New Hampshire Administrative Code

(a) For purposes of this section the following definitions apply: (1) "Qualified long-term care services" means services that meet the requirements of Section 7702B(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary diagnostic, preventive, therapeutic, …

(a) For purposes of this section, "authorized representative" is authorized to act as the covered person's personal representative within the meaning of 45 CFR 164.502(g) promulgated by the Secretary under the Administrative Simplification provisions of the Health Insurance Porta…

(a) For purposes of this section: (1) "Claim" means a request for payment of benefits under an in-force policy, regardless of whether the benefit claimed is covered under the policy or any terms or conditions of the policy have been met. (2) "Clean claim" means a claim that has n…

This section of the rule implements, interprets and makes specific, the provisions of RSA 415-D:8 in prescribing a standard format and the content of an outline of coverage. (a) The outline of coverage shall be a free-standing document, using no smaller than 10 point type; (b) Th…

(a) A long-term care insurance shopper's guide in the format developed by the National Association of Insurance Commissioners, or a guide developed or approved by the commissioner, shall be provided to all prospective applicants of a long-term care insurance policy or certificate…

In addition to any other penalties provided by the laws of this state any insurer and any producer found to have violated any requirement of this state relating to the regulation of long-term care insurance or the marketing of such insurance shall be subject to a fine of up to 3 …

The purpose of this part is to implement filing, notice, and exchange requirements for the New Hampshire long-term care partnership program. Notes N.H. Admin. Code § Ins 3602.01 #9654, eff 2-16-10 Amended by Volume XXXVIII Number 06, Filed February 8, 2018, Proposed by #12472, Ef…

This part shall be applicable to all long-term care insurance policies and to any policy or certificate that will be marketed and sold under the New Hampshire long-term care partnership program. Notes N.H. Admin. Code § Ins 3602.02 #9654, eff 2-16-10 Amended by Volume XXXVIII Num…

(a) "Commissioner" means the commissioner of the New Hampshire insurance department. (b) "Exchange" means an exchange of a long-term care policy or certificate that was issued on or after February 8, 2006, including an exchange of a non-certified partnership policy or certificate…

(a) Except as provided in (b), within 365 calendar days from the date that an insurer begins to advertise, market, offer, or sell coverage under the New Hampshire long-term care partnership program, the insurer shall offer, on a one-time basis to all policyholders or certificate …

(a) The insurer shall exchange long-term care coverage that was purchased on or after February 8, 2006 for partnership coverage in one of the following ways: (1) For all non-certified partnership policies or certificates, by adding an endorsement that all the provisions required …

(a) The following standards shall apply to all insurers that issue or deliver New Hampshire partnership policies or certificates: (1) In addition to the required filing and approval pursuant to this part, any policy or certificate marketed or represented to be a New Hampshire par…

Pursuant to §1917(b)(1)(C)(iii)(IV) of the Social Security Act 42 U.S.C. § 1396p(b)(1)(C)(iii)(IV), an insurer shall not issue a policy or certificate marketed or represented as a partnership policy unless the policy or certificate complies with the following inflation protection…

(a) Each New Hampshire partnership policy or certificate, including any long-term care partnership endorsement issued or delivered, shall comply with the following requirements before being issued or delivered: (1) Each New Hampshire partnership policy, certificate, or endorsemen…

(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…

(a) This rule establishes standards for developing and implementing administrative, technical and physical safeguards to protect the security, confidentiality and integrity of customer information, pursuant to Sections 501, 505(b), and 507 of the Gramm-Leach-Bliley Act, codified …

For purposes of this rule, the following definitions apply: (a) "Customer" means a customer of the licensee as the term customer is defined in Ins 3001.04(i). (b) "Customer information" means nonpublic personal information as defined in Ins 3001.04(s) about a customer, whether in…

Each licensee shall implement a comprehensive written information security program that includes administrative, technical and physical safeguards for the protection of customer information. The administrative, technical and physical safeguards included in the information securit…

A licensee's information security program shall be designed to: (a) Ensure the security and confidentiality of customer information; (b) Protect against any anticipated threats or hazards to the security or integrity of the information; and (c) Protect against unauthorized access…

The actions and procedures described in Ins 3701.06 through Ins 3701.09 are examples of methods of implementation of the requirements of Ins 3701.03 and Ins 3701.04. These examples are non-exclusive illustrations of actions and procedures that licensees may follow to implement In…

The licensee: (a) Identifies reasonably foreseeable internal or external threats that could result in unauthorized disclosure, misuse, alteration or destruction of customer information or customer information systems; (b) Assesses the likelihood and potential damage of these thre…

The licensee: (a) Designs its information security program to control the identified risks, commensurate with the sensitivity of the information, as well as the complexity and scope of the licensee's activities; (b) Trains staff, as appropriate, to implement the licensee's inform…

