application for a certificate of authority be submitted by the new provider within 30 days.
III. [Repealed.]
Source.
1988, 44:2. 1999, 249:6, II, eff. Sept. 7, 1999.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:14 - Waiver Prohibited.

420-D:14 Waiver Prohibited. –
Contracts entered into prior to the date the provider receives the certificate of authority are valid and binding for those providers offering or providing continuing care on January 1, 1989; except that a resident or a prospective resident who has signed a contract prior to that date may request that his contract with the provider be changed to conform with the provisions of this chapter. However, any changes made to such contracts after the date when rules adopted by the commissioner in accordance with RSA 420-D:17 take effect shall conform to all provisions of this chapter and such rules.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:15 - Right to Organize and to Obtain Outside Consultation.

420-D:15 Right to Organize and to Obtain Outside Consultation. –
I. All residents have the right to self-organize, the right to be represented by an individual of their own choice, and the right to engage in concerted activities for their own purposes. They shall have the right both individually and severally to obtain outside advice and consultation of their own choosing on any matter, including, but not limited to, medical, legal, and financial matters.
II. A provider shall be available for meetings at least once each quarter of the year with residents or their representative. The meetings shall be for the purpose of providing a forum for free and open discussion of any point either wishes to discuss. If requested, the manager of a facility shall be present at such meetings, and the residents' organization may also request that an owner, partner, director, or other official of the provider operating the facility be present. Residents shall be given at least 2 weeks' notice of each such meeting.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:17 - Rulemaking.

420-D:17 Rulemaking. –
The commissioner shall adopt rules pursuant to RSA 541-A and after public hearing, relative to:
I. Procedures for application for a certificate of authority under RSA 420-D:2.
II. [Repealed.]
III. Any application fees required under RSA 420-D:2.
IV. Procedures and fees for the renewal process under RSA 420-D:3.
V. Manner of filing and any other information to be contained in the disclosure statement required under RSA 420-D:4.
VI. Procedures for revocation or suspension of a certificate of authority under RSA 420-D:5.
VII. Procedures for hearings and notice requirements under this chapter.
VIII. Manner of filing and other information to be contained in the annual report required in RSA 420-D:7.
IX. The definition of major changes under RSA 420-D:7, II(c).
X. The definition of liquid reserves as required under RSA 420-D:8.
XI. Escrow conditions for liquid reserves under RSA 420-D:8.
XII. Procedures for obtaining and extending liens under RSA 420-D:9.
XIII. Procedures for placing entrance fees in escrow accounts and for releasing such fees under RSA 420-D:10.
XIV. The manner and content of all forms required under this chapter.
XV. What shall constitute cause for intervention under RSA 420-D:12, II.
XVI. A schedule of fees to cover the costs of administering this chapter.
XVII. Continuing care facilities under the division of charitable trusts in accordance with RSA 420-D:2, III.
XVIII. [Repealed.]
Source.
1988, 44:2; 44:6. 1999, 249:6, III, eff. Sept. 7, 1999.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:18 - Dividends.

420-D:18 Dividends. –
A provider subject to this chapter shall obtain prior approval from the commissioner before declaring and distributing any dividends or funds or other assets to owners.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:19 - Repealed by 2001, 276:6, II, eff. Sept. 14, 2001.

420-D:19 Repealed by 2001, 276:6, II, eff. Sept. 14, 2001. –
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:20 - Civil Liability.

