TABLE OF CONTENTS

 

CHAPTER Ins 100 ORGANIZATIONAL RULES

            PART Ins 101 DEFINITIONS

                        Section Ins 101.01 Commissioner

                        Section Ins 101.02 Department

 

            PART Ins 102 DESCRIPTION OF DEPARTMENT

                        Section Ins 102.01 Commissioner

                        Section Ins 102.02 Licensing Division

                        Section Ins 102.03 Consumer Services Division

                        Section Ins 102.04 Life, Accident and Health Division

                        Section Ins 102.05 Property and Casualty Division

                        Section Ins 102.06 Examination Division

                        Section Ins 102.07 Administrative Division

                        Section Ins 102.08 Fraud Division

 

            PART Ins 103 REQUESTS FOR DEPARTMENT DOCUMENT/RECORDS

                        Section Ins 103.01 Document Requests

                        Section Ins 103.02 Requests in Writing, Required Information

                        Section Ins 103.03 Department Response

 

CHAPTER Ins 200  PRACTICES AND PROCEDURES

PART Ins 201  GENERAL INFORMATION

                  Section Ins 201.01  Scope

 

          PART Ins 202  DEFINITIONS

                  Section Ins 202.01  Definitions

 

          PART Ins 203  HEARING OFFICER

                  Section Ins 203.01  Hearing Officer; Appointment; Authority

                  Section Ins 203.02  Withdrawal of Hearing Officer

                  Section Ins 203.03  Inquiry by Hearing Officer

 

          PART Ins 204  APPEARANCES BEFORE THE DEPARTMENT

                  Section Ins 204.01  Who May Appear

                  Section Ins 204.02  Representatives

                  Section Ins 204.03  Right to Counsel

                  Section Ins 204.04  Prohibited Conduct and Representation

                  Section Ins 204.05  Staff of Department

                  Section Ins 204.06  Role of Complainants in Enforcement or Disciplinary Hearings

                  Section Ins 204.07  Ex Parte Communications, Adjudicative Proceedings

 

          PART Ins 205  FILING AND SERVICE OF DOCUMENTS

                  Section Ins 205.01  Date of Issuance or Filing of Documents

                  Section Ins 205.02  Format and Filing of Documents

                  Section Ins 205.03  Delivery of Documents

                  Section Ins 205.04  Computation of Time

                  Section Ins 205.05  Motions and Response Thereto

                  Section Ins 205.06  Confidential Documents and Confidential Information

 

          PART Ins 206  ADJUDICATIVE PROCEEDINGS

                  Section Ins 206.01  Adjudicative Proceedings

                  Section Ins 206.02  Waiver of Procedural Rules

                  Section Ins 206.03  Effect of Failure to Comply with the Rules or Attend Hearing

                  Section Ins 206.04  Summary Suspension of Department Issued Licenses

                  Section Ins 206.05  Burden and Standard of Proof

                  Section Ins 206.06  Continuances

                  Section Ins 206.07  Prehearing Conferences

                  Section Ins 206.08  Discovery and Disclosure

                  Section Ins 206.09  Subpoenas

                  Section Ins 206.10  Evidence

                  Section Ins 206.11  Proposed Findings of Fact and Conclusions of Law

                  Section Ins 206.12  Transcripts

                  Section Ins 206.13  Record

                  Section Ins 206.14  Consolidation

                  Section Ins 206.15  Severance

                  Section Ins 206.16  Limiting Number of Witnesses

 

          PART Ins 207  SETTLEMENT, DECISIONS, AND REHEARING

                  Section Ins 207.01  Settlement

                  Section Ins 207.02  Voluntary Surrender of License

                  Section Ins 207.03  Reopening the Record

                  Section Ins 207.04  Findings and Orders

                  Section Ins 207.05  Reconsideration on the Commissioner’s Own Motion

                  Section Ins 207.06  Motion for Reconsideration

                  Section Ins 207.07  Stay of Department Orders

                  Section Ins 207.08  Record Retention

 

          PART Ins 208  PROCEEDINGS TO DETERMINE COMMERCIAL RESASONABLENESS OF HEALTH CARE FEES

                  Section Ins 208.01  Scope

                  Section Ins 208.02  Petition for Hearing

                  Section Ins 208.03  Response to the Petition

                  Section Ins 208.04  Prehearing Conference

                  Section Ins 208.05  Prehearing Statements

                  Section Ins 208.06  Intervention by the Department

 

          PART Ins 209  PETITION FOR DECLARATORY RULING

                  Section Ins 209.01  Petitions

                  Section Ins 209.02  Action on Petitions

 

          PART Ins 210  RULEMAKING

                  Section Ins 210.01  How Adopted

                  Section Ins 210.02  Manner for Adoption

                  Section Ins 210.03  Petitions to Department for Rulemaking

                  Section Ins 210.04  Public Hearings

                  Section Ins 210.05  Request for Notice of Intended Department Rulemaking Action

                  Section Ins 210.06  Explanation of the Rule

 

          PART Ins 211  WAIVER OF RULES

                  Section Ins 211.01  Waiver of Rules

 

CHAPTER Ins 300 LIFE INSURANCE

          PART Ins 301  LIFE INSURANCE SOLICITATION

                  Section Ins 301.01  Purpose

                  Section Ins 301.02  Scope

                  Section Ins 301.03  Definitions

                  Section Ins 301.04  Duties of Insurers

                  Section Ins 301.05  Preneed Funeral Contracts or Prearrangements

                  Section Ins 301.06  Solicitation of Life Insurance General Rules

                  Section Ins 301.07  Suitability of Recommendation or Sale

                  Section Ins 301.08  Failure to Comply

                  Section Ins 301.09  Life Insurance Buyer’s Guide

                  Section Ins 301.10  Waiver or Suspension of Rules

 

          PART Ins 302  LIFE INSURANCE AND ANNUITIES REPLACEMENT

                  Section Ins 302.01  Purpose

                  Section Ins 302.02  Scope

                  Section Ins 302.03  Definitions

                  Section Ins 302.04  Duties of Producers

                  Section Ins 302.05  Duties of Insurers that Use Producers

                  Section Ins 302.06  Duties of Replacing Insurers that Use Producers

                  Section Ins 302.07  Duties of the Existing Insurer

                  Section Ins 302.08  Duties of Insurers with Respect to Direct Response Solicitations

                  Section Ins 302.09  Violations and Penalties

                  Section Ins 302.10  Waiver or Suspension of Rules

 

          PART Ins 303  DEPOSIT TERM LIFE INSURANCE

                  Section Ins 303.01  Purpose

                  Section Ins 303.02  Scope

                  Section Ins 303.03  Definitions

                  Section Ins 303.04  Advertising and Solicitation Requirements

                  Section Ins 303.05  Disclosure Requirements

                  Section Ins 303.06  Penalty

 

          PART Ins 304  FINANCING OF LIFE INSURANCE PREMIUMS

                  Section Ins 304.01  Premium Financing Requirements

                  Section Ins 304.02  Exemption

                  Section Ins 304.03  Waiver or Suspension of Rules

 

          PART Ins 305  SUITABILITY IN ANNUITY TRANSACTIONS

                  Section Ins 305.01  Purpose

                  Section Ins 305.02  Applicability and Scope

                  Section Ins 305.03  Exemptions

                  Section Ins 305.04  Definitions

                  Section Ins 305.05  Duties of Insurers and of Insurance Producers

                  Section Ins 305.06  Mitigation of Responsibility

                  Section Ins 305.07  Compliance Mitigation; Penalties

                  Section Ins 305.08  Recordkeeping

 

          PART Ins 306  ANNUITY DISCLOSURE

                  Section Ins 306.01  Purpose

                  Section Ins 306.02  Applicability and Scope

                  Section Ins 306.03  Definitions

                  Section Ins 306.04  Standards for the Disclosure and Buyer’s Guide

                  Section Ins 306.05  Standards for Annuity Illustrations

                  Section Ins 306.06  Report to Contract Owners

                  Section Ins 306.07  Penalties

                  Section Ins 306.08  Waiver or Suspension of Rules

 

          PART Ins 307  MORTALITY TABLES FOR USE IN DETERMINING RESERVE LIABILITIES FOR ANNUITIES

                  Section Ins 307.01  Purpose

                  Section Ins 307.02  Scope

                  Section Ins 307.03  Definitions

                  Section Ins 307.04  Individual Annuity or Pure Endowment Contracts

                  Section Ins 307.05  Group Annuity or Pure Endowment Contracts

                  Section Ins 307.06  Application of the 1994 GAR Table

                  Section Ins 307.07  Application of the 2012 IAR Mortality Table

 

          PART Ins 308  LIFE AND HEALTH REINSURANCE AGREEMENTS

                  Section Ins 308.01  Preamble

                  Section Ins 308.02  Purpose

                  Section Ins 308.03  Scope

                  Section Ins 308.04  Accounting Requirements

                  Section Ins 308.05  Written Agreements

                  Section Ins 308.06  Existing Agreements

 

          PART Ins 309  LIFE INSURANCE ILLUSTRATIONS

                  Section Ins 309.01  Purpose

                  Section Ins 309.02  Applicability and Scope

                  Section Ins 309.03  Definitions

                  Section Ins 309.04  Policies to be Illustrated

                  Section Ins 309.05  General Rules and Prohibitions

                  Section Ins 309.06  Standards for Basic Illustrations

                  Section Ins 309.07  Standards for Supplement Illustrations

                  Section Ins 309.08  Delivery of Illustration and Record Retention

                  Section Ins 309.09  Annual Report; Notice to Policy Owners

                  Section Ins 309.10  Annual Certifications

                  Section Ins 309.11  Penalties

                  Section Ins 309.12  Effective Date and Policy Sales

 

          PART Ins 310  MILITARY SALES PRACTICES

                  Section Ins 310.01  Purpose

                  Section Ins 310.02  Scope

                  Section Ins 310.03  Exemptions

                  Section Ins 310.04  Definitions

                  Section Ins 310.05  Practices Declared False, Misleading, Deceptive or Unfair on a Military Installation

                  Section Ins 310.06  Practices Declared False, Misleading, Deceptive or Unfair Regardless of Location

 

          PART Ins 311  USE OF SENIOR-SPECIFIC CERTIFICATIONS AND PROFESSIONAL DESIGNATIONS IN THE SALE OF LIFE INSURANCE AND ANNUITIES

                  Section Ins 311.01  Purpose

                  Section Ins 311.02  Scope

                  Section Ins 311.03  Definitions

                  Section Ins 311.04  Prohibited Uses of Senior-Specific Certifications and Professional Designations

 

          PART Ins 312  STANDARDS FOR PREPARING ANNUAL LIFE INSURANCE DISCLOSURES

                  Section Ins 312.01  Purpose

                  Section Ins 312.02  Applicability & Scope

                  Section Ins 312.03  Definitions

                  Section Ins 312.04  Life Insurer Disclosures to Policyholders

                  Section Ins 312.05  Waiver of Rules

 

