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; Administration Division
Section Ins 102.02 Business Operations Division
Section Ins 102.03 Legal Division
Section Ins 102.04 Life and Health Division
Section Ins 102.05 Financial Regulation Division
Section Ins 102.06 Property and Casualty Division
Section Ins 102.07 Consumer Services Division
PART Ins 103 REQUESTS FOR DEPARTMENT DOCUMENTS OR RECORDS
Section Ins 103.01 Document Requests
Section Ins 103.02 Department Response
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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 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
Section Ins 308.07 Waiver or Suspension of Rules
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
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
TABLE
OF CONTENTS
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
Section Ins 403.08 Standard for Approval of Tier Change
Section Ins 403.09 Applications for Tier Changes
Section Ins 403.10 Required Reporting
TABLE
OF CONTENTS
CHAPTER Ins
500 DOMESTIC STOCK INSURERS - EXPIRED
PART
Ins 501 PROXIES, CONSENTS AND
AUTHORIZATIONS OF DOMESTIC STOCK
INSURERS
Section Ins 501.01 Application of Part
Section Ins 501.02 Definitions
Section Ins 501.03 Proxies, Consents and Authorizations
Section Ins 501.04 Disclosure of Equivalent Information
Section Ins 501.05 Information to be Furnished to Security
Holders
Section Ins 501.06 Requirements as to Proxy and Information
Statement
Section Ins 501.07 Material Required to be Filed
Section Ins 501.08 False or Misleading Statements
Section Ins 501.09 Prohibition of Certain Solicitations
Section Ins 501.10 Special Provisions Applicable to Election
Contests
PART
Ins 502 INFORMATION REQUIRED IN PROXY
STATEMENT OR INFORMATION STATEMENT
Section Ins 502.01 Proxy Statement
PART
Ins 503 INFORMATION TO BE INCLUDED IN
STATEMENTS FILED BY OR ON BEHALF OF A PARTICIPANT OTHER THAN THE INSURER, IN A
PROXY SOLICITATION IN AN ELECTION CONTEST
Section Ins 503.01 Statements Filed
TABLE
OF CONTENTS
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 –
Reciprocal Jurisdictions
Section
Ins 601.08 Credit for Reinsurance
Required by Law
Section
Ins 601.09 Asset or Reduction from
Liability for Reinsurance Ceded to an Unauthorized Assuming Insurer Not Meeting
the Requirements of Ins 601.02 through Ins 601.08
Section Ins 601.10 Trust Agreements Qualified Under Ins 601.09
Section Ins 601.11 Letters of Credit Qualified Under Ins 601.09
Section Ins 601.12 Other Security
Section Ins 601.13 Reinsurance Contract
Section
Ins 601.14 Contacts Affected
TABLE
OF CONTENTS
CHAPTER
Ins 700 REQUIREMENTS FOR FOREIGN
INSURANCE COMPANIES APPLYING FOR A LICENSE TO DO BUSINESS IN THE STATE OF
PART Ins 701 CERTIFICATION; FILING REQUIREMENTS; APPLICATION
FOR LICENSURE
Section Ins 701.01 Scope
Section Ins 701.02 Preliminary Admission Filing Requirements
Section Ins 701.03 Full Application for Licensure
TABLE OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER
Ins 1400 PRIVATE
PASSENGER AUTOMOBILE INSURANCE
PART
Ins 1400 PURPOSE AND SCOPE AND SERVICE REQUIREMENTS
FOR THE VOLUNTARY MARKET AND THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY
Section
Ins 1401.01 Purpose
Section
Ins 1401.02 Scope
PART
Ins 1402 SERVICE REQUIREMENTS FOR THE
VOLUNTARY MARKET AND THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY
Section
Ins 1402.01 Service
PART
Ins 1403 THE WRITING OF AUTOMOBILE
INSURANCE IN THE VOLUNTARY MARKET
Section
Ins 1403.01 Purpose
Section
Ins 1403.02 Definitions Applicable to the
Voluntary Market
Section
Ins 1403.03 Voluntary Market Refusal to
Write; Refusal to Renew; Cancellation
Section
Ins 1403.04 Movement or Placement of a
Policy in the Voluntary Market
Section
Ins 1403.05 Evidence of Financial
Responsibility
PART
Ins 1404 VOLUNTARY MARKET REGULATION
PERTAINING TO RATES, RATING PLANS AND PRACTICES
Section Ins 1404.01 Rating and Rating Plans