420-D:20 Civil Liability. –
I. In the following circumstances, a provider or his agent shall be liable for damages, entrance fees with any accrued interest, and attorneys' fees, plus any other fees paid in advance of receipt of services:
(a) If the provider or agent enters into contracts for continuing care for a facility that does not have a certificate of authority under this chapter;
(b) If he did not deliver a disclosure statement before entering into a contract; or
(c) If a disclosure statement is misleading and induces acceptance of a contract for continuing care or induces payment of any money or transfer of anything of value by a resident or prospective resident.
II. Negligent misrepresentation or omission shall not preclude recovery under this section.
III. An action pursuant to this section may be avoided if the provider, upon written approval of the commissioner, makes a good faith offer to refund all fees and costs listed in paragraph I. Failure of a resident or prospective resident to accept such an offer within 60 days shall preclude further action by such resident or prospective resident. Any action brought pursuant to this section shall be in accordance with applicable state law. An action brought under this chapter shall not limit the liability of the provider under other state laws. A private party shall not be liable by implication unless expressly permitted under this chapter.
Source.
1988, 44:2. 1999, 249:3, eff. Sept. 7, 1999.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:21 - Investigations; Subpoenas.

420-D:21 Investigations;  Subpoenas. –
The commissioner may make such investigations as he or she deems necessary both within and outside the state in accordance with the provisions of RSA 400-A:16 and RSA 400-A:20 through RSA 400-A:22.
Source.
1988, 44:2, eff. Jan. 1, 1989. 2016, 111:6, eff. May 20, 2016.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:22 - Records and Assets to be Kept Within State.

420-D:22 Records and Assets to be Kept Within State. –
All records and assets of a provider shall be established and kept in the state of New Hampshire and shall not be removed from this state by a provider or his agent unless agreed to in writing by the commissioner prior to such removal. The commissioner shall consent to such removal only if the provider submits satisfactory evidence that the removal will facilitate a more economical operation and will not diminish the service or protection given to the residents remaining in this state. The commissioner may order the return of the records and assets if such return is in the best interests of the residents or of the state.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:23 - Audits.

420-D:23 Audits. –
The commissioner or the commissioner's agent shall audit the books and records of a facility subject to this chapter once every 5 years, or more frequently as the commissioner deems necessary to assure the accuracy of reports to him or her taking into consideration other independent audits required under this chapter.
Source.
1988, 44:2. 2002, 207:9, eff. July 15, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:24 - Cease and Desist Orders.

420-D:24 Cease and Desist Orders. –
If it appears that any person subject to this chapter has engaged or is about to engage in acts violating this chapter or any rule adopted pursuant to it, the commissioner may issue an order to cease and desist and bring court action to enforce compliance or enjoin such action. Upon proper request, a court may issue a permanent or temporary injunction, restraining order, or writ of mandamus, and a receiver or conservator may be appointed for the defendant or the defendant's assets. The commissioner shall not be required to post bond.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:25 - Fees.

420-D:25 Fees. –
The commissioner shall charge providers subject to this chapter a fee for services rendered to them by the department of insurance. The fees shall be established and adopted by rule under RSA 541-A and shall be sufficient to cover the costs of administering this chapter.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:26 - Criminal Penalties.

420-D:26 Criminal Penalties. –
Any person, partnership, association or corporation, including state or county or local governmental units or any division, department, board or agency thereof, establishing, conducting, managing, or operating any facility within the meaning of this chapter without first obtaining a certificate as provided in this chapter, or who violates any rule adopted under this chapter, shall be guilty of a misdemeanor if a natural person, or guilty of a felony if any other person. Nothing in this section shall preclude any other action at law against such person.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-D - Continuing Care Communities › Section 420-D:27 - Severability.

420-D:27 Severability. –
If any provision of this chapter or the application thereof to any person or circumstance is held invalid, the invalidity does not affect other provisions or applications of the chapter which can be given effect without the invalid provisions or application, and to this end the provisions of this chapter are severable.
Source.
1988, 44:2, eff. Jan. 1, 1989.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:1 - Definitions.

