TITLE XXXVII
INSURANCE

CHAPTER 420-M
PURCHASING ALLIANCES

Section 420-M:13


[RSA 420-M:13 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-M:13 set out below.]
    420-M:13 Qualified Purchasing Alliance. –
A purchasing alliance that has a minimum of 3,000 enrollees may elect to obtain certification from the commissioner as a qualified purchasing alliance. To obtain certification, a purchasing alliance shall demonstrate:
I. Either that membership in the alliance is open to all employers without discrimination or that the alliance has established membership criteria that limit membership in the alliance to employers that are members of or affiliated with an association, trade group, or other entity that has been in existence for at least 10 years and was established and maintained for purposes other than the provision of health coverage; and
II. That the health benefit plan or plans offered to its members and the provider payment policies associated with those plans will promote more cost effective use of health care services by providing a better alignment of financial incentives with:
(a) Health care quality improvement and efficiency; and
(b) Health promotion and disease prevention.

[RSA 420-M:13 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-M:13 above.]


420-M:13 Qualified Purchasing Alliance. –
A purchasing alliance that has a minimum of 500 enrollees may elect to obtain certification from the commissioner as a qualified purchasing alliance. To obtain certification, a purchasing alliance shall demonstrate:
I. That the purchasing alliance meets all requirements under RSA 415-E to operate as a bona fide pathway II association; and
II. That certification of the applicant as a qualified purchasing alliance will promote the purposes set out in RSA 420-M:1; and
III. That the purchasing alliance has the capacity to monitor and screen sole proprietor members purchasing pathway II association coverage to ensure that they meet all requirements to qualify as an "employee" under 29 C.F.R. section 2510.3-5(b) and meets the per month hourly work requirement contained in RSA 126-AA:2, III.

Source. 2010, 346:1. 2011, 155:2, eff. Aug. 7, 2011. 2019, 346:411.