New Hampshire Administrative Code

(a) "Carrier clinical review criteria" means written criteria that use nationally accepted standards of medical practice consistent with RSA 420-J:6 VI, and that have been adopted and made public by a health insurer, pharmacy benefits manager, or utilization review entity for det…

(a) The appearance of the uniform prior authorization forms shall be as illustrated in Appendix B. (b) Health insurers, pharmacy benefits managers, and utilization review entities shall reproduce and accept the uniform prior authorization forms without changes except as provided …

(a) Health insurers shall ensure that the version of the uniform prior authorization form that they have prepopulated pursuant to Ins 2705.04(c) is available and accessible in a centralized location online. (b) Except as provided in (c) below, health insurers, pharmacy benefits m…

(a) The information collected by health insurers, pharmacy benefits managers, and utilization review entities via ePA, telephonically, or through any other manner of transmission shall be the same as the information collected via the uniform prior authorization forms except as sp…

Health insurers, pharmacy benefits managers, and utilization review entities shall educate contracted and other prescribing providers about the uniform prior authorization forms, including in partnership with membership organizations that represent those prescribing providers. No…

(a) Upon receipt of a rulemaking petition under RSA 541-A:4 asserting that one or more provisions in these rules prevents health insurers, pharmacy benefits managers, and utilization review entities from adopting nationally recognized standards or processes for electronic prior a…

(a) Upon written request of a health insurer, pharmacy benefits manager, or utilization review entity, the department shall grant in writing a waiver of the requirements of one or more provisions of Ins 2705.06 upon a showing by the health insurer, pharmacy benefits manager, or u…

(a) The purpose of this chapter is to set forth rules and procedural requirements which the commissioner deems necessary to carry out the provisions of RSA 412:16 II., III., V., VI.; RSA 412:23 and RSA 412:25 as to rate and supporting information filings of property and casualty …

(a) "Advisory organization" means an organization defined pursuant to RSA 412:3 II. (b) "Expenses" means that portion of a rate attributable to commission expense and other acquisition costs, field supervision costs, collection costs, general administrative costs, taxes, licenses…

(a) Advisory organizations may develop and make reference filings containing advisory prospective loss costs. Such filing shall contain the statistical data and support for any calculations or assumptions underlying those prospective loss costs. The reference filings shall be fil…

Each insurer filing to adopt an advisory organization approved prospective loss cost reference filing shall include a completed copy of the reference filing adoption form RFF-1. Each insurer filing to revise the loss cost multiplier in effect shall likewise include a completed co…

Companies writing insurance in this state shall maintain all underwriting and rating documentation from which any premium charge is developed. Premium supporting records may be in physical, fiche or electronic format provided that these records are identical to the source documen…

(a) On form RFF-1, the insurer shall supply the following information: (1) Insurer name and address, including the name of the person responsible for filing, his/her title and telephone number and the date of the filing; (2) The National Association of Insurance Commissioner's id…

(a) The purpose of this chapter is to set forth the standards which the commissioner may use for identifying insurers found to be in such condition as to render the continuance of their business hazardous to their policyholders, creditors, or the general public. (b) This chapter …

The following standards, either singly or a combination of two or more, may be considered by the commissioner to determine whether the continued operation of any insurer transacting an insurance business in this state might be deemed to be hazardous to its policyholders, creditor…

(a) For the purposes of making a determination of an insurer's financial condition under this chapter, the commissioner may:(1) Disregard any credit or amount receivable resulting from transactions with a reinsurer that is insolvent, impaired, or otherwise subject to a delinquenc…

Any order or decision of the commissioner shall be subject to review in accordance with RSA 541 at the instance of any party to the proceedings whose interests are substantially affected. Notes N.H. Admin. Code § Ins 2901.04 #8919, eff 7-1-07; ss by #9934, eff 6-1-11 Amended by V…

(a) The commissioner, upon the commissioner's own initiative or upon request by an insurer, shall waive any requirement of this chapter if such waiver does not contradict the objective or intent of the rule and: (1) Applying the rule provision would cause confusion or would be mi…

(a) The purpose of this part is to require insurers to deliver to purchasers of life insurance, information that will improve the buyer's ability to select the most appropriate plan of life insurance for the buyer's needs and improve the buyer's understanding of the basic feature…

(a) Except as hereafter exempted, this part shall apply to any solicitation, negotiation, or procurement of life insurance occurring within this state. This part shall apply to any issuer of life insurance contracts including fraternal benefit societies. (b) This part shall not a…

For the purposes of this part, the following definitions shall apply: (a) "Buyer's Guide" means the National Association of Insurance Commissioner's approved Life Insurance Buyer's Guide, available as referenced in Appendix B; (b) "Current scale of nonguaranteed elements" means a…

(a) Requirements applicable generally shall be as follows: (1) The insurer shall provide a Buyer's Guide to all prospective purchasers prior to accepting the applicant's initial premium or premium deposit. Except, if the policy for which application is made contains an unconditio…

The following information shall be adequately disclosed at the time an application is made, prior to accepting the applicant's initial premium or deposit, for a preneed funeral contract or prearrangement that is funded or to be funded by a life insurance policy: (a) The fact that…

(a) Each insurer shall maintain at its home office or principal office a complete file containing one copy of each document authorized and used by the insurer pursuant to this part. The file shall contain one copy of each authorized form for a period of 5 years following the date…