420-E:1 Definitions. –
In this chapter:
I. "Commissioner" means the insurance commissioner.
I-a. "Claim involving urgent care" means any claim for medical care or treatment with respect to which the application of the time periods for making non-urgent care determinations:
(a) Could seriously jeopardize the life or health of the claimant or the ability of the claimant to regain maximum function; or
(b) In the opinion of a physician with knowledge of the claimant's medical condition, would subject the claimant to severe pain that cannot be adequately managed without the care or treatment that is the subject of the claim.
II. "Department" means the insurance department.
III. "Health care provider" means any person, corporation, facility, or institution either licensed by this state or otherwise lawfully providing health care services, including, but not limited to, a physician, hospital or other health care facility, dentist, nurse, optometrist, podiatrist, physical therapist or psychologist, and any officer, employee or agent of such provider acting in the course and scope of his employment or agency related to or supportive of health care services.
III-a. "Pre-service claim" means any claim for a benefit under a health plan with respect to which the terms of the plan condition receipt of the benefit, in whole or in part, on approval of the benefit in advance of obtaining medical care.
IV. "Utilization review" means a system for reviewing the appropriate and efficient allocation of hospital, medical or other health care services given to a patient or group of patients as to necessity, for the purpose of recommending or determining whether such services should be covered or provided by an insurer, nonprofit service organization, health maintenance organization, third-party administrator or employer. The terms include those programs or processes whether they apply prospectively or retrospectively to medical services. Utilization review services include, but are not limited to, the following: second opinion programs; prehospital admission certification; preinpatient service eligibility certification; and concurrent hospital review to determine appropriate length of stay. Utilization review shall not include claims review or decisions.
Source.
1992, 142:2. 1996, 188:12. 2001, 207:4, 5, eff. Jan. 1, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:2 - Licensure or Registration Required.

420-E:2 Licensure or Registration Required. –
I. Any person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or an employee of those exempt organizations, that performs medical utilization review services on behalf of commercial insurers, nonprofit service organizations, health maintenance organizations, third-party administrators or employers, shall apply for a license to be issued by the department and shall pay an application fee and an annual license fee. No person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, or the employees of exempt organizations shall perform utilization review services or medical utilization review services unless the person, partnership, or corporation has received a license in accordance with this chapter.
II. [Repealed.]
Source.
1992, 142:2. 1993, 249:1. 1996, 188:13. 1997, 345:8, III. 1999, 249:4, eff. Sept. 7, 1999.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:2-a - Medical Director.

420-E:2-a Medical Director. –
Every medical utilization review entity licensed by the department under this chapter shall employ a medical director licensed under RSA 329 or, in the case of a dental utilization review entity, a dentist licensed under RSA 317-A.
Source.
2000, 18:3. 2004, 187:5, eff. July 31, 2004.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:3 - Information Required.

420-E:3 Information Required. –
I. Each person, partnership or corporation licensed under this chapter shall, at the time of initial licensure and on or before April 1 of each succeeding year, provide the department with the following information:
(a) The process used by the entity to carry out its utilization review services, including the categories of health care personnel that perform utilization review activities and whether or not such individuals are licensed in this state.
(b) The process used by the entity for addressing beneficiary or provider complaints.
(c) The types of utilization review programs offered by the entity, including, but not limited to:
(1) Second opinion programs.
(2) Prehospital admission certification.
(3) Preinpatient service eligibility determination.
(4) Concurrent hospital review to determine appropriate length of stay.
(d) The process used by the entity to preserve beneficiary confidentiality of medical information.
II. Each person, partnership, or corporation licensed under this chapter shall adopt as the minimal acceptable standards for licensure either the Utilization Review Accreditation Commission (URAC) standards, the National Committee for Quality Assurance (NCQA) standards, or other similar standards acceptable to the commissioner, unless rules establishing stricter standards are adopted pursuant to the commissioner's authority under RSA 420-E:7, XII.
Source.
1992, 142:2. 1993, 249:2. 1999, 249:5, eff. Sept. 7, 1999.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:4-a - Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits.