CHAPTER Ins 400  FILINGS FOR LIFE, ACCIDENT AND HEALTH INSURANCE

          PART Ins 401  FORM AND RATE FILINGS

                  Section Ins 401.01  Purpose and Scope

                  Section Ins 401.02  Definitions

                  Section Ins 401.03  Policy Definition Requirements

                  Section Ins 401.04  Rules Applicable to All Forms

                  Section Ins 401.05  Individual Life and Annuity Contracts

                  Section Ins 401.06  Individual Accident and Health

                  Section Ins 401.07  Group Life Policies

                  Section Ins 401.08  Group and Blanket Accident and Health

                  Section Ins 401.09  Group Annuity Contracts

                  Section Ins 401.10  Variable Contracts

                  Section Ins 401.11  Computation of Cash Values for Variable Annuities

                  Section Ins 401.12  Applications

                  Section Ins 401.13  Life Settlement Filings

                  Section Ins 401.14  Forms Filing, Review and Inventory Procedures

                  Section Ins 401.15  Penalty; Generally

                  Section Ins 401.16  Waiver or Suspension of Rules

 

          PART Ins 402  STANDARDS FOR FILINGS PROVIDING A RETURN OF PREMIUM OR CASH BENEFITS

                  Section Ins 402.01  Scope

                  Section Ins 402.02  Standards Required

                  Section Ins 402.03  Rate Filings

                  Section Ins 402.04  Nonconforming Forms Subject to This Part

                  Section Ins 402.05  Penalties

                  Section Ins 402.06  Separability

 

          PART Ins 403  STANDARD WELLNESS PLAN RATE AND FORM FILING STANDARDS

                  Section Ins 403.01  Purpose

                  Section Ins 403.02  Applicability and Scope

                  Section Ins 403.03  Definitions

                  Section Ins 403.04  Standard Wellness Plan

                  Section Ins 403.05  Wellness Incentive Plan

                  Section Ins 403.06  Hospital Tiering

                  Section Ins 403.07  Application for Carrier Specific Hospital Tiering

                  Section Ins 403.08  Standard for Approval of Tier Change

                  Section Ins 403.09  Applications for Tier Changes

                  Section Ins 403.10  Required Reporting

 

CHAPTER Ins 500 DOMESTIC STOCK INSURERS - EXPIRED

 

CHAPTER Ins 600 CREDIT FOR REINSURANCE

          PART Ins 601  CREDIT FOR REINSURANCE

                  Section Ins 601.01  Purpose

                  Section Ins 601.02  Credit for Reinsurance – Reinsurer Licensed in This State

                  Section Ins 601.03  Credit for Reinsurance – Accredited Reinsurers

                  Section Ins 601.04  Credit for Reinsurance – Reinsurer Domiciled in Another State

                  Section Ins 601.05  Credit for Reinsurance – Reinsurers Maintaining Trust Funds

                  Section Ins 601.06  Credit for Reinsurance – Certified Reinsurers

                  Section Ins 601.07  Credit for Reinsurance Required by Law

Section Ins 601.08  Asset or Reduction from Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer Not Meeting the Requirements of Ins 601.02 through Ins 601.07

                  Section Ins 601.09  Trust Agreements Qualified Under Ins 601.08

                  Section Ins 601.10  Letters of Credit Qualified Under Ins 601.08

                  Section Ins 601.11  Other Security

                  Section Ins 601.12  Reinsurance Contract

                  Section Ins 601.13  Contacts Affected

 

CHAPTER Ins 700 REQUIREMENTS FOR FOREIGN INSURANCE COMPANIES APPLYING FOR A LICENSE TO DO BUSINESS IN THE STATE OF NEW HAMPSHIRE - EXPIRED

 

CHAPTER Ins 800  REPORTING OF STATISTICAL DATA BY PROPERTY AND CASUALTY INSURANCE COMPANIES

          PART Ins 801  REPORTING REQUIREMENTS

                  Section Ins 801.01  Purpose

                  Section Ins 801.02  Scope

                  Section Ins 801.03  Definitions

                  Section Ins 801.04  Examination of Statistical Agents

                  Section Ins 801.05  Filing of Statistical Plans by Statistical Agents

                  Section Ins 801.06  Statistical Plans and Reporting by Insurers

                  Section Ins 801.07  Statistical Agents’ Compliance with the Statistical Handbook

                  Section Ins 801.08  Multiple Statistical Agents for the Same Line of Insurance

                  Section Ins 801.09  Edit and Control Procedures for Statistical Agents

                  Section Ins 801.10  Insurer Edit and Audit Procedures

                  Section Ins 801.11  Adoption of Changes to the Statistical Handbook

                  Section Ins 801.12  Disclosure of Complying and Non-Complying Insurers

                  Section Ins 801.13  Access to Data

                  Section Ins 801.14  Disclosure of Data

                  Section Ins 801.15  Exemption

                  Section Ins 801.16  Lines of Insurance without a Statistical Agent

                  Section Ins 801.17  Penalty

 

CHAPTER Ins 900 ACTUARIES

            PART Ins 901  QUALIFICATION OF ACTUARIES

                        Section Ins 901.01  Scope

                        Section Ins 901.02  Definitions

                        Section Ins 901.03  Restriction on Use of Terms “Actuary” or “Actuarial”

 

            PART Ins 902  ACTUARIAL REVIEW OF RATE FILINGS

                        Section Ins 902.01  Scope

                        Section Ins 902.02  Review of Rate Filings

                        Section Ins 902.03  Expense

 

            PART Ins 903  OTHER REQUISITE REPORTS AND DOCUMENTS

                        Section Ins 903.01  Signature of Actuary Required for Annual Statements

                        Section Ins 903.02  Actuarial Certification

 

            PART Ins 904  LIMITATIONS

                        Section Ins 904.01  Limitations

 

CHAPTER Ins 1000 CLAIM SETTLEMENT

            PART Ins 1001 CLAIM SETTLEMENT

                  Section Ins 1001.01  Communications Time Limit

                  Section Ins 1001.02  Claims Settlement Time Limits

                  Section Ins 1001.03  Additional Information Required in Accepting or Rejecting Claims

                  Section Ins 1001.04  Undisputed Amounts

                  Section Ins 1001.05  Notice of Insurance Department

                  Section Ins 1001.06  Advance Payments

                  Section Ins 1001.07  Physician's Examination

                  Section Ins 1001.08  Insurers Use of Unlicensed Adjusters Prohibited

                  Section Ins 1001.09  Telephone Communications With Claims Department

                  Section Ins 1001.10  Other Insurer Responsibilities

                  Section Ins 1001.11  Penalty

 

          PART Ins 1002  CLAIM SETTLEMENT FOR PROPERTY & CASUALTY INSURANCE

                  Section Ins 1002.01  Purpose and Scope

                  Section Ins 1002.02  Definitions

                  Section Ins 1002.03  Computation of Time

                  Section Ins 1002.04  Communications Time Limit

                  Section Ins 1002.05  Claims Settlement Time Limits

                  Section Ins 1002.06  Additional Information Required in Accepting or Denying Claims

                  Section Ins 1002.07  Undisputed Amounts

                  Section Ins 1002.08  Claims Payments

                  Section Ins 1002.09  Value of Total Losses – (Other than Motor Vehicle)

                  Section Ins 1002.10  Insurers Use of Unlicensed Adjusters Prohibited

                  Section Ins 1002.11  Communications With Claims Department

                  Section Ins 1002.12  Other Insurer Responsibilities

                  Section Ins 1002.13  Loss of Use

                  Section Ins 1002.14  Estimates

                  Section Ins 1002.15  Determining Amount of Motor Vehicle Total Loss Claims

                  Section Ins 1002.16  Willing and Able Contractors and Repairers; Other Than Motor Vehicle

                  Section Ins 1002.17  Willing and Able Repair Facilities; Motor Vehicle Insurance

                  Section Ins 1002.18  Additional Requirements, Settlement of Jewelry Claims

                  Section Ins 1002.19  Miscellaneous Provisions

                  Section Ins 1002.20  Insurer Documentation

                  Section Ins 1002.21  Penalty

 

CHAPTER Ins 1100 CONFIDENTIALITY OF HIV TESTS

            PART Ins 1101 PURPOSE AND SCOPE

                        Section Ins 1101.01 Purpose

                        Section Ins 1101.02 Scope

 

            PART Ins 1102 DEFINITIONS

                        Section Ins 1102.01 Definitions

 

            PART Ins 1103 MAINTAINING THE CONFIDENTIALITY OF AND PROTECTING THE PRIVACY OF HUMAN IMMUNODEFICIENCY VIRUS TEST RESULTS

                        Section Ins 1103.01 Informed Consent and Forms Pertaining Thereto

                        Section Ins 1103.02 Confidentiality and Disclosure of Test Results

                        Section Ins 1103.03 Penalties

                        Section Ins 1103.04 Disclosure to the Department of Health and Human Services

 

CHAPTER Ins 1200 CREDIT INSURANCE

          PART Ins 1201  CREDIT LIFE AND CREDIT ACCIDENT AND HEALTH INSURANCE

                  Section Ins 1201.01  Purpose

                  Section Ins 1201.02  Scope

                  Section Ins 1201.03  Definitions

                  Section Ins 1201.04  Rights and Treatment of Debtors

                  Section Ins 1201.05  Premium Refunds

                  Section Ins 1201.06  Policy Forms and Related Material

                  Section Ins 1201.07  Determination of Reasonableness of Premiums in Relation to Benefits

                  Section Ins 1201.08  Nominal Rates for Credit Life Insurance

                  Section Ins 1201.09  Nominal Rates for Credit Accident and Health Insurance

                  Section Ins 1201.10  Actual Premium Rates for Credit Insurance

                  Section Ins 1202.11  Annual Experience Reports

                  Section Ins 1202.12  Description of Forms A and B

                  Section Ins 1201.13  Rate Deviation Procedures

                  Section Ins 1201.14  Supervision of Credit Insurance Operations

                  Section Ins 1201.15  Prohibited Transactions

                  Section Ins 1201.16  Special Rules for Open-End Credit Transactions

                  Section Ins 1201.17  Statutory Requirements

                  Section Ins 1201.18  Actual Premium Rates

                  Section Ins 1201.19  Waiver or Suspension of Rules

 

CHAPTER Ins 1300 PRODUCERS AND ADJUSTERS

            PART Ins 1301  CONTINUING EDUCATION GENERAL INFORMATION

                        Section Ins 1301.01  Purpose and Applicability

                        Section Ins 1301.02  Definitions

 

            PART Ins 1302  CONTINUING EDUCATIONAL REQUIREMENTS FOR PRODUCERS AND ADJUSTERS

                        Section Ins 1302.01  Purpose

                        Section Ins 1302.02  Applicability

                        Section Ins 1302.03  Educational Requirements for Producers

                        Section Ins 1302.04  Educational Requirements for Insurance Claims Adjusters and Public Adjusters

                        Section Ins 1302.05  Penalty

 

            PART Ins 1303  CONTINUING EDUCATION COUNCILS, COURSES AND APPROVALS

                        Section Ins 1303.01  Purpose and Applicability

                        Section Ins 1303.02  Continuing Education Advisory Councils

                        Section Ins 1303.03  Criteria

                        Section Ins 1303.04  Compliance

                        Section Ins 1303.05  Course Approval

                        Section Ins 1303.06  Course Completion Certificate

                        Section Ins 1303.07  Continuing Education Course List

 

            PART Ins 1304  ONE TIME FLOOD INSURANCE TRAINING REQUIREMENT

                        Section Ins 1304.01  Purpose

                        Section Ins 1304.02  Applicability

                        Section Ins 1304.03  Educational Requirements

                        Section Ins 1304.04  Penalty

 

