TITLE XXXVII
INSURANCE

CHAPTER 420-K
SMALL EMPLOYER HEALTH REINSURANCE POOL

Section 420-K:1


[RSA 420-K:1 effective until 60 days after certification by the insurance commissioner that 29 C.F.R. section 2510.3-5(b) is valid and that issues raised in State of New York v. United States Department of Labor have been resolved, but not later than December 1, 2021; see also RSA 420-K:1 set out below.]

2019, 346:414 amends the RSA 420-K heading to read "Small Employer Health Risk Adjustment Program" effective 60 days after certification by the insurance commissioner that 29 C.F.R. section 2510.3-5(b) is valid and that issues raised in State of New York v. United States Department of Labor have been resolved, but not later than December 1, 2021.
    420-K:1 Definitions. –
In this chapter:
I. "Assessment" means the liability of the member insurer to the reinsurance pool.
II. "Board" means the board of directors of the small employer health reinsurance pool.
III. "Commissioner" means the insurance commissioner.
IV. "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, and where coverage has been purchased by a group health insurance plan subject to the Employee Retirement Income Security Act of 1974, Public Law No. 93-406 (ERISA).
V. "Health carrier" means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B that delivers, issues for delivery or maintains in force policies of health insurance in New Hampshire.
VI. "Health insurance" means "health insurance" as defined in RSA 404-G:2, VII.
VII. "Plan of operation" means the plan of operation of the small employer health reinsurance pool, including articles, bylaws and operating rules, procedures and policies approved by the commissioner and adopted by the pool.
VIII. "Pool" means the small employer health reinsurance pool.
IX. "Small employer" means "small employer" as defined in RSA 420-G: 2, XVI.
X. "Standard health benefit plan" means a health benefit plan developed pursuant to RSA 420-K:4, I.

[RSA 420-K:1 effective 60 days after certification by the insurance commissioner that 29 C.F.R. section 2510.3-5(b) is valid and that issues raised in State of New York v. United States Department of Labor have been resolved, but not later than December 1, 2021; see also RSA 420-K:1 above.]


420-K:1 Definitions. –
In this chapter:
I. "Assessment" means the liability of the member insurer to the reinsurance pool.
II. "Board" means the board of directors of the small employer health reinsurance pool.
III. "Bona fide pathway II association coverage" means coverage, whether self-funded or fully insured, that constitutes an employee welfare benefit plan sponsored by a bona fide pathway II association as defined in RSA 415-E:1.
IV. "Commissioner" means the insurance commissioner.
V. "Covered lives" shall include all persons who have health insurance via a health carrier and who are employees or dependents of employees of a small employer, including sole proprietors covered under bona fide pathway II association coverage.
VI. "Health insurance" means "health insurance" as defined in RSA 404-G:2, VII.
VII. "Plan of operation" means the plan of operation of the small employer health risk adjustment program, including articles, bylaws and operating rules, procedures and policies approved by the commissioner and adopted by the pool.
VIII. "Small employer" means "small employer" as defined in RSA 420-G:2, XVI.
IX. "Small employer health carrier" means any entity licensed pursuant to RSA 402, RSA 420-A, or RSA 420-B that delivers, issues for delivery or maintains in force policies of health insurance in New Hampshire to any small employer. For purposes of this chapter, health carrier shall include any association, organization or arrangement offering or sponsoring bona fide pathway II association coverage.

Source. 2005, 225:12. 2008, 375:7, eff. July 1, 2008. 2019, 346:415.