420-E:4-a Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits. –
I. Beginning July 1, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs may, when requiring prior authorization for a prescription drug, use and accept the prior authorization paper forms or electronic standard described in this section.
II. Beginning December 31, 2017, all health insurers, health maintenance organizations, health services corporations, medical services corporations, and preferred provider programs shall, when requiring prior authorization for a prescription drug, use and accept only the prior authorization paper forms or electronic standard described in this section.
III. On or before March 1, 2017, the commissioner shall adopt rules, pursuant to RSA 541-A, specifying the contents and format of the uniform prior authorization paper forms and the electronic prior authorization standard, consistent with the requirements of this section. In developing the paper forms and the electronic standard, the commissioner shall seek input from interested stakeholders, including but not limited to prescribers, pharmacists, carriers, and prescription benefits managers, and shall support adoption of nationally recognized standards for electronic prior authorization of prescription drugs, including those provided by the National Council for Prescription Drug Programs or an equivalent organization as available.
IV. The prior authorization paper forms adopted under this section shall not exceed 2 pages in length.
V. Nothing in this section shall require a carrier or pharmacy benefits manager to use electronic prior authorization. A carrier or pharmacy benefits manager shall not require use of electronic prior authorization when:
(a) A pharmacist or prescriber lacks broadband Internet access;
(b) A pharmacist or prescriber has low patient volume;
(c) A pharmacist or prescriber has opted-out for a certain medical condition or for a patient request;
(d) A pharmacist or prescriber lacks an electronic medical record system;
(e) The electronic prior authorization interface does not provide for the pre-population of prescriber and patient information; or
(f) The electronic prior authorization interface requires an additional cost to the prescriber.
VI. Nothing in this section shall prohibit the use of prior authorization for prescription drug benefits.
VII. This section shall apply to RSA 420-J and shall not apply to the Medicaid managed care program under RSA 126-A:5, XIX.
Source.
2016, 228:3, eff. June 9, 2016.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:5 - Listing.

420-E:5 Listing. –
The commissioner shall compile and maintain a current listing of persons, partnerships or corporations licensed pursuant to this chapter. The list shall be available to the public.
Source.
1992, 142:2, eff. July 5, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:6 - Periodic Reviews.

420-E:6 Periodic Reviews. –
The commissioner or designee may conduct periodic reviews of the operations of the entities licensed under this chapter to ensure that they continue to meet the minimum standards set in RSA 420-E:4 and any applicable rules adopted by the commissioner. The commissioner may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required in RSA 420-E:4, I.
Source.
1992, 142:2. 2001, 207:7, eff. Jan. 1, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:7 - Rulemaking.

420-E:7 Rulemaking. –
The commissioner shall adopt rules, under RSA 541-A and after public hearing, relative to:
I. Procedures for application for license under RSA 420-E:2.
II. Initial application fees and annual license fees.
III. The time period for notification of determination as required under RSA 420-E:4, IV.
IV. Standards for telephone accessibility as required under RSA 420-E:4, I.
V. Manner for filing and other information for minimum standards as required under RSA 420-E:4.
VI. Manner and content of all forms required under this chapter.
VII. What shall constitute cause to take actions under RSA 420-E:6 and RSA 420-E:8.
VIII. Confidentiality of records and access to records of the provider and reviewer, as required under RSA 420-E:4.
IX. The scope of the review and the information which the reviewer is entitled to review and have access to from the provider.
X. Qualification of the reviewer, as required under RSA 420-E:4, II.
XI. Procedures for registration.
XII. Additional standards for licensure of medical utilization review entities under RSA 420-E:3, II.
Source.
1992, 142:2. 1993, 249:4. 2001, 207:8, 9. 2012, 171:24, eff. Aug. 10, 2012.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:8 - Enforcement; Administrative Fine; Hearings.

420-E:8 Enforcement;  Administrative Fine;  Hearings. –
I. The commissioner may take appropriate action against a licensee which fails to meet the standards under this chapter or any rules adopted by the commissioner, or who fails to respond in a timely manner to corrective actions ordered by the commissioner. The commissioner may impose an administrative fine not to exceed $1,000 for each violation or may deny, suspend or revoke the license.
II. Before taking the actions authorized by this section to deny, suspend or revoke the license, the commissioner shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing under RSA 541-A. Rehearings and appeals shall be conducted in accordance with RSA 541.
Source.
1992, 142:2, eff. July 5, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-E - Licensure of Medical Utilization Review Entities › Section 420-E:9 - Rulings on Appropriateness of Medical Judgments Not Authorized.

