New Hampshire Administrative Code

Small employer stop loss carriers shall submit a filing that includes all documentation required of this subsection at least annually. Notes N.H. Admin. Code § Ins 4105.06 #9690, eff 4-9-10; ss by #9938, eff 6-10-11 The amended version of this section by New Hampshire Register Vo…

Small employer stop loss carriers may make an interim filing between its required annual filings, to propose adjustments to only certain factors. Notes N.H. Admin. Code § Ins 4105.07 #9690, eff 4-9-10; ss by #9938, eff 6-10-11 The amended version of this section by New Hampshire …

The purpose of this part is to provide requirements for the submission and the filing of disability income health insurance rates, blanket coverage and group supplemental coverage and any other type of health insurance that is defined as an excepted benefit under RSA 420-G:2, IX.…

This part shall apply to disability income insurance as defined in Ins 1901.06(h) , blanket coverage, group supplemental coverage and any other type of health coverage that is identified as an excepted benefit under RSA 420-G:2, IX. Notes N.H. Admin. Code § Ins 4106.02 #9690, eff…

For the purposes of this part: (a) "Actuarial certification" means a written statement signed by a member of the American Academy of Actuaries that, to the best of the actuary's knowledge and judgment, the entire rate filing is in compliance with all of the applicable laws and ru…

(a) All submissions shall include an actuarial memorandum, as follows: (1) For new policy forms, the actuarial memorandum shall include: a. A brief description of: 1. The type of policy; 2. Benefits; 3. Renewability; 4. General marketing method; 5. Issue age limits; and 6. Rate d…

(a) Carriers shall estimate the average annual premium per policy form based on an anticipated distribution of business by all significant criteria having a price difference such as:(1) Age; (2) Coverage amount; (3) Dependent status; and (4) Rider frequency. (b) Carriers shall as…

(a) Carriers shall estimate the average annual premium, both before and after the revision, per policy form based on an anticipated distribution of business by all significant criteria having a price difference, including: (1) Age; (2) Coverage amount; (3) Dependent status; and (…

(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…

This chapter contains the provisions for submission of data on all encounters for health care by uninsured patients from hospitals, community health centers, and hospital owned or controlled physician practices and other providers. Notes N.H. Admin. Code § Ins 4201.01 #9806, eff …

For the purposes of this chapter: (a) "Agent" means a person engaged under contractual agreement with the department for the performance of services. (d) "Commissioner" means the New Hampshire insurance department commissioner. (e) "Community health centers" means non-profit comm…

All licensed hospitals, community health centers, hospital owned or controlled physician practices, and hospital owned or controlled licensed healthcare service providers shall be required to submit patient encounter data sets to the department. Hospitals and community health cen…

Beginning with encounters occurring on January 1, 2011, hospitals and community health centers shall submit to the department, or its designee, a completed healthcare data set for all encounters for healthcare services with uninsured patients. Each hospital shall ensure submittal…

(a) For hospital based services that are normally billed to third-party payers using the UB-04 form, hospitals shall submit data to the department, or its agent, using a format compliant with the "Official UB-04 Data Specifications Manual" published by the National Uniform Billin…

Hospitals and community health centers shall submit header and trailer records and uninsured patient encounter data set records using the following specifications in submitting their healthcare uninsured patient encounter data set: (a) The file header record layout shall be submi…

(a) Each hospital and community health center that is subject to the submission requirements shall submit a registration to the department, or its designee, within one month of the effective date of these rules, and annually thereafter, with the following information: (1) The hos…

With each submission of data, a transmittal record shall also be supplied that contains the following information: (a) Submitting hospital or community health center; (b) If different from submitting healthcare facility, the name and address of the location where the encounters i…

(a) Each hospital or community health center shall submit to the department, or its agent, a test data submission for the purpose of determining compliance with the required data submission standards. (b) Each test data submission shall contain 3 months worth of encounter data. (…

The submission period for healthcare facilities submission of data sets shall, at a minimum, be annually. Notes N.H. Admin. Code § Ins 4202.08 #9806, eff 11-1-10

With each submission, healthcare data sets shall comply with the following reporting requirements: (a) The applicable code for each data element shall be within the eligible values of the element; (b) Coding values indicating "data not available", "data unknown", or the equivalen…

(a) Each hospital or community health center shall be notified when data submissions do not meet the standards described in this rule, including the specific file and data elements that do not meet the standards. (b) Each hospital or community health center notified of a non-comp…

(a) The purpose of this part is to provide standards and requirements regarding the fiduciary obligation of insurance producers. (b) This part shall apply to all resident and non-resident insurance producers licensed pursuant to RSA 402-J. Notes N.H. Admin. Code § Ins 4301.01 (Se…

(a) "Commissioner" means the insurance commissioner. (b) "Producer" means a resident or non-resident producer pursuant to the provisions of RSA 402-J. Notes N.H. Admin. Code § Ins 4301.02 (See Revision Note at chapter heading for Ins 4300) #8935, eff 8-1-07 Amended by Volume XXXV…