CHAPTER Ins 1400  AUTOMOBILE INSURANCE

          PART Ins 1400  PURPOSE , SCOPE AND SERVICE REQUIREMENTS FOR THE VOLUNTARY MARKET AND THE NEW HAMSPHIRE AUTOMOBILE REINSURANCE FACILITY

                  Section Ins 1401.01  Purpose

                  Section Ins 1401.02  Scope

                  Section Ins 1401.03  Service

 

          PART Ins 1402  THE WRITING OF AUTOMOBILE INSURANCE IN THE VOLUNTARY MARKET

                  Section Ins 1402.01  Purpose

                  Section Ins 1402.02  Definitions Applicable to the Voluntary Market

                  Section Ins 1402.03  Voluntary Market Refusal to Write; Refusal to Renew; Cancellation

                  Section Ins 1402.04  Movement/Placement of a Policy in the Voluntary Market

                  Section Ins 1402.05  Evidence of Financial Responsibility

 

          PART Ins 1403  VOLUNTARY MARKET REGULATION PERTAINING TO RATES, RATING PLANS AND PRACTICES

                  Section Ins 1403.01  Rating and Rating Plans

                  Section Ins 1403.02  Rating Practices

                  Section Ins 1403.03  Reflecting Driver Performance

 

          PART Ins 1404  RECORD RETENTION PROCEDURES IN THE VOLUNTARY MARKET AND THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY

                  Section Ins 1404.01  Record Retention Procedures

 

          PART Ins 1405  PLAN OF OPERATION FOR THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY

                  Section Ins 1405.01  Purpose

                  Section Ins 1405.02  Definitions

                  Section Ins 1405.03  Insurers Required to Participate

                  Section Ins 1405.04  Basis of Participation

                  Section Ins 1405.05  Evidence of Financial Responsibility

                  Section Ins 1405.06  Obligation of Members

                  Section Ins 1405.07  Board of Governors

                  Section Ins 1405.08  Meetings

                  Section Ins 1405.09  Statistical Data

                  Section Ins 1405.10  Cessions

                  Section Ins 1405.11  Facility Charges, Premium, and Allowance

                  Section Ins 1405.12  Safe Driver Incentive Plan and SDIP Points for the New Hampshire Automobile Reinsurance Facility

                  Section Ins 1405.13  Assessments and Participation

                  Section Ins 1405.14  Audits

                  Section Ins 1405.15  Indemnification

                  Section Ins 1405.16  Hearings and Review

                  Section Ins 1405.17  Amendments

                  Section Ins 1405.18  Claim Reserves

                  Section Ins 1405.19  Reinsurance Facility Rates

                  Section Ins 1405.20  Nonrenewal and Cancellation Protection

 

          PART Ins 1406  RESIDENCY REQUIREMENTS FOR AUTOMOBILE INSURANCE IN THE VOLUNTARY MARKET AND THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY

                  Section Ins 1406.01  Statement of Residency Including Applicable Exemptions

 

CHAPTER Ins 1500  INSURANCE HOLDING COMPANIES

            PART Ins 1501  FILINGS

                  Section Ins 1501.01  Purpose

                  Section Ins 1501.02  Definitions

                  Section Ins 1501.03  Forms - General Requirements

                  Section Ins 1501.04  Forms - Incorporation by Reference, Summaries and Omissions

                  Section Ins 1501.05  Forms - Information Unknown or Unavailable and Extension of Time to Furnish

                  Section Ins 1501.06  Forms - Additional Information and Exhibits

                  Section Ins 1501.07  Forms – Subsidiaries of Domestic Insurers

                  Section Ins 1501.08  Acquisition of Control – Statement Filing

                  Section Ins 1501.09  Amendments to Form A

                  Section Ins 1501.10  Acquisition of Persons Controlling a Domestic Insurer

                  Section Ins 1501.11  Pre-Acquisition Notification

                  Section Ins 1501.12  Annual Registration of Insurers - Statement Filing

                  Section Ins 1501.13  Summary of Registration – Statement Filing

                  Section Ins 1501.14  Amendments to Form B

                  Section Ins 1501.15  Alternative and Consolidated Registrations

                  Section Ins 1501.16  Disclaimers and Termination of Registration

                  Section Ins 1501.17  Transactions Subject to Prior Notice – Notice Filing

                  Section Ins 1501.18  Enterprise Risk Report

                  Section Ins 1501.19  Extraordinary Dividends and Other Distributions

                  Section Ins 1501.20  Adequacy of Surplus

 

CHAPTER Ins 1600 SUBSIDIARIES OF INSURANCE COMPANIES - EXPIRED

 

CHAPTER Ins 1700  MEDICAL MALPRACTICE LIABILITY INSURANCE - EXPIRED

            PART Ins 1701  NEW HAMPSHIRE MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION PLAN

                  Section Ins 1701.01  Purpose

 

          IPART Ins 1702  PLAN PARTICIPATION

                  Section Ins 1702.01  Persons Required to Participate

                  Section Ins 1702.02  Termination of Participation

                  Section Ins 1702.03  Basis of Participation

                  Section Ins 1702.04  Service

 

          PART Ins 1703  PLAN OF OPERATION NEW HAMPSHIRE MEDICAL MALPRACTICE JOINT UNDERWRITING ASSOCIATION

                  Section Ins 1703.01  Definitions

                  Section Ins 1703.02  Obligation of Members

                  Section Ins 1703.03  Meetings of the Members

                  Section Ins 1703.04  Board of Directors

                  Section Ins 1703.05  Service Carriers

                  Section Ins 1703.06  Servicing Carrier Allowance

                  Section Ins 1703.07  Assessment of Members for Deficits Incurred as a Result of Policies Issued on or After January 1, 1986

                  Section Ins 1703.08  Assessment of Members for Deficits Incurred as a Result of Policies Issued Prior to January 1, 1986

                  Section Ins 1703.09  Stabilization Reserve Fund Trust

                  Section Ins 1703.10  Collection and Remitting of the Stabilization Reserve Fund Charges

                  Section Ins 1703.11  Coverage, Rates and Forms

                  Section Ins 1703.12  Records and Reports

                  Section Ins 1703.13  Joint Liability for Association Business

                  Section Ins 1703.14  Indemnification

                  Section Ins 1703.15  Hearing Review

 

CHAPTER Ins 1800 CONTINUING CARE RETIREMENT COMMUNITIES

            PART Ins 1801  PURPOSE AND SCOPE

                        Section Ins 1801.01  Purpose

                        Section Ins 1801.02  Scope

 

            PART Ins 1802  DEFINITIONS

                        Section Ins 1802.01  Definitions

 

            PART Ins 1803  CERTIFICATE OF AUTHORITY

                        Section Ins 1803.01  Application Procedures

                        Section Ins 1803.02  Revocation or Suspension

 

            PART ins 1804  ANNUAL REPORTS

                        Section Ins 1804.01  Annual Reports

 

            PART Ins 1805  LIQUID RESERVES

                        Section Ins 1805.01  Liquid Reserves

                  Section Ins 1805.02  Days-Cash-On-Hand Calculation

 

            PART Ins 1806  PROCEDURES FOR OBTAINING AND EXTENDING LIENS

                        Section Ins 1806.01  Procedures for Obtaining and Extending Liens

 

            PART Ins 1807  ENTRANCE FEE ESCROW ACCOUNTS

                        Section Ins 1807.01  Entrance Fee Escrow Accounts

 

            PART Ins 1808  STANDARDS FOR RESIDENT CONTRACT AND DISCLOSURE STATEMENTS

                        Section Ins 1808.01  Requirements for Documents

                        Section Ins 1808.02  Resident Contract Standards

                        Section Ins 1808.03  Disclosure Statements

 

            PART Ins 1809  FEES

                        Section Ins 1809.01  Fees

 

            PART Ins 1810  AUDITS AND INVESTIGATIONS

                        Section Ins 1810.01  Audits and Investigations

 

            PART Ins 1811 TRANSFER OR SALE OF INTEREST

                        Section Ins 1811.01  Transfer or Sale of Interest

 

            PART Ins 1812  ENFORCEMENT

                        Section Ins 1812.01  Violations

 

          PART Ins 1813  WAIVER

                  Section Ins 1813.01  Waiver of Rules

 

CHAPTER Ins 1900 ACCIDENT AND HEALTH INSURANCE

            PART Ins 1901  MINIMUM STANDARDS FOR ACCIDENT AND HEALTH INSURANCE - EXPIRED

 

            PART Ins 1902  MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES ISSUED PRIOR TO ADOPTION OF INSURANCE REGULATION 1975

                        Section Ins 1902.01  Purpose

                        Section Ins 1902.02  Applicability and Scope

                        Section Ins 1902.03  Definitions

                        Section Ins 1902.04  Policy Definitions and Terms

                        Section Ins 1902.05  Prohibited Policy Provisions

                        Section Ins 1902.06  Minimum Standards for Medicare Supplement Policies

                        Section Ins 1902.07  Required Disclosure Provisions

                        Section Ins 1902.08  Requirements for Application Forms and Replacement Coverage

                        Section Ins 1902.09  Loss Ratio Standards and Refund or Credit of Premiums

                        Section Ins 1902.10  Standard for Claims Payment

                        Section Ins 1902.11  Permitted Compensation Arrangements

                        Section Ins 1902.12  Appropriations of Recommended Purchase and Excessive Insurance

                        Section Ins 1902.13  Reporting of Multiple Policies

                        Section Ins 1902.14  Prohibition Against Pre-existing Conditions, Waiting Periods, Elimination Periods and Probationary Periods in Replacement Policies or Certificates

                        Section Ins 1902.15  Benefit Conversion Requirements During Transition

 

            PART Ins 1903  MEDICARE SUPPLEMENT INSURANCE

                        Section Ins 1903.01  Purpose

                        Section Ins 1903.02  Applicability and Scope

                        Section Ins 1903.03  Definitions

                        Section Ins 1903.04  Benefit Conversion Requirements

                        Section Ins 1903.05  Requirements for New Policies and Certificates

                        Section Ins 1903.06  Separability

 

            PART Ins 1904  GROUP COORDINATION OF BENEFITS

                        Section Ins 1904.01  Scope

                        Section Ins 1904.02  Purpose

                        Section Ins 1904.03  Definitions

                        Section Ins 1904.04  Use of Model COB Contract Provision

                        Section Ins 1904.05  Rules for Coordination of Benefits

                        Section Ins 1904.06  Procedure to be Followed by Secondary Plan to Calculate Benefits and Pay a Claim

                        Section Ins 1904.07  Notice to Covered Persons

                        Section Ins 1904.08  Miscellaneous Provisions

                        Section Ins 1904.09  Effective Date for Existing Contracts

                        Section Ins 1904.10  Penalties

 

          PART Ins 1905  MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES

                  Section Ins 1905.01  Purpose

                  Section Ins 1905.02  Applicability and Scope

                  Section Ins 1905.03  Definitions

                  Section Ins 1905.04  Policy Definitions and Terms

                  Section Ins 1905.05  Policy Provisions

                  Section Ins 1905.06  Minimum Benefit Standards for Pre-Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery Prior To July 1, 1992

                  Section Ins 1905.07  Benefit Standards for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued or Delivered on or after July 1, 1992 and Prior to June 1, 2010

                  Section Ins 1905.08  Benefit Standards for 2010 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After June 1, 2010

                  Section Ins 1905.09  Standard Medicare Supplement Benefit Plans for 1990 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After July 1, 1992 and Prior to June 1, 2010