420-E:9 Rulings on Appropriateness of Medical Judgments Not Authorized. –
Nothing in this chapter requires or authorizes the commissioner to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents.
Source.
1992, 142:2, eff. July 5, 1992.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:2 - Directors.

420-F:2 Directors. –
I. The board of directors who shall manage the business and affairs of Delta shall be composed of 7 participating dentists, 4 public members, and 4 purchaser members.
II. A nominating committee composed of 2 participating dentists, one member of the general public, and 2 purchasers, none of whom are members of the board, selected by a majority vote of the entire board, shall develop recommendations for board nominees, as board vacancies occur, which nominees shall be approved to serve on the board by a majority vote of the entire board. The nominating committee may use an outside consultant in selecting new board members as vacancies occur.
Source.
1992, 252:1. 1998, 180:3, eff. July 1, 1998.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:2-a - Bylaws.

420-F:2-a Bylaws. –
Any bylaw developed by the board of directors or developed by the members shall require approval of both 2/3 of the members of the board and a simple majority of all the members of Delta.
Source.
1998, 180:4, eff. July 1, 1998.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:3 - Agent License.

420-F:3 Agent License. –
I. No person, for himself or in behalf of any person, shall sell or offer to sell any Delta benefit plan, as is provided for in this chapter, without being licensed by the commissioner pursuant to the provisions of RSA 402-J.
II. Upon written notice by Delta of its appointment of a person to act as its agent, the commissioner shall issue, if he is first satisfied that the appointee is a suitable person and intends to hold himself out in good faith as an agent and upon payment of the proper fee by the applicant, to the appointee a license to act as such agent.
III. A license previously issued may be renewed upon the application of Delta upon payment of the proper fee.
IV. The commissioner, at any time after granting such license, for cause shown and after notice and hearing, may determine such licensee to be unsuitable to act as such agent, and shall thereupon revoke such license and notify both Delta and the agent of such revocation.
V. Unless revoked by the commissioner, or unless Delta by written notice to the commissioner cancels the agent's authority to act for it, such license issued to an agent, or any renewal thereof, shall expire on June 14 of the second year after its issue.
VI. If a person acts or aids in any manner in the negotiation of Delta contracts, or solicits or receives any application for such contracts, without a license from the commissioner, or if the license granted to him or her or Delta for whom he or she acts as agent has been revoked, he or she shall be guilty of a class A misdemeanor if a natural person, or guilty of a felony if any other person; but any contract issued on an application thus procured shall bind Delta if otherwise valid. This paragraph shall not apply to any clerical employee of Delta, or to any persons rendering their services without compensation.
Source.
1992, 252:1. 2000, 315:24. 2005, 206:9, eff. Jan. 1, 2006.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:4 - Filing and Approval of Contracts.

420-F:4 Filing and Approval of Contracts. –
Delta shall not revise or modify any contract or issue a new contract to a contract holder until it shall have filed with the commissioner a copy of the form of such amendment, modification or contract, including all riders and endorsements, and until the commissioner's approval shall have been obtained. Any form of amendment, modification or contract not disapproved by the commissioner within 90 days after the filing, shall be deemed to have been approved as filed.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:5 - Contracts With Contract Holders.

