New Hampshire Revised Statutes 404-G:2 – Definitions
Current as of: 2023 | Check for updates
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In this chapter:
I. “Actively marketing” means actively marketing, issuing, and renewing all of the health coverages the respective carrier sells in the individual market to all individuals.
I-a. “Act” means the Patient Protection and Affordable Care Act of 2009 (PL 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (PL 111-152).
II. “Assessment” means the liability of the member insurer to the association.
III. “Association” means the entity created within this chapter which shall be the same association as that created under the order, defined in paragraph X.
IV. “Commissioner” means the insurance commissioner.
V. “Covered lives” shall include all persons who are:
(a) Covered under an individual health insurance policy issued or delivered in New Hampshire;
(b) Covered under a group health insurance policy that is issued or delivered in New Hampshire;
(c) Covered under a group health insurance policy evidenced by a certificate of insurance that is issued or delivered in New Hampshire;
(d) Protected, in part, by a group excess loss insurance policy where the policy or certificate of coverage has been issued or delivered in New Hampshire.
V-a. “Group excess loss insurance” means coverage purchased by an employer against the risk that any one claim made against the employer’s health plan will exceed a specified dollar amount or coverage purchased by an employer against the risk that the employer’s total liability for the health plan will exceed a specified amount.
VI. “Group health insurance” means health insurance coverage other than individual health insurance coverage.
VII. “Health insurance” means health insurance coverage issued in accordance with RSA 415, 420-A, or 420-B. For the purposes of this chapter, health insurance shall not include accident only, credit, dental, vision, Medicare supplement, Medicare Risk, Medicare+Choice, Managed Medicaid, long-term care, disability income, coverage issued as a supplement to a liability insurance, workers’ compensation or similar insurance, automobile medical payment insurance, policies or certificates of specified disease, hospital confinement indemnity, limited benefit health insurance, and coverage provided through the Federal Employees’ Program. Health insurance does include group excess loss insurance.
VIII. “Individual health insurance” means health insurance sold directly to an individual and not on a group remittance basis. Individual health insurance shall include franchise health insurance.
IX. “Insurer” means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B.
X. “Order” means the insurance department findings and final order dated November 26, 1997, in the matter of the individual health insurance market in New Hampshire pursuant to RSA 404-C.
X-a. “Plan of operation” means the plan of operation of the risk sharing mechanism, the high risk pool, support for the program established in RSA 126-AA, and the federally qualified high risk pool, including articles, bylaws and operating rules, procedures and policies adopted by the association.
X-b. “Pool” means the New Hampshire health insurance high risk pool.
X-c. [Repealed.]
XI. “Writer” means a writing carrier.
I. “Actively marketing” means actively marketing, issuing, and renewing all of the health coverages the respective carrier sells in the individual market to all individuals.
I-a. “Act” means the Patient Protection and Affordable Care Act of 2009 (PL 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (PL 111-152).
II. “Assessment” means the liability of the member insurer to the association.
III. “Association” means the entity created within this chapter which shall be the same association as that created under the order, defined in paragraph X.
IV. “Commissioner” means the insurance commissioner.
V. “Covered lives” shall include all persons who are:
(a) Covered under an individual health insurance policy issued or delivered in New Hampshire;
(b) Covered under a group health insurance policy that is issued or delivered in New Hampshire;
(c) Covered under a group health insurance policy evidenced by a certificate of insurance that is issued or delivered in New Hampshire;
(d) Protected, in part, by a group excess loss insurance policy where the policy or certificate of coverage has been issued or delivered in New Hampshire.
V-a. “Group excess loss insurance” means coverage purchased by an employer against the risk that any one claim made against the employer’s health plan will exceed a specified dollar amount or coverage purchased by an employer against the risk that the employer’s total liability for the health plan will exceed a specified amount.
VI. “Group health insurance” means health insurance coverage other than individual health insurance coverage.
VII. “Health insurance” means health insurance coverage issued in accordance with RSA 415, 420-A, or 420-B. For the purposes of this chapter, health insurance shall not include accident only, credit, dental, vision, Medicare supplement, Medicare Risk, Medicare+Choice, Managed Medicaid, long-term care, disability income, coverage issued as a supplement to a liability insurance, workers’ compensation or similar insurance, automobile medical payment insurance, policies or certificates of specified disease, hospital confinement indemnity, limited benefit health insurance, and coverage provided through the Federal Employees’ Program. Health insurance does include group excess loss insurance.
VIII. “Individual health insurance” means health insurance sold directly to an individual and not on a group remittance basis. Individual health insurance shall include franchise health insurance.
IX. “Insurer” means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B.
X. “Order” means the insurance department findings and final order dated November 26, 1997, in the matter of the individual health insurance market in New Hampshire pursuant to RSA 404-C.
X-a. “Plan of operation” means the plan of operation of the risk sharing mechanism, the high risk pool, support for the program established in RSA 126-AA, and the federally qualified high risk pool, including articles, bylaws and operating rules, procedures and policies adopted by the association.
X-b. “Pool” means the New Hampshire health insurance high risk pool.
X-c. [Repealed.]
XI. “Writer” means a writing carrier.