                  Section Ins 1905.10  Standard Medicare Supplement Benefit Plans for 2010 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery on or After June 1, 2010

 

                  Section Ins 1905.11  Standard Medicare Supplement Benefit Plans for 2020 Standardized Medicare Supplement Benefit Plan Policies or Certificates Issued for Delivery to Individuals Newly Eligible for Medicare On or After January 1, 2020

                  Section Ins 1905.12  Medicare Select Policies and Certificates

                  Section Ins 1905.13  Open Enrollment

                  Section Ins 1905.14  Guaranteed Issue for Eligible Persons

                  Section Ins 1905.15  Standards for Claims Payment

                  Section Ins 1905.16  Loss Ratio Standards and Refund or Credit of Premium

                  Section Ins 1905.17  Filing and Approval of Policies and Certificates and Premium Rates

                  Section Ins 1905.18  Permitted Compensation Arrangements

                  Section Ins 1905.19  Required Disclosure Provisions

                  Section Ins 1905.20  Requirements for Application Forms and Replacement Coverage

                  Section Ins 1905.21  Filing Requirement for Advertising

                  Section Ins 1905.22  Standards for Marketing

                  Section Ins 1905.23  Appropriateness of Recommended Purchase and Excessive Insurance

                  Section Ins 1905.24  Reporting of Multiple Policies

                  Section Ins 1905.25  Prohibition Against Preexisting Conditions, Waiting Periods, Elimination Periods and Probationary Periods in Replacement Policies or Certificates

                  Section Ins 1905.26  Prohibition Against Use of Genetic Information and Requests for Genetic Testing

                  Section Ins 1905.27  Waiver or Suspension of Rules

 

            PART Ins 1906  DISCONTINUANCE AND REPLACEMENT OF GROUP ACCIDENT AND HEALTH COVERAGE - EXPIRED

 

            PART Ins 1907  NONDISCRIMINATION IN HEALTH INSURANCE COVERAGE IN THE GROUP MARKET

                        Section Ins 1907.01  Purpose and Scope

                        Section Ins 1907.02  Definitions

                        Section Ins 1907.03  Prohibited Discrimination in Rules for Eligibility

                        Section Ins 1907.04  Prohibited Discrimination in Premium and Contribution Rates

                        Section Ins 1907.05  Application of Ins 1907.03 to Plan Benefits; Preexisting Condition Exclusions; Similarly Situated Individuals

                        Section Ins 1907.06  Application of Ins 1907.03 and Ins 1907.04 to Nonconfinement and Actively-at-Work Provisions

                        Section Ins 1907.07  Enforcement

 

            PART Ins 1908  COVERAGE FOR INDIVIDUALS UNDER THE AGE OF 19

                    Section Ins 1908.01  Purpose

                    Section Ins 1908.02  Scope and Applicability

                    Section Ins 1908.03  Definitions

                    Section Ins 1908.04  Risk Adjustment and Subsidization

                    Section Ins 1908.05  Assessment and Disbursement Plans

                    Section Ins 1908.06  Initial Subsidy Period

 

CHAPTER Ins 2000 MEDICAL UTILIZATION REVIEW ENTITIES

          PART Ins 2001  LICENSURE OF MEDICAL UTILIZATION REVIEW ENTITIES

                  Section Ins 2001.01  Purpose

                  Section Ins 2001.02  Scope of Rule

                  Section Ins 2001.03  Definitions

                  Section Ins 2001.04  Licensure Procedure

                  Section Ins 2001.05  Procedures for Licensure Renewal

                  Section Ins 2001.06  Privileged Information

                  Section Ins 2001.07  Forms Required

                  Section Ins 2001.08  Change in Name

                  Section Ins 2001.09  Fees

                  Section Ins 2001.10  Standards Relative to Time Periods for Notification of Determinations

                  Section Ins 2001.11  Manner and Intent of Notification

                  Section Ins 2001.12  Standards for Telephone Accessibility

                  Section Ins 2001.13  Reconsideration Procedures

                  Section Ins 2001.14  Confidentiality

                  Section Ins 2001.15  Scope of Review

                  Section Ins 2001.16  Reviewers

                  Section Ins 2001.17  Other Provisions

                  Section Ins 2001.18  Compliance

                  Section Ins 2001.19  Waiver of Rules

 

CHAPTER Ins 2100 MUTUAL COMPANIES - EXPIRED

 

CHAPTER Ins 2200 HEALTH MAINTENANCE ORGANIZATIONS

          PART Ins 2201  DOMESTIC HEALTH MAINTENANCE ORGANIZATIONS

                  Section 2201.01  Purpose

                  Section 2201.02  Applicability and Scope

                  Section 2201.03  Definitions

                  Section 2201.04  Certificate of Authority

                  Section 2201.05  Evidences of Coverage and Advertising

                  Section 2201.06  Periodic and Special Reporting

                  Section 2201.07  Annual Reports

                  Section 2201.08  Licensing of Producers

                  Section 2201.09  Continuity of Benefits

 

CHAPTER Ins 2300 THIRD PARTY ADMINISTRATORS

          PART Ins 2301  REGULATION OF THIRD PARTY ADMINISTRATORS

                  Section Ins 2301.01  Purpose

                  Section Ins 2301.02  Definitions

                  Section Ins 2301.03  Application Forms

                  Section Ins 2301.04  Disclosure of Information

                  Section Ins 2301.05  Surety Bond

                  Section Ins 2301.06  Audited Financial Statement

                  Section Ins 2301.07  Written Agreement Necessary

                  Section Ins 2301.08  Fiduciary Obligation

                  Section Ins 2301.09  Establishment of Premium Trust Account

                  Section Ins 2301.10  Commingling of Funds Prohibited

                  Section Ins 2301.11  Interest-Bearing Accounts

                  Section Ins 2301.12  Return Premiums

                  Section Ins 2301.13  Recordkeeping Requirements

                  Section Ins 2301.14  Periodic Audit

                  Section Ins 2301.15  Responsibilities of the Insurer

                  Section Ins 2301.16  Approval of Advertising

                  Section Ins 2301.17  Grounds for Denial, Nonrenewal, Suspension or Revocation of Certificate; Penalty

                  Section Ins 2301.18  Inquiry by Commissioner

                  Section Ins 2301.19  Hearing and Appeal

                  Section Ins 2301.20  Violations and Penalties

                  Section Ins 2301.21  Waiver or Suspension of Rules

 

CHAPTER Ins 2400 ACTUARIAL OPINION AND MEMORANDUM

          PART Ins 2401  GUIDELINES AND STANDARDS

                  Section Ins 2401.01  Purpose

                  Section Ins 2401.02  Applicability and Scope

                  Section Ins 2401.03  Definitions

                  Section Ins 2401.04  General Requirements

                  Section Ins 2401.05  Statement of Actuarial Opinion Based on an Asset Adequacy Analysis

                  Section Ins 2401.06  Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary

                  Section Ins 2401.07  Waiver of Rules

 

          PART Ins 2402  PROPERTY AND CASUALTY ACTUARIAL OPINION

                  Section Ins 2402.01  Purpose

                  Section Ins 2402.02  Applicability and Scope

                  Section Ins 2402.03  Statement of Actuarial Opinion

                  Section Ins 2402.04  Actuarial Opinion Summary

                  Section Ins 2402.05  Actuarial Report and Workpapers

                  Section Ins 2402.06  Confidentiality

                  Section Ins 2402.07  Waiver of Rules

 

CHAPTER Ins 2500 HOME WARRANTY INSURANCE - REPEALED

 

CHAPTER Ins 2600  ADVERTISEMENTS OF INSURANCE

          PART Ins 2601  ADVERTISEMENTS OF ACCIDENT AND HEALTH INSURANCE

                  Section Ins 2601.01  Purpose

                  Section Ins 2601.02  Applicability

                  Section Ins 2601.03  Definitions

                  Section Ins 2601.04  Method of Disclosure of Required Information

                  Section Ins 2601.05  Form and Content of Advertisements

                  Section Ins 2601.06  Advertisements of Benefits Payable, Losses Covered or Premiums Payable

               Section Ins 2601.07  Necessity for Disclosing Policy Provisions Relating to Renewability, Cancellability and Termination

               Section Ins 2601.08  Standards for Marketing

               Section Ins 2601.09  Testimonials or Endorsements by Third Parties

               Section Ins 2601.10  Use of Statistics

               Section Ins 2601.11  Identification of Plan or Number of Policies

               Section Ins 2601.12  Disparaging Comparisons and Statements

               Section Ins 2601.13  Jurisdictional Licensing and Status of Insurer

               Section Ins 2601.14  Identity of Insurer

               Section Ins 2601.15  Group or Quasi-Group Implications

               Section Ins 2601.16  Introductory, Initial or Special Offers

               Section Ins 2601.17  Statements About an Insurer

               Section Ins 2601.18  Enforcement Procedures

               Section Ins 2601.19  Filing for Prior Review

               Section Ins 2601.20  Penalties

 

          PART Ins 2602  ADVERTISEMENTS OF LIFE INSURANCE AND ANNUITIES

                  Section Ins 2602.01  Purpose

                  Section Ins 2602.02  Applicability

                  Section Ins 2602.03  Definitions

                  Section Ins 2602.04  Form and Content of Advertisements

                  Section Ins 2602.05  Disclosure Requirements

                  Section Ins 2602.06  Identity of Insurer

                  Section Ins 2602.07  Jurisdictional Licensing and Status of Insurer

                  Section Ins 2602.08  Statements About the Insurer

                  Section Ins 2602.09  Enforcement Procedures

                  Section Ins 2602.10  Penalties

                  Section Ins 2602.11  Conflict with Other Laws or Rules

 

          PART Ins 2603  ADVERTISEMENTS OF MEDICARE SUPPLEMENT INSURANCE WITH INTERPRETIVE GUIDELINES

                  Section Ins 2603.01  Purpose

                  Section Ins 2603.02  Applicability

                  Section Ins 2603.03  Definitions

                  Section Ins 2603.04  Method of Disclosure of Required Information

                  Section Ins 2603.05  Form and Content of Advertisements

                  Section Ins 2603.06  Advertisements of Benefits, Losses Covered or Premiums Payable

                  Section Ins 2603.07  Necessity for Disclosing Policy Provisions Relating to Renewability, Cancellability and Termination

                  Section Ins 2603.08  Testimonials or Endorsements by Third Parties

                  Section Ins 2603.09  Use of Statistics

                  Section Ins 2603.10  Disparage Comparisons and Statements

                  Section Ins 2603.11  Jurisdictional Licensing and Status of Insurer

                  Section Ins 2603.12  Identify of Insurer

                  Section Ins 2603.13  Group of Quasi-Group Implications

                  Section Ins 2603.14  Introductory, Initial or Special Offers

                  Section Ins 2603.15  Statements About an Insurer

                  Section Ins 2603.16  Enforcement Procedures

                  Section Ins 2603.17  Filing for Prior Review

 

          PART Ins 2604  ALL OTHER ADVERTISEMENTS OF LIVE, ACCIDENT, AND HEALTH INSURANCE

                  Section Ins 2604.01  Purpose

                  Section Ins 2604.02  Applicability and Scope

                  Section Ins 2604.03  Definitions

                  Section Ins 2604.04  Reference to Policy Form Numbers

                  Section Ins 2604.05  Advertisements in General

                  Section Ins 2604.06  Advertisements of Benefits Payable, Losses Covered or Premiums Payable