420-F:5 Contracts With Contract Holders. –
Every contract between Delta and a contract holder shall be in writing, a copy of which shall be furnished to the contract holder and shall contain the following provisions:
I. A statement of the amount payable to Delta by the contract holder and the manner in which such amount is payable.
II. A statement of the nature and extent of the benefits to be provided, and if any benefits are to be limited or excepted, an enumeration of such limitations or exceptions shall be printed with the same prominence as the statement of benefits conferred.
III. A statement of the terms and conditions upon which the contract may be cancelled or otherwise terminated at the option of either party.
IV. A statement that the contract includes endorsements and attached papers, if any, and that it comprises the entire contract.
V. A provision that no statement by the contract holder in its application for a contract shall void the contract or be used in any legal proceeding on the contract unless an exact copy of the application is included or attached to the contract.
VI. A statement of the grace period which will be allowed the contract holder for making any payment due under the contract. Such period shall be not less than 10 days.
VII. If the coverage for dependent children includes coverage for dependent children who are full-time students, as defined by the appropriate educational institution, beyond the age of 18, such dependent coverage shall include coverage for a dependent's medically necessary leave of absence from school for a period not to exceed 12 months or the date on which coverage would otherwise end pursuant to the terms and conditions of the policy, whichever comes first. Any breaks in the school semester shall not disqualify the dependent child from coverage under this paragraph. Documentation and certification of the medical necessity of a leave of absence shall be submitted to the insurer by the student's attending physician and shall be considered prima facie evidence of entitlement to coverage under this paragraph. The date of the documentation and certification of the medical necessity of a leave of absence shall be the date the insurance coverage under this paragraph commences.
Source.
1992, 252:1. 2007, 289:20, eff. Jan. 1, 2008.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:5-a - Dependent Coverage.

420-F:5-a Dependent Coverage. –
I. A policy may, at the election of the carrier, insure, originally or by subsequent amendment, upon application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children, or any other person dependent upon the policyholder. In the event a carrier elects to provide coverage for dependent children, the term "dependent child" shall include a subscriber's child by blood or by law, who is under age 26.
I-a. The coverage of any family member insured by such policy, pursuant to paragraph I, who is mentally or physically incapable of earning his or her own living as of the date on which such dependent's status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this paragraph, such dependent shall be entitled upon the termination of such incapacity to coverage offered by the New Hampshire high risk pool under RSA 404-G.
II. Nothing in this section shall be construed to require:
(a) Coverage for services provided to a dependent before the effective date of this section; or
(b) That an employer pay all or part of the cost of family coverage that includes a dependent as provided pursuant to this section.
III. A subscriber that elects family coverage during any applicable open enrollment period may enroll any dependent eligible pursuant to this section.
IV. Coverage for a dependent provided pursuant to this section shall be provided until the earlier of the following:
(a) The dependent is disqualified for dependent status as set forth in paragraph I of this section; or
(b) The date upon which the employer under whose contract coverage is provided to a dependent ceases to provide coverage to the subscriber.
V. Nothing in this section shall be construed to permit a health insurance carrier to refuse an election for coverage by a dependent pursuant to paragraph III, based upon the dependent's prior disqualification pursuant to subparagraph IV(a).
VI. (a) Notice regarding coverage for a dependent as provided pursuant to this section shall be provided to a subscriber:
(1) In the certificate of coverage prepared for subscribers on or about the date of commencement of coverage; and
(2) Within 30 days following the effective date of this section.
(b) Such notice shall include information regarding the required special open enrollment period.
Source.
2007, 352:5. 2009, 235:14. 2010, 243:12, eff. Sept. 23, 2010.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:6 - Rates and Contracts to be Approved.

420-F:6 Rates and Contracts to be Approved. –
Delta shall file with the insurance commissioner a full schedule of the rates to be paid by contract holders and shall obtain the commissioner's approval prior to implementing any rate changes. The commissioner may refuse such approval if he finds the rates are excessive, inadequate, or discriminatory.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:7 - Cancellation or Nonrenewal.