The licensee: (a) Exercises appropriate due diligence in selecting its service providers; and (b) Requires its service providers to implement appropriate measurers designed to meet the objectives of this rule, and, where indicated by the licensee's risk assessment, takes appropri…

The licensee monitors, evaluates and adjusts, as appropriate, the information security program in light of any relevant changes in technology, the sensitivity of its customer information, internal or external threats to information, and the licensee's own changing business arrang…

Violations of any of the provisions of this part shall be subject to the penalties of RSA 400-A:15 III. Notes N.H. Admin. Code § Ins 3701.10 #8901, eff 7-1-07 Amended by Volume XXXVI Number 06, Filed February 11, 2016, Proposed by #11015, Effective 1/8/2016, Expires 1/8/2026.…

This part establishes the standards for the notice to customers of a security breach involving the unauthorized access or use of the customer's information. Notes N.H. Admin. Code § Ins 3702.01 #7964, eff 1-1-04#8901, eff 7-1-07 Amended by Volume XXXVI Number 06, Filed February 1…

For the purposes of this part, definitions shall be the same as those delineated at Ins 3701.02 with the following exceptions: (a) "Customer information" means nonpublic personal information as defined in RSA 359-C:19, IV. (a) and (b) about a customer, in electronic form, that is…

(a) When a licensee becomes aware of an incident of unauthorized access to customer information, the licensee shall immediately conduct an investigation to promptly determine the likelihood that the information has been or will be misused. (b) If a licensee determines that misuse…

(a) If a licensee, based upon its investigation, can determine from its logs or other data precisely which customers' information has been improperly accessed, it may limit notification to those customers with regard to whom the licensee determines that misuse of their informatio…

(a) Customer notice shall be given in a clear and conspicuous manner. The notice shall describe the incident in general terms, the type of customer information that was the subject of the unauthorized access or use and the approximate date of the breach. (b) The notice shall incl…

(a) Customer notice shall be delivered in any manner designed to ensure that a customer can be expected to receive it. The licensee may choose to contact all customers affected by telephone provided the licensee maintains a log of each such notification, or by U.S. mail, or by el…

Violations of any of the provisions of this part shall be subject to the penalties of RSA 400-A2:15 III. Notes N.H. Admin. Code § Ins 3702.07 #8901, eff 7-1-07 Amended by Volume XXXVI Number 06, Filed February 11, 2016, Proposed by #11015, Effective 1/8/2016, Expires 1/8/2026.…

Notes N.H. Admin. Code § Ins 3801.01 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.02 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.03 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.04 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.05 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.06 #8754, eff 12-1-06 Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Number 27, Filed July 8, 2021, Proposed by # 13217, Effective 6/23/2021, Expires 6/…

Notes N.H. Admin. Code § Ins 3801.07 #8754, eff 12-1-06 MEDICAL PROFESSIONAL LIABILITY INSURANCE CLAIM REPORT FORMS (EXCEL DOCUMENTS) Amended byVolume XXXIV Number 50, Filed December 11, 2014, Proposed by #10732, Effective 12/1/2014, Expires12/1/2024. Reserved by Volume XLI Numbe…

In accordance with RSA 415-A and the U.S. Department of Labor Benefit Claims Procedure Regulation, 29 CFR 2560.503, this section establishes the minimum requirements for carriers pertaining to the processing of claims for disability benefits by participants and claimants. These r…

(a) "Adverse benefit determination" means a denial, reduction, or termination of, or a failure to provide or make payment (in whole or in part) for, a benefit, including any such denial, reduction, termination, or failure to provide or make payment that is based on a determinatio…

(a) Health carriers that offer disability benefits shall establish and maintain reasonable procedures governing the filing of benefit claims, notification of benefit determinations, and appeal of adverse benefit determinations, hereinafter collectively referred to as claims proce…

In the case of the failure of a carrier to establish or follow its claims and appeals procedures, a claimant shall be deemed by the department to have exhausted the administrative remedies available under the plan and shall be entitled to pursue any available legal remedies on th…

This section shall apply to claims filed under a plan on or after March 1, 2004. Notes N.H. Admin. Code § Ins 3901.05 #8020, eff 3-1-04; ss by #10122, eff 5-1-12

The purpose of this part is to permit the sale of individual supplementary insurance against the loss of income due to the involuntary loss of employment and to establish standards governing such coverage. Notes N.H. Admin. Code § Ins 3902.01 Derived From Volume XXXV Number 27, F…

This part shall apply to all licensed insurers authorized to insure casualty risks. Notes N.H. Admin. Code § Ins 3902.02 Derived From Volume XXXV Number 27, Filed July 9, 2015 , Proposed by #10866, Effective 8/1/2015, Expires8/1/2025.

(a) "Individual supplemental unemployment insurance" means individual insurance that provides supplemental benefits, paid directly to an insured, for protection against the loss of income due to the involuntary loss of employment. (b) "Loss of income" means loss of income as the …