                  Section Ins 2604.07  Testimonials

                  Section Ins 2604.08  Use of Statistics

                  Section Ins 2604.09  Inspection of Policy

                  Section Ins 2604.10  Identification of Plan or Number of Policies

                  Section Ins 2604.11  Jurisdictional Licensing

                  Section Ins 2604.12  Identity of Insurer

                  Section Ins 2604.13  Introductory, Initial or Special Offers

                  Section Ins 2604.14  Third Party Approval and Endorsement

                  Section Ins 2604.15  Advertising File

                  Section Ins 2604.16  Soliciting Names of Prospective Insureds

                  Section Ins 2604.17  Penalty Provisions

 

CHAPTER Ins 2700 MANAGED CARE

          PART Ins 2701  HEALTH AND DENTAL BENEFIT PLAN NETWORK ADEQUACY

                  Section Ins 2701.01  Purpose

                  Section Ins 2701.02  Scope

                  Section Ins 2701.03  Definitions

                  Section Ins 2701.04  Basic Access Requirement

                  Section Ins 2701.05  Reasonable Access to Health Care Services

                  Section Ins 2701.06  Standards for Geographic Accessibility

                  Section Ins 2701.07  Classification of Services as “Core”, “Common”, and “Specialized”

                  Section Ins 2701.08  Exceptions

                  Section Ins 2701.09  Standards for Waiting Times for Appointments and Access to After-Hours Care

                  Section Ins 2701.10  Choice of and Access to Providers of Specialty Care

                  Section Ins 2701.11  Reporting Requirement

                  Section Ins 2701.12  Provider Directories

                  Section Ins 2701.13  Enforcement

                  Section Ins 2701.14  Waiver of Rules

 

          PART Ins 2702  PARITY IN MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS

                  Section Ins 2702.01  Purpose

                  Section Ins 2702.02  Scope and Applicability

                  Section Ins 2702.03  Definitions

                  Section Ins 2702.04  Parity Requirements

                  Section Ins 2702.05  Waiver of Rules

 

            PART Ins 2703 EXTERNAL REVIEW

                        Section Ins 2703.01 Applicability and Scope

                        Section Ins 2703.02 Definitions

                        Section Ins 2703.03 The Right to External Review

                        Section Ins 2703.04 Notice of Right to External Review

                        Section Ins 2703.05 Standard External Review

                        Section Ins 2703.06 Expedited External Review

                        Section Ins 2703.07 Certification of Independent Review Organizations

                        Section Ins 2703.08 External Review Reporting Requirements

                        Section Ins 2703.09 General Provisions Regarding External Review

 

          PART Ins 2704  PHARMACY BENEFITS MANAGERS

                  Section Ins 2704.01  Purpose

                  Section Ins 2704.02  Definitions

                  Section Ins 2704.03  Registration

                  Section Ins 2704.04  Registration Renewal and Annual Reports

                  Section Ins 2704.05  Claims Processing

                  Section Ins 2704.06  Complaint Process

                  Section Ins 2704.07  Enforcement

                  Section Ins 2704.08  Reporting to the New Hampshire Board of Pharmacy

                  Section Ins 2704.09  Confidentiality

                  Section Ins 2704.10  Periodic Audit

                  Section Ins 2704.11  Inquiry by Commissioner

                  Section Ins 2704.12  Waiver of Rules

 

          PART Ins 2705  UNIFORM PRIOR AUTHORIZATION FORMS AND ELECTRONIC STANDARD FOR PRESCRIPTION DRUG BENEFITS

                  Section Ins 2705.01  Purpose

                  Section Ins 2705.02  Scope

                  Section Ins 2705.03  Definitions

                  Section Ins 2705.04  Format of Uniform Prior Authorization Forms

                  Section Ins 2705.05  Use of Uniform Prior Authorization Forms and Electronic Standard for Prescription Drug Benefits

                  Section Ins 2705.06  Standards for Electronic Prior Authorization Processes

                  Section Ins 2705.07  Outreach to Prescribing Providers

                  Section Ins 2705.08  Revisions

                  Section Ins 2705.09  Waivers to Support Use of National ePA Standards

 

CHAPTER Ins 2800 PROPERTY AND CASUALTY RATE AND SUPPLEMENTARY INFORMATION FILINGS

            PART Ins 2801 ADVISORY ORGANIZATION

                        Section Ins 2801.01 Purpose, Applicability and Scope

                        Section Ins 2801.02 Definitions

                        Section Ins 2801.03 Advisory Organization Reference Filing of Advisory Prospective Loss Costs

                        Section Ins 2801.04 Required Filing Documents

                        Section Ins 2801.05 Underwriting and Rating Documentation

                        Section Ins 2801.06 Instructions for the Completion of Form RFF-1

 

CHAPTER Ins 2900 HAZARDOUS FINANCIAL CONDITIONS, LICENSED COMPANIES

            PART Ins 2901 REGULATION OF COMPANIES DEEMED TO BE IN HAZARDOUS FINANCIAL CONDITION

                  Section Ins 2901.01  Purpose

                  Section Ins 2901.02  Standards

                  Section Ins 2901.03  Commissioner’s Authority

                  Section Ins 2901.04  Judicial Review

                  Section Ins 2901.05  Waiver of Rules

 

CHAPTER Ins 3000 PRIVACY OF CONSUMER FINANCIAL AND HEALTH INFORMATION

          PART Ins 3001  NONPUBLIC PERSONAL HEALTH AND FINANCIAL INFORMATION

                  Section Ins 3001.01  Purpose

                  Section Ins 3001.02  Scope

                  Section Ins 3001.03  Rule of Construction

                  Section Ins 3001.04  Definitions

 

          PART Ins 3002  PRIVACY, AND OPT OUT NOTICES FOR FINANCIAL INFORMATION

                  Section Ins 3002.01  Initial Privacy Notice to Consumers Required

                  Section Ins 3002.02  Annual Privacy Notice to Customers Required

                  Section Ins 3002.03  Information to be Included in Privacy Notices

                  Section Ins 3002.04  Form of Opt Out Notice to Consumers and Opt Out Methods

                  Section Ins 3002.05  Revised Privacy Notices

                  Section Ins 3002.06  Privacy Notices to Group Policyholders

                  Section Ins 3002.07  Delivery

 

          PART Ins 3003  LIMITS ON DISCLOSURES OF FINANCIAL INFORMATION

                  Section Ins 3003.01  Limits on Disclosure of Nonpublic Personal Financial Information to Nonaffiliated Third Parties

                  Section Ins 3003.02  Limits on Redisclosure and Reuse of Nonpublic Personal Financial Information

                  Section Ins 3003.03  Limits on Sharing Account Number Information for Marketing Purposes

 

          PART Ins 3004  EXCEPTIONS TO LIMITS ON DISCLOSURES OF FINANCIAL INFORMATION

                  Section Ins 3004.01  Exception to Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Service Providers and Joint Marketing

                  Section Ins 3004.02  Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Processing and Servicing Transactions

                  Section Ins 3004.03  Other Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information

 

          PART Ins 3005  RULES FOR HEALTH INFORMATION

                  Section Ins 3005.01  When Authorization Required for Disclosure of Nonpublic Personal Health Information

                  Section Ins 3005.02  Authorizations

                  Section Ins 3005.03  Authorization Request Delivery

                  Section Ins 3005.04  Relationship to Federal Rules

                  Section Ins 3005.05  Relationship to State Laws

 

          PART Ins 3006  ADDITIONAL PROVISIONS

                  Section Ins 3006.01  Protection of Fair Credit Reporting Act

                  Section Ins 3006.02  Nondiscrimination

                  Section Ins 3006.03  Violation

 

          PART Ins 3007  WAIVER OF RULES

                  Section Ins 3007.01  Waiver of Rules

 

CHAPTER Ins 3100  ELECTRONIC FILINGS

            PART Ins 3101  ELECTRONIC FILING STANDARDS

                        Section Ins 3101.01  Purpose

                        Section Ins 3101.02  Applicability and Scope

                        Section Ins 3101.03  Definitions

                        Section Ins 3101.04  Procedural Requirements

 

CHAPTER Ins 3200 SALES OF INSURANCE BY FINANCIAL INSTITUTIONS

            PART Ins 3201 GENERAL INFORMATION

                        Section Ins 3201.01 Purpose

 

            PART Ins 3202 LICENSING REQUIREMENTS

                        Section Ins 3202.01 License Required

                        Section Ins 3202.02 Financial Institution License Application

                        Section Ins 3202.03 Authorized or Approved Carriers

 

            PART Ins 3203 PROCEDURES FOR AUTHORITY TO SELL INSURANCE

                        Section Ins 3203.01 Insurance Sales Relationships

                        Section Ins 3203.02 Special Requirements for Depository Institutions

                        Section Ins 3203.03 Qualifications and Training

                        Section Ins 3203.04 Independent Agent or Agency

                        Section Ins 3203.05 Commissions

                        Section Ins 3203.06 Referral Fees

                        Section Ins 3203.07 Inducements or Rebating

 

            PART Ins 3204 CONSUMER PROTECTION

                        Section Ins 3204.01 Statutory Requirements

                        Section Ins 3204.02 Disclosures

                        Section Ins 3204.03 Disclosures When Insurance is Required as a Condition of Obtaining a Loan

                        Section Ins 3204.04 Tying of Non-Insurance Products with Insurance Products Prohibited

                        Section Ins 3204.05 Discrimination Against Nonaffiliated Companies or Agents Prohibited

                        Section Ins 3204.06 Affirmative Statement Signed by Insurance Customer

                        Section Ins 3204.07 Separation from Deposit and Loan Activities

                        Section Ins 3204.08 Customer Privacy

                        Section Ins 3204.09 Advertising of Insurance by a Financial Institution

 

            PART Ins 3205 COMPLIANCE, ENFORCEMENT AND PENALTY PROVISIONS

                        Section Ins 3205.01 Compliance

                        Section Ins 3205.02 Penalties

 

CHAPTER Ins 3300 INSURANCE SCORES

          PART Ins 3301  USE OF INSURANCE SCORES

                  Section Ins 3301.01  Purpose

                  Section Ins 3301.02  Scope

                  Section Ins 3301.03  Definitions

                  Section Ins 3301.04  Waiver of Rules

 

          PART Ins 3302  WRITTEN STANDARDS ON OBTAINING AN INSURANCE SCORE OR A CONSUMER REPORT

                  Section Ins 3302.01  Written Standards

 

          PART Ins 3303  USE OF INSURANCE SCORES AND CONSUMER REPORT INFORMATION IN UNDERWRITING

                  Section Ins 3303.01  Use in Underwriting

 

          PART Ins 3304  USE OF INSURANCE SCORES AND CONSUMER REPORT INFORMATION IN RATEMAKING

                  Section Ins 3304.01  Ratemaking Use

 

          PART Ins 3305  PROHIBITED USE OF CERTAIN CREDIT FACTORS IN RATING OR UNDERWRITING

                  Section Ins 3305.01  Prohibited Factors

                  Section Ins 3305.02  Extraordinary Life Circumstances

 

          PART Ins 3306  FILING OF UNDERWRITING MODELS

                  Section Ins 3306.01  Underwriting Filing Required

 

          PART Ins 3307  FILING OF RATES

                  Section Ins 3307.01  Rate Filing Required

 