420-F:7 Cancellation or Nonrenewal. –
I. No contract with a contract holder authorized under this chapter shall be cancelled by Delta, except for nonpayment of premium, unless the contract holder receives a notice of cancellation in accordance with this section. Notice of cancellation for breach of the contract by the contract holder shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 10 days prior to the effective date of the cancellation. Notice of cancellation for lack of participation shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta, at least 30 days prior to the effective date of the cancellation.
II. No contract with a contract holder authorized under this chapter shall be nonrenewed by Delta, except for nonpayment of premium, unless the contract holder receives either a notice of nonrenewal or an offer of renewal in accordance with this section. The notice of nonrenewal or offer of renewal shall be delivered to the contract holder or mailed to the contract holder's last address as shown in the records of Delta at least 30 days prior to the renewal date of the contract.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:9 - Financial Report and Examination.

420-F:9 Financial Report and Examination. –
I. Delta shall file with the commissioner, on March 1, a report verified by an appropriate official of Delta, showing its financial condition on the last day of the preceding fiscal year.
II. Such report shall include:
(a) Delta's financial statements, including its balance sheet and statement of income and expenditures for the preceding year, certified by an independent public accountant;
(b) Such other financial information relating to Delta's performance as the commissioner may require.
Source.
1992, 252:1. 2001, 224:9, eff. Jan. 1, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:10 - Contingency Reserve Fund.

420-F:10 Contingency Reserve Fund. –
Delta shall collect reasonable rates as described in RSA 420-F:6, designed to permit it to accumulate and maintain a contingency reserve fund which shall not be less than 8 percent of Delta's annual premium risk income.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:11 - Examination.

420-F:11 Examination. –
I. The commissioner shall make an examination of Delta as often as he or she deems it necessary, but not less frequently than once in every 5 years. All examinations shall be conducted at the expense of Delta.
II. Delta shall submit its books and records relating to its operations to such examinations and in every way facilitate them. For the purpose of examinations, the commissioner may issue subpoenas, administer oaths to, and examine the officers and agents of Delta.
Source.
1992, 252:1, eff. Jan. 1, 1993. 2018, 36:4, eff. May 15, 2018.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:12 - Appeals.

420-F:12 Appeals. –
All orders and decisions of the commissioner concerning matters within his jurisdiction under this chapter shall be subject to rehearing and appeal as provided in RSA 541. RSA 541:18 and 19 shall apply to orders and decisions of the insurance commissioner affecting the rates of Delta.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:13 - Administrative Services.

420-F:13 Administrative Services. –
Delta may contract to furnish administrative, marketing, and managerial services to any health related organization, agency, entity or plan.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:14 - Nonliability of Corporation.

420-F:14 Nonliability of Corporation. –
Delta, its officers or employees, shall not be liable for injuries resulting from negligence, malfeasance, nonfeasance or malpractice on the part of any provider in the course of rendering any dental care.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:15 - Not-for-Profit-Status.

420-F:15 Not-for-Profit-Status. –
Delta is not organized and shall not be maintained or operated for private profit or benefit. The income or property of Delta from whatever source derived shall be applied solely toward the promotion of the purposes of Delta and no portion of such income or property shall be transferred to or inure to the profit or benefit of any provider, officer, director or employee of Delta or any individual, provided that nothing in this section shall prevent the payment in good faith of reasonable remuneration to any officer, director or employee of Delta, or to any other person, or to any participating dentist who has entered into contracts with Delta to furnish dental care, for any services rendered to Delta or to individuals pursuant to contracts with Delta for dental care.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:16 - Relationship of Provider and Patient.

420-F:16 Relationship of Provider and Patient. –
Nothing in this chapter shall be deemed to alter the relationship of provider and patient. Delta shall not in any way influence the subscriber in the free choice of provider. Nothing in this chapter shall be deemed to abridge the right of any provider to decline patients in accordance with lawful standards and practices of such provider.
Source.
1992, 252:1, eff. Jan. 1, 1993.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:17 - Rulemaking Authority.

420-F:17 Rulemaking Authority. –
The commissioner may adopt rules in accordance with RSA 541-A, which are reasonable and necessary to administer and enforce the provisions of this chapter.
Source.
1992, 252:1. 2002, 207:49, eff. July 15, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-F - Delta Dental Plan of New Hampshire, Inc. › Section 420-F:18 - Prohibited Practices.