Reasonable inquiry shall be made by insurers and producers to determine the suitability of any recommendations or sales, and all replacement of life insurance policies shall comply with Ins 302. Notes N.H. Admin. Code § Ins 301.07 #1900, eff 1-1-82; amd by #2141, eff 1-1-83; ss b…

Failure of an insurer to provide or deliver a Buyer's Guide, an in force illustration, a policy summary, and policy data as provided in Ins 301.04 shall constitute an omission which misrepresents the benefits, advantages, conditions, or terms of an insurance policy and be subject…

(a) Electronic sales of life insurance as described in RSA 420-Q shall be subject to the identical disclosure and record keeping requirements as non-electronic sales. Notes N.H. Admin. Code § Ins 301.09 Derived from Volume XXXVII Number 50, Filed December 14, 2017, Proposed by #1…

(a) The commissioner, upon the commissioner's own initiative or upon request by an insurer, shall waive any requirement of this chapter if such waiver does not contradict the objective or intent of the rule and: (1) Applying the rule provision would cause confusion or would be mi…

(a) The purpose of this part is: (1) To regulate the activities of insurers and producers with respect to the replacement of existing life insurance and annuities; and (2) To protect the interests of life insurance and annuity purchasers by establishing minimum standards of condu…

(a) Unless otherwise specifically included, this part shall not apply to transactions involving: (1) Credit life insurance; (2) Group life insurance or group annuities where there is no direct solicitation of individuals by an insurance[WC1] producer. Direct solicitation shall no…

(a) "Direct-response solicitation" means a solicitation through a sponsoring or endorsing entity or individually solely through mails, telephone, the Internet, or other mass communication media. (b) "Existing insurer" means the insurance company whose policy or contract is or wil…

(a) A producer who initiates an application shall submit to the insurer, with or as part of the application, a statement signed by both the applicant and the producer as to whether the applicant has existing policies or contracts. If the answer is "no," the producer's duties with…

(a) Each insurer shall maintain a system of supervision and control to insure compliance with the requirements of this rule that shall include at least the following: (1) Inform its producers of the requirements of this rule and incorporate the requirements of this rule into all …

(a) Where a replacement is involved in the transaction, the replacing insurer shall: (1) Verify that the required forms are received and are in compliance with this rule; (2) Notify any other existing insurer that may be affected by the proposed replacement within 5 business days…

(a) Where a replacement is involved in the transaction, the existing insurer shall: (1) Retain and be able to produce all replacement notifications received, indexed by replacing insurer, for at least 5 years or until the conclusion of the next regular examination conducted by th…

(a) In the case of an application that is initiated as a result of a direct response solicitation, the insurer shall require, with or as part of each completed application for a policy or contract, a statement asking whether the applicant, by applying for the proposed policy or c…

(a) Any failure to comply with this rule shall be considered a violation of RSA 417:4. Examples of violations include: (1) Any deceptive or misleading information set forth in sales material; (2) Failing to ask the applicant in completing the application the pertinent questions r…

(a) The commissioner, upon the commissioner's own initiative or upon request by an insurer, shall waive any requirement of Ins 302 if such waiver does not contradict the objective or intent of the rule and: (1) Applying the rule provision would cause confusion or would be mislead…

The purpose of this part is to require insurance companies and agents to disclose certain information to purchasers of deposit term life insurance products prior to the consummation of the sale in order to guarantee that deposit term life insurance products are properly sold by t…

(a) This part shall apply to all policies or plans of life insurance defined in Ins 303.03(a) as deposit term life insurance. (b) This part does not prohibit the use of additional material which is not in violation of this part or any other statute or part. Notes N.H. Admin. Code…

(a) "Commissioner" means the insurance commissioner of the state of New Hampshire. (b) "Deposit term life insurance" means those policies or plans which provide that an additional first year premium shall be paid in order that certain values and options will be available at the e…

(a) No insurer, agent, broker or any such person shall make any statement in any form in any sales presentation or advertisement for a deposit term life insurance policy which:(1) Indicates or implies that the additional first year premium is or resembles a form of interest-beari…

(a) Prior to taking an application for a deposit term life insurance policy, the insurer, agent, broker or any other such person shall present to the applicant a completed Disclosure Statement for Policy with an Additional First Year Premium, the substance and format of which sha…

(a) Failure of an insurer or agent to comply with any of the requirements contained in Ins 303.04 or Ins 303.05 of this part shall be a violation of the part, subject to the penalties provided in RSA 400-A:15, subject to the requirements therein, in addition to any other penaltie…

(a) If a note is taken to finance less than the full first year premium, the balance shall be paid by the applicant at the time the application is taken. (b) If a note is taken to finance all or part of the first year's premium, said note may be sold or otherwise negotiated or tr…

Premium financing plans requiring the delivery of the prospectus filed with the Securities and Exchange Commission under the Securities Act of 1933 shall be exempt from the provisions and requirements of this part. Notes N.H. Admin. Code § Ins 304.02 #1942, eff 2-1-82; ss by #428…

(a) The commissioner, upon the commissioner's own initiative or upon request by an insurer, shall waive any requirement of this part if such waiver does not contradict the objective or intent of the rule and: (1) Applying the rule provision would cause confusion or would be misle…