          PART Ins 3308  FILINGS REQUIRED FOR INSURANCE SCORING MODELS AND USE OF CONSUMER REPORT INIFORMATION

Section Ins 3308.01  Submission of Basis for Insurance Score or Use of Consumer Report Information

Section Ins 3308.02  Confidentiality of Submission

 

          PART Ins 3309  NOTICE TO INSURED, USE OF INFORMATION FROM CONSUMER REPORTS; ADVERSE ACTION

                  Section Ins 3309.01  Initial Notification

                  Section Ins 3309.02  Adverse Action Notification

 

          PART 3310  ADDITIONAL CONSUMER PROTECTIONS

                  Section Ins 3310.01  Review of Action

 

          PART Ins 3311  PENALTY PROVISION

                  Section Ins 3311.01  Penalty Provision

 

CHAPTER Ins 3400 PURCHASING ALLIANCES

          PART Ins 3401  PURCHASING ALLIANCE STANDARDS

                  Section Ins 3401.01  Purpose

                  Section Ins 3401.02  Definitions

                  Section Ins 3401.03  Jurisdiction of the Commissioner; Penalties

                  Section Ins 3401.04  Purchasing Alliance Application, Licensing and Continuing Review Process

                  Section Ins 3401.05  Powers and Duties of and Restrictions on Purchasing Alliances

                  Section Ins 3401.06  Requirements for Participating Carriers

                  Section Ins 3401.07  Marketing Health Benefit Plans

                  Section Ins 3401.08  Risk Adjustment Mechanism

                  Section Ins 3401.09  Conflict of Interest

                  Section Ins 3401.10  Purchasing Alliance Distinguished From Multiple Employer Welfare Arrangement

                  Section Ins 3401.11  Purchasing Alliance Evaluation

 

CHAPTER Ins 3500 VALUATION OF LIFE INSURANCE POLICIES

          PART Ins 3501  PURPOSE

                  Section Ins 3501.01  Purpose

 

          PART Ins 3502  APPLICABILITY

                  Section Ins 3502.01  Applicability

 

          PART Ins 3503  DEFINITIONS

                  Section Ins 3503.01  Definitions

 

          PART Ins 3504  GENERAL CALCULATION REQUIREMENTS FOR BASIC RESERVES AND PREMIUM DEFICIENCY RESERVES

                  Section Ins 3504.01  Basic Reserves Calculation Requirements

                  Section Ins 3504.02  Deficiency Reserves Calculation Requirements

                  Section Ins 3504.03  Other Calculation Requirements

 

          PART Ins 3505  CALCULATION OF MINIMUM VALUATION STANDARD FOR POLICIES WITH GUARANTEED NONLEVEL GROSS PREMIUMS OR GUARANTEED NONLEVEL BENEFITS (OTHER THAN UNIVERSAL LIFE POLICIES)

                  Section Ins 3505.01  Calculation of Basic Reserves

                  Section Ins 3505.02  Calculation of Deficiency Reserves

                  Section Ins 3505.03  Minimum Value

                  Section Ins 3505.04  Unusual Pattern of Guaranteed Cash Surrender Values

                  Section Ins 3505.05  Optional Exemption for Yearly Renewable Term Reinsurance

                  Section Ins 3505.06  Optional Exemption for Attained-Age-Based Yearly Renewal Term Life Insurance Polices

                  Section Ins 3505.07  Exemption from Unitary Reserves for Certain n-Year Renewable Term Life Insurance Policies

                  Section Ins 3505.08  Exemption from Unitary Reserves for Certain Juvenile Policies

 

          PART Ins 3506  CALCULATION OF MINIMUM VALUATION STANDARD FOR FLEXIBLE PREMIUM AND FIXED PREMIUM UNIVERSAL LIFE INSURANCE POLICIES THAT CONTAIN PROVISIONS RESULTING IN THE ABILITY OF A POLICYHOLDER TO KEEP A POLICY IN FORCE OVER A SECONDARY GUARANTEE PERIOD

                  Section Ins 3506.01  General Provisions

                  Section Ins 3506.02  Basic Reserves for the Secondary Guarantees

                  Section Ins 3506.03  Deficiency Reserves for the Secondary Guarantees

                  Section Ins 3506.04  Minimum Reserves

 

          PART Ins 3507  RECOGNITION OF THE 2001 CSO MORTALITY TABLE FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES AND NONFORFEITURE BENEFITS

                  Section Ins 3507.01  Purpose

                  Section Ins 3507.02  Definitions Used in This Section

                  Section Ins 3507.03  2001 CSO Mortality Table

                  Section Ins 3507.04  Conditions

                  Section Ins 3507.05  Applicability of the 2001 CSO Mortality Table

                  Section Ins 3507.06  Gender-Blended Tables

 

 

          PART Ins 3508  PERMITTING THE RECOGNITION OF PREFERRED MORTALITY TABLES FOR USE IN DETERMINING MINIMUM RESERVE LIABILITIES

                  Section Ins 3508.01  Purpose

                  Section Ins 3508.02  Definitions

                  Section Ins 3508.03  2001 CSO Preferred Class Structure Table

                  Section Ins 3508.04  Conditions

 

          PART Ins 3509  Preneed Life Insurance Minimum Standards for Determining Reserve Liabilities and Nonforfeiture Values

                  Section Ins 3509.01  Purpose

                  Section Ins 3509.02  Applicability and Scope

                  Section Ins 3509.03  Definitions

                  Section Ins 3509.04  Minimum Valuation Mortality Standards

                  Section Ins 3509.05  Minimum Valuation Interest Rate Standards

                  Section Ins 3509.06  Minimum Valuation Method Standards

                  Section Ins 3509.07  Transition Rules

 

CHAPTER Ins 3600  LONG-TERM CARE INSURANCE

          PART Ins 3601  LONG-TERM CARE INSURANCE

                  Section Ins 3601.01  Purpose

                  Section Ins 3601.02  Applicability and Scope

                  Section Ins 3601.03  Definitions

                  Section Ins 3601.04  Policy Definitions

                  Section Ins 3601.05  Policy Practices and Provisions

                  Section Ins 3601.06  Unintentional Lapse

                  Section Ins 3601.07  Required Disclosure Provisions

                  Section Ins 3601.08  Required Disclosure of Rating Practices to Consumers

                  Section Ins 3601.09  Initial Filing Requirements

                  Section Ins 3601.10  Prohibition Against Post-Claims Underwriting

                  Section Ins 3601.11  Minimum Standards for Home Health and Community Care Benefits in Long-Term Care Insurance Policies

                  Section Ins 3601.12  Requirement to Offer Inflation Protection

                  Section Ins 3601.13  Requirements for Application Forms and Replacement Coverage

                  Section Ins 3601.14  Reporting Requirements

                  Section Ins 3601.15  Licensing

                  Section Ins 3601.16  Discretionary Powers of Commissioner

                  Section Ins 3601.17  Reserve Standards

                  Section Ins 3601.18  Loss Ratio

                  Section Ins 3601.19  Premium Rate Schedule Increases

                  Section Ins 3601.20  Filing Requirement

                  Section Ins 3601.21  Filing Requirement for Advertising

                  Section Ins 3601.22  Standards for Marketing

                  Section Ins 3601.23  Suitability

                  Section Ins 3601.24  Prohibition Against Preexisting Conditions and Probationary Periods in Replacement Policies or Certificates

                  Section Ins 3601.25  Availability of New Services or Providers

                  Section Ins 3601.26  Right to Reduce Coverage and Lower Premiums

                  Section Ins 3601.27  Nonforfeiture Benefit Requirement

                  Section Ins 3601.28  Standards for Benefit Triggers

Section Ins 3601.29  Additional Standards for Benefit Triggers for Qualified Long-Term Care Insurance Contracts

                  Section Ins 3601.30  Appealing and Insurer’s Determination that the Benefit Trigger is Not Met

                  Section Ins 3601.31  Prompt Payment of Clean Claims

                  Section Ins 3601.32  Standard Format Outline of Coverage

                  Section Ins 3601.33  Requirement to Deliver Shopper’s Guide

 

PART Ins 3602  NEW HAMPSHIRE LONG-TERM CARE PARTNERSHIP PROGRAM

                  Section Ins 3602.01  Purpose

                  Section Ins 3602.02  Applicability and Scope

                  Section Ins 3602.03  Definitions

                  Section Ins 3602.04  Notification, Offer of Exchange

                  Section Ins 3602.05  Exchanges

               Section Ins 3602.06  Standards and Reporting Requirements for Approved Long-Term Care Partnership Policies and Certificates

                  Section Ins 3602.07  Inflation Protection Requirements for Long-Term Care Partnership Policies and Certificates

                  Section Ins 3602.08  Filing Requirements for Long-Term Care Partnership Policies

                  Section Ins 3602.09  Waiver or Suspension of Rules

 

CHAPTER Ins 3700  STANDARDS FOR SAFEGUARDING CUSTOMER INFORMATION

          PART Ins 3701  STANDARDS

                  Section Ins 3701.01  Purpose and Scope

                  Section Ins 3701.02  Definitions

                  Section Ins 3701.03  Information Security Program

                  Section Ins 3701.04  Objectives of Information Security Program

                  Section Ins 3701.05  Examples of Methods of Development and Implementation

                  Section Ins 3701.06  Assess Risk

                  Section Ins 3701.07  Manage and Control Risk

                  Section Ins 3701.08  Oversee Service Provider Arrangements

                  Section Ins 3701.09  Adjust the Program

                  Section Ins 3701.10  Violations

 

          PART Ins 3702  CUSTOMER NOTICE

                  Section Ins 3702.01  Purpose and Scope

                  Section Ins 3702.02  Definitions

                  Section Ins 3702.03  Standards for Providing Notice

                  Section Ins 3702.04  Affected Customers

                  Section Ins 3702.05  Content of Customer Notice

                  Section Ins 3702.06  Delivery of Customer Notice

                  Section Ins 3702.07  Violations

 

CHAPTER Ins 3800  RESERVED

          PART Ins 3801 - RESERVED

 

CHAPTER Ins 3900  DISABILITY INSURANCE

            PART Ins 3901 DISABILITY INSURANCE

                        Section Ins 3901.01 Purpose and Scope

                        Section Ins 3901.02 Definitions

                        Section Ins 3901.03 Claims Procedures

                        Section Ins 3901.04 Failure to Establish and Follow Reasonable Claims Procedures

                        Section Ins 3901.05 Effective Date

 

          PART Ins 3902  INDIVIDUAL SUPPLEMENTAL UNEMPLOYMENT INSURANCE

                  Section Ins 3902.01  Purpose

                  Section Ins 3902.02  Scope

                  Section Ins 3902.03  Definitions

                  Section Ins 3902.04  Benefits

                  Section Ins 3902.05  Exclusionary Periods

                  Section Ins 3902.06  Mandatory Disclosures

                  Section Ins 3902.07  Mandatory Minimum Policy Provisions

                  Section Ins 3902.08  Repayment of Benefits

                  Section Ins 3902.09  Penalties

 

CHAPTER Ins 4000  UNIFORM REPORTING SYSTEM FOR HEALTH CARE CLAIMS DATA SETS

          PART Ins 4001  PURPOSE AND SCOPE

                  Section Ins 4001.01  Purpose and Scope

 

          PART Ins 4002  DEFINITIONS

                  Section Ins 4002.01  Definitions

 