420-F:18 Prohibited Practices. –
RSA 417 shall be construed to apply to Delta and the contracts which Delta issues, except to the extent that the commissioner determines that the nature of Delta, and the contracts which Delta issues, renders such provisions inappropriate.
Source.
1992, 252:1. 1997, 190:16, eff. Jan. 1, 1998.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-G - Portability, Availability, and Renewability of Health Coverage › Section 420-G:1 - Purpose.

420-G:1 Purpose. –
The purpose of this chapter is to:
I. Facilitate the portability, availability, and renewability of health coverage for all New Hampshire residents and persons principally employed in New Hampshire who wish to obtain health coverage or maintain it as individuals or as employees of large and small employers.
II. To promote competition among health carriers on the basis of efficient claims handling, ability to manage health care services, consumer satisfaction, and low administrative costs.
III. To regulate underwriting and rating practices in the small employer and individual markets so as to promote access to affordable coverage for higher risk groups or individuals.
Source.
1997, 344:1. 1998, 340:7. 2001, 295:1, eff. July 1, 2002.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-G - Portability, Availability, and Renewability of Health Coverage › Section 420-G:3 - Applicability and Scope of Chapter.

420-G:3 Applicability and Scope of Chapter. –
I. This chapter shall apply to any entity licensed, controlled or regulated by RSA 415, RSA 415-E, RSA 420-A, RSA 420-B, or RSA 420-C which offers or provides health coverage for delivery in this state. This chapter shall also apply to any multi-employer plan, trust, association, claims administrator, claims paying agent or any other entity whether fully insured, partially insured, or self-funded which offers or provides health coverage for delivery in this state.
(a) This chapter shall not apply to pooled risk management programs which meet the standards established by RSA 5-B.
(b) This chapter shall not apply to student major medical expense coverage, except student major medical expense coverage shall be given credit and shall count as credit for previous health coverage as defined in RSA 420-G:7.
(c) Notwithstanding any other provision of this chapter, any multiple employer welfare arrangement which meets the requirements of RSA 415-E:2, III shall be exempt from the provisions of this chapter until January 1, 1998.
II. A qualified association trust or other entity, as defined by RSA 420-G:2, XV, shall comply with the requirements stated in RSA 420-G:10.
III. Notwithstanding any law to the contrary, the provisions of this chapter shall prevail with respect to the subject matter within this chapter.
Source.
1997, 344:1; 344:11. 2002, 207:10. 2010, 188:12, eff. Aug. 20, 2010. 2019, 220:13, eff. Sept. 10, 2019.
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-G - Portability, Availability, and Renewability of Health Coverage › Section 420-G:4-a - Repealed by 2016, 111:7, I, eff. June 19, 2016.

420-G:4-a Repealed by 2016, 111:7, I, eff. June 19, 2016. –
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-G - Portability, Availability, and Renewability of Health Coverage › Section 420-G:4-b - Repealed by 2016, 111:7, II, eff. June 19, 2016.

420-G:4-b Repealed by 2016, 111:7, II, eff. June 19, 2016. –
2023 New Hampshire Revised Statutes › Title XXXVII - Insurance › Chapter 420-G - Portability, Availability, and Renewability of Health Coverage › Section 420-G:4-c - Health Coverage Tax Incentive Plan.

420-G:4-c Health Coverage Tax Incentive Plan. –
I. Any carrier that offers small group health coverage in the state shall make its small employer group coverage available with a limited open enrollment period to individual employees of small employers when the coverage is purchased through a premium only cafeteria plan that satisfies the requirements of 26 U.S.C. section 125 and RSA 275:43-c.
II. [Repealed.]
Source.
2010, 204:2, eff. Aug. 21, 2010. 2019, 220:14, eff. Sept. 10, 2019.