Title XXXVII, Insurance

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 tran…

I. The department may require a provider to submit a financial plan, if either of the following applies: (a) A provider fails to file a complete annual report. (b) The department has reason to believe that the provider is insolvent, is in imminent danger of becoming insolvent, is…

The existence of a court order under RSA 169-B, RSA 169-C, or RSA 169-D for a service, program, or placement that is covered under any insurance for the minor shall not be considered in determining qualification for third-party payment under such insurance. Benefits for such serv…

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 a…

I. The commissioner may, if it is in the best interest of the residents, petition a court of competent jurisdiction to appoint a trustee to rehabilitate or liquidate a facility. Such rehabilitation or liquidation shall occur only if the commissioner finds, after proper notice and…

All health service corporations and every other similar corporation licensed under the laws of another state shall provide to each subscriber, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedu…

Every organization subject to this chapter shall pay to the commissioner those fees required for payment by hospital and medical service corporations under RSA 400-A:29.

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 accor…

Any health carrier who proposes, advertises, solicits, issues or delivers to any person or entity in this state any form which does not comply with this chapter or who shall in any way violate this chapter may: I. Be prohibited from marketing, selling, or otherwise administering …

I. Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, the health carrier providing such benefits shall rely upon ASAM criteria when determining medical necessity and developing utilization review standards for level…

I. Each resident may, upon 90-days' written notice, cancel the resident's continuing care agreement for any reason. II. Each resident shall be provided at least 60-days' written notice from the provider if the resident's continuing care contract is being canceled for just cause. …

Every health service corporation and every other similar corporation licensed under the laws of another state shall provide to each new subscriber who is a resident of this state a copy of the patients' bill of rights law under RSA 151:21.

I. Upon cancellation of the continuing care contract by either the resident or the provider, the resident shall have the right to receive a refund of the amount of any unearned entrance fee as provided in the continuing care contract or as otherwise provided by law. The amount of…

The commissioner may adopt rules pursuant to RSA 541-A to implement this chapter.

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.

I. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses shall provide to each individu…

I. Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, no prior authorization shall be required for the first 2 routine outpatient visits of an episode of care by an individual for assessment and care with respect to…

Every organization doing business pursuant to this chapter shall be subject to the premium tax requirements of RSA 400-A:31 and 32. Except for payments made by the state of New Hampshire, no tax shall be levied on any premiums, fees-for-service and other payments for health, dent…

Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any policy, plan, or contract of individual or group accident or health insurance providing benefits for medical or hospital expenses, shall provide to ea…

I. Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any group policy of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certi…

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical or hospital expenses, which provides coverage for outpatient service…

I. (a) Every health service corporation, and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group accident or health insurance providing benefits for medical or hospital expenses for its insured persons s…

I. In this section "retroactive denial of a previously paid claim" means any attempt by a health service corporation to retroactively collect payments already made to a health care provider with respect to a claim by requiring repayment of such payments, reducing other payments c…

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing maternity benefits shall also provide to each group, or to the portion of each group comp…

Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of group accident or health insurance providing benefits for medical, rehabilitation, or hospital expenses, which provides coverage for o…

All persons engaged in the solicitation or enrollment of enrolled participants shall be duly licensed agents for the sale of health insurance in the state pursuant to the provisions of RSA 402-J.

A provider shall obtain prior approval from the commissioner before declaring and distributing any dividends, if a for-profit entity, or, except as noted below, transferring any cash, dividends, or any other funds or assets of the provider to an affiliate of any entity. Notwithst…

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.

No health service corporation shall invest its funds otherwise than as provided in RSA 411-A relating to the investments and holding of real estate by domestic life insurance companies; provided that not exceeding 10 percent of a health service corporation's total admitted assets…

Whenever substance use disorder services are a covered benefit under a health benefit plan subject to this chapter, a health carrier shall: I. Be required to offer at least one medication-assisted treatment therapy option approved by the federal Food and Drug Administration for t…

I. An individual or group health insurance plan or policy providing prescription drug coverage in New Hampshire, shall permit and apply a prorated, daily cost-sharing rate to covered prescriptions for a chronic condition that are dispensed by an in-network pharmacy for less than …

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…

I. An insurance company licensed in this state, or a hospital, medical or health service corporation authorized to do business in this state, either directly or through a subsidiary or affiliate, may organize and operate a health maintenance organization under the provisions of t…

I. No contract between a health service corporation and a physician, for the purpose of delineating the rights and obligations of the parties within the provider network, shall limit the liability of the health service corporation for any actions of the physician for which the he…

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 purchase…

In this chapter: I. "Commissioner" means the insurance commissioner. II. "Covered person" means an individual entitled to reimbursement for expenses of health care services under a policy issued or administered by a health care insurer. II-a. "Date of enrollment" means the first …

This chapter shall apply to all health carriers offering a managed care plan in this state.

I. No person or provider may solicit funds other than non-binding deposit fees of not more than $1,000, accept payments of any kind, or otherwise engage in providing any form of continuing care without acquiring and maintaining a certificate of authority issued by the commissione…

I. No managed care insurer may enter into any new exclusive arrangement or renew any exclusive arrangement with any person on or after the effective date of this act. II. No managed care insurer shall maintain exclusive arrangements or engage in any act or practice that would res…

Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 41…

As used in this chapter: I. "Certificate" means a document received by an insured, enrollee, or subscriber from an insurer in lieu of a policy or contract which evidences the coverage to which the insured, enrollee or subscriber is entitled. II. "Commissioner" means the commissio…

I. This chapter establishes the exclusive state standards applicable to licensees for data security, the investigation of a cybersecurity event, as defined in RSA 420-P:3, IV, and notification to the commissioner. II. This chapter shall not be construed to create or imply a priva…

In this chapter: I. "Actuarial certification" means a written statement by a member of the American Academy of Actuaries or other individual acceptable to the commissioner that a small employer health carrier is in compliance with the provisions of and the rules adopted by the co…

In this chapter: I. "Commissioner" means the insurance commissioner. II. "Plan document" means evidence of coverage furnished to a student that sets forth all benefits and terms and conditions, with regard to a student health plan. III. "Qualified actuary" means an actuary who is…

I. No person may operate a health maintenance organization without obtaining a certificate of authority from the commissioner. A foreign corporation may qualify under this chapter subject to its registration to do business in this state as a foreign corporation under RSA 293-A. I…

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 o…