          PART Ins 4003  ANNUAL REGISTRATION REQUIREMENT

                  Section Ins 4003.01  Annual Registration Requirement

                  Section Ins 4003.02  Contents of NHCHIS Registration Form

                  Section Ins 4003.03  Submission of NHCHIS Registration Form

 

          PART Ins 4004  FILING SCHEDULES

                  Section Ins 4004.01  Filing Schedules

                  Section Ins 4004.02  First-time Filers

                  Section Ins 4004.03  Changes to Data Submitter’s Process, Format or Sources

 

          PART Ins 4005  REQUIRED FILERS AND EXCLUSIONS

                  Section Ins 4005.01  Required Filers and Data Sets

                  Section Ins 4005.02  Exclusions from Filing Requirements

                  Section Ins 4005.03  Opt-In by Self-Funded Private Employers

 

          PART Ins 4006  HEALTH CARE CLAIMS DATA SET FILING

                  Section Ins 4006.01  General Requirements

                  Section Ins 4006.02  Subscriber and Member Identification Data Elements

                  Section Ins 4006.03  Included Records and Data Requirements

                  Section Ins 4006.04  Observation Period for Record Selection

                  Section Ins 4006.05  Health Care Effectiveness Data and Information Set, HEDIS®, Reporting Requirements

                  Section Ins 4006.06  Consumer Assessment of Health Plans Survey, CAHPS®, Reporting Requirements

 

          PART Ins 4007  DATA STANDARDS COMPLIANCE

                  Section Ins 4007.01  Data Standards Compliance

 

          PART Ins 4008  WAIVERS

                  Section Ins 4008.01  Waiver of Requirement to Submit Specific Data Element

 

          PART Ins 4009  TECHNICAL SPECIFICATIONS

                  Section Ins 4009.01  Technical Specifications for Registration Form

                  Section Ins 4009.02  Subscriber and Member Identification Data Elements

                  Section Ins 4009.03  Technical Specifications and Format for File Transfer

                  Section Ins 4009.04  Data Quality Requirements

                  Section Ins 4009.05  External Code Sources

 

          PART Ins 4010  DATA TABLES

                  Section Ins 4010.01  Member Eligibility Data Tables

                  Section Ins 4010.02  Member Claims Data Tables

                  Section Ins 4010.03  Pharmacy Claims Data Tables

                  Section Ins 4010.04  Dental Claims Data Tables

                  Section Ins 4010.05  Provider File Data Tables

                  Section Ins 4010.06  Data Submission Manual Code Tables

                  Section Ins 4010.07  Mapping and Format Information Tables

 

CHAPTER Ins 4100  REQUIREMENTS FOR ACCIDENT AND HEALTH INSURANCE RATE SUBMISSIONS

          PART Ins 4101  REQUIREMENTS GOVERNING ALL ACCIDENT AND HEALTH INSURANCE RATE SUBMISSIONS

                  Section Ins 4101.01  Purpose

                  Section Ins 4101.02  Applicability and Scope

                  Section Ins 4101.03  Federal Regulations Apply

                  Section Ins 4101.04  Definitions

                  Section Ins 4101.05  Rate Filing Review and Inventory Procedures

                  Section Ins 4101.06  Rate Filing Submission Requirements

 

          PART Ins 4102  REQUIREMENTS FOR INDIVIDUAL HEALTH INSURANCE SUBJECT TO
RSA 420-G

                  Section Ins 4102.01  Purpose

                  Section Ins 4102.02  Applicability and Scope

                  Section Ins 4102.03  Definitions

                  Section Ins 4102.04  Underwriting and Issue Requirements

                  Section Ins 4102.05  Renewal Requirements

                  Section Ins 4102.06  Data Considerations and Notice Requirements

                  Section Ins 4102.07  Rate Filing Standards

                  Section Ins 4102.08  Loss Ratio Standards

 

          PART Ins 4103  REQUIREMENTS FOR SMALL EMPLOYER GROUP HEALTH INSURANCE SUBJECT TO RSA 420-G

                  Section Ins 4103.01  Purpose

                  Section Ins 4103.02  Applicability and Scope

                  Section Ins 4103.03  Definitions

                  Section Ins 4103.04  Underwriting and Issue Requirements

                  Section Ins 4103.05  Renewal Requirements

                  Section Ins 4103.06  Disclosure

                  Section Ins 4103.07  Rate Filing Standards

                  Section Ins 4103.08  Loss Ratio Standards for Policy Forms

 

          PART Ins 4104  REQUIREMENTS FOR LARGE EMPLOYER GROUP HEALTH INSURANCE

                  Section Ins 4104.01  Purpose

                  Section Ins 4104.02  Applicability and Scope

                  Section Ins 4104.03  Definitions

                  Section Ins 4104.04  Underwriting and Issue Requirements

                  Section Ins 4104.05  Renewal Requirements

                  Section Ins 4104.06  Rate Filing Standards

                  Section Ins 4104.07  Loss Ratio Standards for New Policy Forms

 

          PART Ins 4105  REQUIREMENTS FOR GROUP STOP LOSS INSURANCE

                  Section Ins 4105.01  Purpose

                  Section Ins 4105.02  Applicability and Scope

                  Section Ins 4105.03  Definitions

                  Section Ins 4105.04  Underwriting and Issue Requirements

                  Section Ins 4105.05  Rate Submission Requirements

                  Section Ins 4105.06  Annual Filing Required

                  Section Ins 4105.07  Interim Filing

 

          PART Ins 4106  REQUIREMENTS FOR OTHER TYPES OF HEALTH INSURANCE

                  Section Ins 4106.01  Purpose

                  Section Ins 4106.02  Applicability and Scope

                  Section Ins 4106.03  Definitions

                  Section Ins 4106.04  Submission Requirements

                  Section Ins 4106.05  Loss Ratio Standards for New Policy Forms

                  Section Ins 4106.06  Loss Ratio Standards for Rate Revisions

 

          PART Ins 4107  WAIVER OF RULES

                  Section Ins 4107.01  Waiver of Rules

 

CHAPTER Ins 4200  UNIFORM REPORTING SYSTEM FOR UNINSURED PATIENT ENCOUNTER DATA

          PART Ins 4201  GENERAL REQUIREMENTS

                  Section 4201.01  Purpose and Scope

                  Section 4201.02  Definitions

 

          PART Ins 4202  UNINSURED PATIENT ENCOUNTER DATA SET SUBMISSION REQUIREMENTS

                  Section Ins 4202.01  Entities Required to Submit Uninsured Encounter Data Sets

                  Section Ins 4202.02  Uninsured Encounter Data Set Submission Description

                  Section Ins 4202.03  General Requirements for Data Set Submission

                  Section Ins 4202.04  Required Data Elements for Submission Made Pursuant to Ins 4202.03

                  Section Ins 4202.05  Registration

                  Section Ins 4202.06  Transmittal Record

                  Section Ins 4202.07  Submission of Test Data

                  Section Ins 4202.08  Submission Periods

                  Section Ins 4202.09  Submission Compliance

                  Section Ins 4202.10  Non-Compliant Data Submission

 

CHAPTER Ins 4300  FIDUCIARY OBLIGATION OF PRODUCERS

            PART Ins 4301  FIDUCIARY STANDARDS AND PROCEDURES

                        Section Ins 4301.01  Purpose and Scope

                        Section Ins 4301.02  Definitions

                        Section Ins 4301.03  Fiduciary Obligation

                        Section Ins 4301.04  Establishment of Premium Trust Account

                        Section Ins 4301.05  Commingling of Funds Prohibited

                        Section Ins 4301.06  Return Premiums

                        Section Ins 4301.07  Exchange Terms

                        Section Ins 4301.08  Recordkeeping Requirements

                        Section Ins 4301.09  Penalty

 

CHAPTER Ins 4400  STOP LOSS INSURANCE

            PART Ins 4401  ACTUARIAL CERTIFICATION

                  Section Ins 4401.01  Purpose and Scope

                  Section Ins 4401.02  Definitions

                  Section Ins 4401.03  Actuary Criteria; Change of Actuary

                  Section Ins 4401.04  Certification by Actuary: Polices Issued or Renewed Prior to January 1, 2017

                  Section Ins 4401.05  Certification by Actuary: Policies Issued or Renewed On or After January 1, 2017

                  Section Ins 4401.06  Term of Certification and Annual Filing

 

CHAPTER Ins 4500  ANNUAL FINANCIAL REPORTING

          PART Ins 4501  ANNUAL FINANCIAL REPORTING

                  Section Ins 4501.01  Purpose and Scope

                  Section Ins 4501.02  Definitions

                  Section Ins 4501.03  General Requirements Related to Filing and Extensions for Filing of Annual Audited Financial Reports and Audit Committee Appointment

                  Section Ins 4501.04  Contents of Annual Audited Financial Report

                  Section Ins 4501.05  Designation of Independent Certified Public Accountant

                  Section Ins 4501.06  Qualifications of Independent Certified Public Accountant

                  Section Ins 4501.07  Consolidated or Combined Audits

                  Section Ins 4501.08  Scope of Audit and Report of Independent Certified Public Accountant

                  Section Ins 4501.09  Notification of Adverse Financial Condition

                  Section Ins 4501.10  Communication of Internal Control Related Matters Noted in an Audit

                  Section Ins 4501.11  Accountant’s Letter of Qualifications

                  Section Ins 4501.12  Definition, Availability and Maintenance of Independent Certified Public Accountant Workpapers

                  Section Ins 4501.13  Requirements for Audit Committees

                  Section Ins 4501.14  Internal Audit Function Requirements

                  Section Ins 4501.15  Conduct of Insurer in Connection with the Preparation of Required Reports and Documents

                  Section Ins 4501.16  Management’s Report of Internal Control Over Financial Reporting

                  Section Ins 4501.17  Exemptions and Effective Dates

                  Section Ins 4501.18  Canadian and British Companies

 

          PART Ins 4502  CORPORATE GOVERNANCE ANNUAL DISCLOSURE

                  Section Ins 4502.01  Purpose

                  Section Ins 4502.02  Definitions

                  Section Ins 4502.03  Filing Procedures

                  Section Ins 4502.04  Contents of Corporate Governance Annual Disclosure

                  Section Ins 4502.05  Severability Clause

 

CHAPTER Ins 4600  ANTIFRAUD PLAN STANDARDS

          PART Ins 4601  Antifraud Plans

                  Section Ins 4601.01  Purpose

                  Section Ins 4601.02  Applicability and Scope

                  Section Ins 4601.03  Definitions

                  Section Ins 4601.04  Antifraud Plans Submitted Upon Request

                  Section Ins 4601.05  Antifraud Plan Requirements

                  Section Ins 4601.06  Regulatory Compliance

                  Section Ins 4601.07  Confidentiality of Antifraud Plans

                  Section Ins 4601.08  Waiver of Rules

 

CHAPTER Ins 4700  TRAVEL INSURANCE

          PART Ins 4701  BLANKET ACCIDENT AND HEALTH TRAVEL INSURANCE

                  Section Ins 4701.01  Purpose

                  Section Ins 4701.02  Applicability and Scope

                  Section Ins 4701.03  Definitions

                  Section Ins 4701.04  Filing Requirements

                  Section Ins 4701.05  Coverage Filing Requirements

                  Section Ins 4701.06  Minimum Benefit Requirements

                  Section Ins 4701.07  Prohibited Policy Provisions, Exclusions and Limitations

                  Section Ins 4701.08  Disclosures

                  Section Ins 4701.09  Description of Coverage

                  Section Ins 4701.10  Claim Settlement

                  Section Ins 4701.11  Advertisements of Insurance

 