Section
Ins 1404.02 Rating Practices
Section
Ins 1404.03 Reflecting Driver
Performance
PART
Ins 1405 RECORD RETENTION PROCEDURES IN
THE VOLUNTARY MARKET AND THE NEW HAMPSHIRE AUTOMOBILE REINSURANCE FACILITY
Section
Ins 1405.01 Record Retention Procedures
PART
Ins 1406 PLAN OF OPERATION FOR THE NEW HAMPSHIRE
AUTOMOBILE REINSURANCE FACILITY
Section Ins 1406.01 Purpose
Section Ins 1406.02 Definitions
Section Ins 1406.03 Insurers Required to Participate
Section Ins 1406.04 Basis of Participation
Section Ins 1406.05 Evidence of Financial Responsibility
Section Ins 1406.06 Obligation of Members
Section Ins 1406.07 Board of Governors
Section Ins 1406.08 Meetings
Section Ins 1406.09 Statistical Data
Section
Ins 1406.10 Cessions
Section Ins 1406.11 Facility Charges, Premium, and Allowance
Section Ins 1406.12 Safe Driver Incentive Plan and SDIP Points
for the New Hampshire Automobile Reinsurance Facility
Section Ins 1406.13 Assessments and Participation
Section Ins 1406.14 Audits
Section Ins 1406.15 Indemnification
Section Ins 1406.16 Hearings and Review
Section Ins 1406.17 Amendments
Section
Ins 1406.18 Claim Reserves
Section Ins 1406.19 Reinsurance Facility Rates
Section Ins 1406.20 Nonrenewal and Cancellation Protection
PART
Ins 1407 WAIVER OF RULES PROVISION
Section
Ins 1407.01 Waiver of Rules
TABLE
OF CONTENTS
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
Section Ins 1501.19 Extraordinary Dividends and Other Distributions
Section Ins 1501.20 Adequacy of Surplus
TABLE
OF CONTENTS
CHAPTER Ins 1600 SUBSIDIARIES OF INSURANCE COMPANIES - EXPIRED
PART Ins 1601 VALUATION OF SUBSIDIARIES OF INSURANCE
COMPANIES
Section Ins 1601.01 Definitions
Section Ins 1601.02 Valuation of a Subsidiary Which is an Insurer
Section Ins 1601.03 Valuation of a Subsidiary Which is Not an
Insurer
Section Ins 1601.04 Additional Provisions
Section Ins 1601.05 Adjustment; Hearings
TABLE
OF CONTENTS
CHAPTER
Ins 1700 MEDICAL MALPRACTICE LIABILITY
INSURANCE - EXPIRED
PART
Ins 1701
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
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
TABLE
OF CONTENTS
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
Section Ins 1810.01 Audits
PART Ins 1811 TRANSFER OR
Section
Ins 1811.01 Transfer or
PART Ins 1812 ENFORCEMENT
Section Ins 1812.01 Violations
PART Ins 1813 WAIVER
Section Ins 1813.01 Waiver of Rules
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER Ins
2100 MUTUAL COMPANIES - EXPIRED
PART
Ins 2101 ADVANCES MADE TO MUTUAL
COMPANIES OTHER THAN LIFE INSURANCE COMPANIES
Section Ins 2101.01 Definitions
Section Ins 2101.02 Advances to be Cash Transactions
Section Ins 2101.03 403:4 Certificate Issuance
Section Ins 2101.04 Report of Outstanding 403:4 Certificates
Section Ins 2101.05 Information to be Contained in 403:4 Certificates
Section
Ins 2101.06 Information to be Filed with
the Insurance Commissioner Prior to Making Advances Pursuant to RSA 403:4; Statement
by Person Making Advance
Section Ins 2101.07
Section
Ins 2101.08 Payment of Principal and
Interest on 403:4 Certificate; Method of Selection for Payment or Redemption
Section Ins 2101.09 Certificates of Information to be Filed with
the Commissioner
Section Ins 2101.10 Report of 403:4 Certificate in Annual Statement
Section Ins 2101.11 Penalties
Section
Ins 2101.12 Existing 403:4 Certificates
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER Ins 2500 HOME WARRANTY INSURANCE - REPEALED
TABLE
OF CONTENTS
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 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
TABLE OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
Section Ins 3101.05 Waiver of Rules
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER Ins 3400 PURCHASING ALLIANCES
PART Ins 3401 PURCHASING
Section Ins 3401.01 Purpose
Section Ins 3401.02 Definitions
Section Ins 3401.03 Jurisdiction of the Commissioner; Penalties