(a) Insurance producers shall hold premiums and return premiums as a trustee, and not as the owner of the beneficial title to the funds. (b) Any money, or thing of value received by a producer as premium or return premium on or under any policy of insurance or application therefo…

(a) Each insurance producer shall establish a premium trust account if the insurance producer expects to receive premiums or return premiums on New Hampshire business. (b) An insurance producer shall only utilize such accounts that require no advance notice for the withdrawal of …

(a) Under no circumstances shall an insurance producer place fiduciary funds in a personal or business operating account. The insurance producer may retain commission income or other funds in the premium trust account in order to advance premiums, establish reserves for paying re…

The insurance producer shall hold the return premiums as a fiduciary. The producer shall retain the return premium in the trust account until remittance to the client is made which is to occur no later than 15 days from the date the return premium is determined by the carrier. If…

Transactions that are handled simply as exchange items, such as New Hampshire automobile reinsurance facility business and direct mail downpayments, shall flow through the premium trust account. Notes N.H. Admin. Code § Ins 4301.07 (See Revision Note at chapter heading for Ins 43…

(a) The following records relative to the premium trust account shall be maintained at all times by the insurance producer pursuant to RSA 400-B:3: (1) Periodic statements of account supplied by the bank for all premium trust accounts maintained pursuant to this part; (2) Records…

(a) Any insurance producer who shall knowingly violate any provision of this part shall be subject to the provisions of RSA 400-A:15, III. (b) In addition to (a) above, violations involving possible criminal acts shall be referred to the office of the attorney general or to the c…

(a) The purpose of this part is to establish criteria for actuarial certification that the insurer is in compliance with RSA 415-H. (b) This part shall apply to all accident and health insurers licensed to do business in this state. Notes N.H. Admin. Code § Ins 4401.01 #9244, eff…

(a) "Actuarial certification" means "actuarial certification" as defined in RSA 415-H:2 I. (b) "Attachment point" means "attachment point" as defined in RSA 415-H:2 II. (c) "Expected claims" means "expected claims" as defined in RSA 415-H:2 III. Notes N.H. Admin. Code § Ins 4401.…

(a) The board of directors of each stop loss insurer shall appoint an actuary responsible for the filing of the actuarial certification required by RSA 415-H. (b) The actuary shall meet the requirements of Ins 2401.04(b) and (c). (c) The insurer shall immediately notify the commi…

For the purposes of actuarial certification, the actuary shall perform the following duties for policies issued or renewed on or after January 1, 2017 and until January 1, 2021: (a) Certify that the insurer has not issued or renewed any stop loss policy with an annual attachment …

For the purposes of actuarial certification, the actuary shall perform the following duties for policies issued or renewed on or after January 1, 2021: (a) Certify that the insurer has not issued or renewed any stop loss policy with an annual attachment point for claims incurred …

(a) The actuarial certification period shall be coterminous with a calendar year. (b) The actuarial certification shall be submitted to the commissioner annually, to the attention of the life, accident and health insurance division, on or before March 15 following the period for …

(a) The purpose of this rule is to improve the New Hampshire insurance department's surveillance of the financial condition of insurers by requiring: (1) An annual audit of financial statements reporting the financial position and the results of operations of insurers by independ…

The terms and definitions contained herein are intended to provide definitional guidance as the terms are used within this rule. (a) "Accountant" or "independent certified public accountant" means an independent certified public accountant or accounting firm in good standing with…

(a) All insurers shall have an annual audit by an independent certified public accountant and shall file an audited financial report with the commissioner on or before June 1 for the year ended December 31 immediately preceding. The commissioner may require an insurer to file an …

(a) The annual audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows and changes in capital and surplus for the year then ended in conformity with statutory accounti…

(a) Each insurer required by this rule to file an annual audited financial report shall within 60 days after becoming subject to the requirement, register with the commissioner in writing the name and address of the independent certified public accountant or accounting firm retai…

(a) The commissioner shall not recognize a person or firm as a qualified independent certified public accountant if the person or firm: (1) Is not in good standing with the AICPA and in all states in which the accountant is licensed to practice, or, for a Canadian or British comp…

An insurer may make written application to the commissioner for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies that utilizes a pooling or 100 p…

Financial statements furnished pursuant to Ins 4501.04 shall be examined by the independent certified public accountant. The audit of the insurer's financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 …

(a) The insurer required to furnish the annual audited financial report shall require the independent certified public accountant to report, in writing, within 5 business days to the board of directors or its audit committee any determination by the independent certified public a…

(a) In addition to the annual audited financial report, each insurer shall furnish the commissioner with a written communication as to any unremediated material weaknesses in its internal controls over financial reporting noted during the audit. Such communication shall be prepar…

The accountant shall furnish the insurer in connection with, and for inclusion in, the filing of the annual audited financial report, a letter stating: (a) That the accountant is independent with respect to the insurer and conforms to the standards of his or her profession as con…