          PART Ins 4702  INDIVIDUAL ACCIDENT AND HEALTH TRAVEL INSURANCE

                  Section Ins 4702.01  Purpose

                  Section Ins 4702.02  Applicability and Scope

                  Section Ins 4702.03  Definitions

                  Section Ins 4702.04  Filing Requirements

                  Section Ins 4702.05  Coverage Filing Requirements

                  Section Ins 4702.06  Minimum Benefit Requirements

                  Section Ins 4702.07  Prohibited Policy Provisions, Exclusions and Limitations

                  Section Ins 4702.08  Disclosures

                  Section Ins 4702.09  Description of Coverage

                  Section Ins 4702.10  Claim Settlement

                  Section Ins 4702.11  Advertisements of Insurance

 

          PART Ins 4703  PERSONAL INLAND MARINE TRAVEL INSURANCE

                  Section Ins 4703.01  Purpose

                  Section Ins 4703.02  Applicability and Scope

                  Section Ins 4703.03  Definitions

                  Section Ins 4703.04  Filing Requirements

                  Section Ins 4703.05  Coverage Filing Requirements

                  Section Ins 4703.06  Minimum Policy Requirements

                  Section Ins 4703.07  Prohibited Policy Provisions

                  Section Ins 4703.08  Disclosures

                  Section Ins 4703.09  Description of Coverage

                  Section Ins 4703.10  Claim Settlement

                  Section Ins 4703.11  Advertisements of Insurance

 

          PART Ins 4704  WAIVER OF RULES

                  Section Ins 4704.01  Waiver of Rules

 

CHAPTER Ins 4800  RULES FOR DISPUTE RESOLUTION IN MEDICAL INJURY EARLY OFFER PROCEEDINGS

          PART Ins 4801  PURPOSE AND APPLICABILITY

                  Section Ins 4801.01  Purpose

                  Section Ins 4801.02  Applicability

 

          PART Ins 4802  DEFINITIONS

                  Section Ins 4802.01  Definitions

 

          PART Ins 4803  REQUEST FOR HEARING

                  Section Ins 4803.01  Issues

                  Section Ins 4803.02  Request for Hearing

 

          PART Ins 4804  HEARING OFFICER SELECTION, ACCEPTANCE, AND AUTHORITY

                  Section Ins 4804.01  Hearing Officer Selection

                  Section Ins 4804.02  Hearing Officer Acceptance

                  Section Ins 4804.03  Docket Number and Recordkeeping

                  Section Ins 4804.04  Ex Parte Communications

                  Section Ins 4804.05  Hearing Officer Authority

                  Section Ins 4804.06  Waiver of Rules by Hearing Officer

 

          PART Ins 4805  FILING, FORMAT AND DELIVERY OF DOCUMENTS

                  Section Ins 4805.01  Date of Issuance of Filing

                  Section Ins 4805.02  Format of Documents

                  Section Ins 4805.03  Delivery of Documents

 

          PART Ins 4806  TIME PERIODS

                  Section Ins 4806.01  Computation of Time

 

          PART Ins 4807  MOTIONS

                  Section Ins 4807.01  Motions; Objections

 

          PART Ins 4808  NOTICE OF HEARING; APPEARANCES; PRE-HEARING CONFERENCES

                  Section Ins 4808.01  Scheduling of Hearing

                  Section Ins 4808.02  Docket Numbers

                  Section Ins 4808.03  Notice of Hearing

                  Section Ins 4808.04  Appearances and Representation

                  Section Ins 4808.05  Prehearing Conference

                  Section Ins 4808.06  Telephonic Hearings

         

          PART Ins 4809  INTERVENTION

                  Section Ins 4809.01  Intervention

 

          PART Ins 4810  POSTPONEMENT REQUESTS

                  Section Ins 4810.01  Postponements

 

          PART Ins 4811  EXCHANGE OF INFORMATION AND DOCUMENTS

                  Section Ins 4811.01  Production of Information

 

          PART Ins 4812  RECORD, PROOF, EVIDENCE AND DECISIONS

                  Section Ins 4812.01  Record of the Hearing

                  Section Ins 4812.02  Standard and Burden of Proof

                  Section Ins 4812.03  Testimony; Order of Proceeding

                  Section Ins 4812.04  Evidence

                  Section Ins 4812.05  Proposed Findings of Fact and Conclusions of Law

                  Section Ins 4812.06  Closing the Record

                  Section Ins 4812.07  Reopening the Record

                  Section Ins 4812.08  Decisions

 

          PART Ins 4813  COST OF HEARING

                  Section Ins 4813.01  Filing and Payment of Costs

 

CHAPTER Ins 4900  EARLY OFFERS FOR MEDICAL INJURY CLAIMS - REPORTING

          PART Ins 4901  MANDATORY REPORTING OF EARLY OFFERS

                  Section Ins 4901.01  Purpose

                  Section Ins 4901.02  Scope

                  Section Ins 4901.03  Definitions

                  Section Ins 4901.04  Detailed Reporting Requirements

                  Section Ins 4901.05  Penalty

                  Section Ins 4901.06  Confidentiality

 

CHAPTER Ins 5000   STANDARDS AND PROCEDURES FOR THE FILING OF PROPERTY AND CASUALTY INSURANCE FORMS AND RATES

          PART Ins 5001  PROPERTY AND CASUALTY FORM AND RATE FILINGS

                  Section Ins 5001.01  Purpose and Scope

                  Section Ins 5001.02  Definitions

                  Section Ins 5001.03  Form Filing Procedures

                  Section Ins 5001.04  Rate Filing Procedures

                  Section Ins 5001.05  Rules Applicable to All Applications

                  Section Ins 5001.06  Rules Applicable to All Forms

                  Section Ins 5001.07  Form Provision Rules

                  Section Ins 5001.08  Waiver of Rules

 

CHAPTER Ins 6000  PROVISIONS APPLICABLE TO ALL ANCILLARY HEALTH AND BLANKET INSURANCE

          PART Ins 6001  STANDARD DEFINITIONS AND POLICY PROVISIONS

                  Section Ins 6001.01  Purpose

                  Section Ins 6001.02  Applicability and Scope

                  Section Ins 6001.03  Definitions

                  Section Ins 6001.04  Policy Definition Requirements

                  Section Ins 6001.05  Prohibited Policy Provisions

                  Section Ins 6001.06  Required Policy Provisions

                  Section Ins 6001.07  Waiver or Suspension of Rules

 

CHAPTER Ins 6100  DISCONTINUANCE AND REPLACEMENT OF ANCILLARY HEALTH AND BLANKET COVERAGE

          PART Ins 6101 DISCONTINUANCE AND REPLACEMENT OF GROUP ANCILLARY HEALTH AND BLANKET COVERAGE

                  Section Ins 6101.01  Scope and Applicability

                  Section Ins 6101.02  Effective Date of Discontinuance for Nonpayment of Premium

                  Section Ins 6101.03  Requirements for Notice of Discontinuance

                  Section Ins 6101.04  Extension of Benefits

                  Section Ins 6101.05  Continuance of Coverage in Situations Involving Replacement of One Carrier by Another

 

          PART Ins 6102  REPLACEMENT OF INDIVIDUAL ANCILLARY HEALTH COVERAGE

                  Section Ins 6102.01  Scope and Applicability

                  Section Ins 6102.02  Requirements for Replacement of Individual Ancillary Health Insurance

                  Section Ins 6102.03  Waiver of Rules

 

          PART Ins 6103  DISCONTINUANCE OF INDIVIDUAL ANCILLARY HEALTH COVERAGE

                  Section Ins 6103.01  Applicability and Scope

                  Section Ins 6103.02  Definitions

                  Section Ins 6103.03  Requirements for Discontinuance of Individual Ancillary Health Coverage

                  Section Ins 6103.04  Notification Requirements

                  Section Ins 6103.05  Waiver of Rules

 

CHAPTER Ins 6200  ANCILLARY HEALTH MINIMUM STANDARDS

          PART Ins 6201  ANCILLARY HEALTH MINIMUM STANDARDS GENERAL PROVISIONS

                  Section Ins 6201.01  Purpose

                  Section Ins 6201.02  Applicability and Scope

                  Section Ins 6201.03  Definitions

                  Section Ins 6201.04  Ancillary Health Minimum Standards

                  Section Ins 6201.05  Required Disclosure Provisions

                  Section Ins 6201.06  Outline of Coverage Requirements

                  Section Ins 6201.07  Waiver of Rules

 

          PART Ins 6202  ANCILLARY HEALTH MINIMUM STANDARDS FOR HOPSPITAL CONFINEMENT FIXED INDEMNITY AND OTHER FIXED INDEMNITY COVERAGE

                  Section Ins 6202.01  Applicability and Scope

                  Section Ins 6202.02  Definitions

                  Section Ins 6202.03  Minimum Standards for Benefits

                  Section Ins 6202.04  Prohibited Policy Provisions

                  Section Ins 6202.05  Required Disclosure Provisions

                  Section Ins 6202.06  Outline of Coverage

                  Section Ins 6202.07  Waiver of Rules

 

          PART Ins 6203  ANCILLARY HEALTH MINIMUM STANDARDS FOR BENEFITS FOR ACCIDENT-ONLY AND SPECIFIED ACCIDENT COVERAGE

                  Section Ins 6203.01  Application and Scope

                  Section Ins 6203.02  Definitions

                  Section Ins 6203.03  Minimum Standards for Benefits

                  Section Ins 6203.04  Prohibited Policy Provisions

                  Section Ins 6203.05  Required Disclosure Provisions

                  Section Ins 6203.06  Outline of Coverage

                  Section Ins 6203.07  Waiver of Rules

 

          PART Ins 6204  ANCILLARY HEALTH MINIMUM STANDARDS FOR BENEFITS FOR SPECIFIED DISEAS COVERAGE

                  Section Ins 6204.01  Applicability and Scope

                  Section Ins 6204.02  Definitions

                  Section Ins 6204.03  Minimum Standards for Benefits

                  Section Ins 6204.04  Prohibited Policy Provisions

                  Section Ins 6204.05  Required Disclosure Provisions

                  Section Ins 6204.06  Outline of Coverage

                  Section Ins 6204.07  Waiver of Rules

 

 

CHAPTER Ins 7000  SHORT TERM LIMITED DURATION HEALTH INSURANCE

          PART Ins 7001  MINIMUM STANDARDS FOR SHORT TERM LIMITED DURATION HEALTH INSURANCE

                  Section Ins 7001.01  Purpose

                  Section Ins 7001.02  Applicability and Scope

                  Section Ins 7001.03  Definitions

                  Section Ins 7001.04  Policy Definition Requirements

                  Section Ins 7001.05  Prohibited Policy Provisions

                  Section Ins 7001.06  Required Policy Provisions

                  Section Ins 7001.07  Additional Policy Provisions

                  Section Ins 7001.08  Disclosures

                  Section Ins 7001.09  Outline of Coverage

                  Section Ins 7001.10  Grievance and Appeals

                  Section Ins 7001.11  Continuation of Coverage for Hospital Confinement

                  Section Ins 7001.12  Waiver of Rules