Section Ins 3401.04 Purchasing
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
Section Ins 3401.11 Purchasing
TABLE
OF CONTENTS
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
Section Ins 3507.07 Waiver or Suspension of Rules
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
Section Ins 3601.34 Penalties
Section Ins 3601.35 Waiver of Rules
PART
Ins 3602
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
TABLE
OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER Ins 3800
- RESERVED
PART Ins 3801 Reserved
TABLE
OF CONTENTS
CHAPTER Ins 3900 OTHER INSURANCES
PART Ins 3901 GROUP DISABILITY INSURANCE CLAIM PROCESSING
STANDARDS
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
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 Subscriber and Member Identification Data
Elements
Section Ins 4009.02 Technical Specifications and Format for File
Transfer
Section
Ins 4009.03 Data Quality Requirements
Section Ins 4009.04 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
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
TABLE OF CONTENTS
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
TABLE OF CONTENTS
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
TABLE
OF CONTENTS
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 Between January 1, 2017 and January 1, 2021
Section
Ins 4401.05 Certification
by Actuary: Policies Issued or Renewed On or After
January 1, 2021
Section Ins 4401.06 Term of Certification and Annual Filing
TABLE
OF CONTENTS
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
TABLE OF CONTENTS
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
TABLE OF CONTENTS
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
TABLE
OF CONTENTS
CHAPTER
Ins 4800 - RESERVED
PART
Ins 4801 Reserved
PART Ins 4802 Reserved
PART Ins 4803 Reserved
PART Ins 4804 Reserved
PART Ins 4805 Reserved
PART Ins 4806 Reserved
PART Ins 4807 Reserved
PART Ins 4808 Reserved
PART Ins 4809 Reserved
PART Ins 4810 Reserved
PART Ins 4811 Reserved
PART Ins 4812 Reserved
PART Ins 4813 Reserved
TABLE OF CONTENTS
CHAPTER
Ins 4900 RESERVED
PART
Ins 4901 Reserved
TABLE
OF CONTENTS
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
TABLE OF CONTENTS
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
TABLE OF CONTENTS
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
TABLE OF CONTENTS
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 DISEASE 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
PART Ins 6205 ANCILLARY HEALTH MINIMUM STANDARDS FOR
BENEFITS FOR DISABILITY INCOME PROTECTION COVERAGE
Section Ins 6205.01 Applicability and Scope
Section Ins 6205.02 Definitions
Section Ins 6205.03 Minimum Standards for Benefits for All Disability
Income Policies
Section Ins 6205.04 Additional Minimum Standards for Benefits for
Individual Policies
Section Ins 6205.05 Additional Minimum Standards for Benefits for
Group Coverage
Section Ins 6205.06 Prohibited Policy Provisions
Section Ins 6205.07 Required Disclosure Provisions
Section
Ins 6205.08 Outline of Coverage
Section Ins 6205.09 Group Disability Insurance Claim Processing
Standards
Section Ins 6205.10 Failure to Establish and Follow Reasonable
Claims Procedures
Section Ins 6205.11 Waiver of Rules
TABLE OF CONTENTS
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
TABLE OF CONTENTS
CHAPTER Ins 8000 FAMILY AND MEDICAL LEAVE WAGE REPLACEMENT COVERAGE
PART Ins 8001 MINIMUM STANDARDS FOR FAMILY AND MEDICAL LEAVE
WAGE REPLACEMENT COVERAGE
Section Ins 8001.01 Applicability and Scope
Section
Ins 8001.02 Definitions
Section Ins 8001.03 Minimum Standards for Benefits for All
Policies and Certificates
Section
Ins 8001.04 Required Policy Provisions
Section Ins 8001.05 Prohibited Policy Provisions
Section Ins 8001.06 Required Claim Provisions
Section Ins 8001.07 Required Disclosure Provisions
Section Ins 8001.08 Outline of Coverage
Section Ins 8001.09 Rates
Section Ins 8001.10 Waiver of Rules