HB 1605-FN – AS INTRODUCED
2008 SESSION
01/09
HOUSE BILL 1605-FN
AN ACT making certain technical changes in the insurance laws.
SPONSORS: Rep. Spratt, Hills 3; Rep. DeStefano, Merr 13; Rep. McLeod, Graf 2
This bill makes technical changes in the insurance laws and clarifies the definition of “dependent” for purposes of dependent care coverage.
This bill is a request of the insurance department.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
08-2482
01/09
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eight
AN ACT making certain technical changes in the insurance laws.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Accident and Health Insurance; Group. Amend the introductory paragraph of RSA 415:18, I to read as follows:
I. Policies, certificates and other forms attached to group or blanket accident or health insurance, or accident and health insurance, shall comply with all applicable laws, including RSA 420-G, and with rules adopted by the commissioner. No [such] policy or certificate or other form evidencing group coverage shall be delivered or issued for delivery in this state to a resident of this state [without] or to any employer or qualified association trust with a business location in this state, until a copy of the form has been submitted to, and received the prior written approval of the commissioner. The commissioner shall adopt rules, pursuant to RSA 541-A, establishing conditions by which insurers may deem such policies or certificate forms approved upon the expiration of a 30-day period following the commissioner’s receipt of the insurer’s submission of the policy and certificate forms for approval. No policy of group or blanket accident or health insurance, or accident and health insurance affecting a resident of New Hampshire, whether such policy is delivered or issued for delivery in this state or any other state, and no certificate thereunder shall, except as provided in paragraph III of this section, be delivered or issued for delivery in this state unless the policy or certificate contains in substance each and all of the provisions set forth in the following subparagraphs or provisions which in the opinion of the commissioner are more favorable to the holders of such certificates or not less favorable to the holders of such certificates and more favorable to policyholders:
2 Accident and Health Insurance; Group. Amend RSA 415:18, XVI(h)(5) to read as follows:
(5) The date on which the group plan terminates subject to the continuation rights set forth in [this paragraph] RSA 415:18, VII(g)(4).
3 Unfair Insurance Trade Practices. Amend RSA 417:4, VIII(e) to read as follows:
(e) Refusing to insure risks solely because of age (except in the case of life[,] or accident [or health] insurance), place or area or residence, race, color, creed, national origin, ancestry, marital or civil union status, lawful occupation including the military service (except in the case of life[,] or accident [or health] insurance), of anyone who is or seeks to become insured or solely because another insurer has refused to write a policy, or has cancelled or has refused to renew an existing policy in which that person was the name insured or, except in the instance of excess coverages, solely because the insured does not insure collateral primary, personal types of insurance with the insurer. The exemption in this subparagraph shall not permit a mortgage life insurance policy or certificate to cease, cancel or terminate solely on the basis of the mortgagor’s age, until the mortgagor has reached the age of 80.
4 Continuing Care Communities. Amend RSA 420-D:1, III to read as follows:
III. “Continuing care” or “life care” means furnishing to a person, other than one who is related by consanguinity or affinity up to, but not including, the third degree, services that shall include lodging, or both board [or] and lodging, [or both, and may include] together with nursing services, medical services, or other health related services, irrespective of whether the lodging and services are provided at the same location or provided by a third party, pursuant to a contractual agreement extending for the life of such person or for a period of a year or more in consideration of payment of an entrance fee which may also include additional periodic charges for the services provided and including contracts which are terminable by either party.
5 Health Insurance Coverage. Amend RSA 420-G:2, I-a to read as follows:
I-a. “Business location” means the street address of an employer, whether owned or leased, in which any of the business of the employer is conducted.
I-b. “Case characteristics” means demographic or other relevant characteristics of a small employer group that may be considered by the health carrier in the determination of premium rates for that group.
6 Health Insurance Coverage; Scope of Chapter. Amend the introductory paragraph of RSA 420-G:3, I to read as follows:
I. This chapter shall apply to any entity licensed, controlled or regulated by RSA 415, RSA 415-E, RSA 420-A, RSA 420-B, or RSA 420-C which offers or provides health coverage for delivery in this state. This chapter shall also apply to any multi-employer plan, trust, association, claims administrator, claims paying agent or any other entity whether fully insured, partially insured, or self-funded which offers or provides health coverage for delivery in this state. Any carrier that offers or provides health coverage to an employer that has a business location in New Hampshire shall comply with this chapter, regardless of whether the policy is issued or delivered to an out-of-state trust, association, employer, or other entity. The certificate, policy, or other form evidencing coverage for an employer with a New Hampshire business location shall be deemed to have been issued and delivered in this state regardless of the location of actual delivery.
7 Accident and Health Insurance. Amend RSA 415:5, I(3)(a) to read as follows:
(3)(a) It purports to insure only one person, except that a policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(1) Is less than 26 years of age;
(2) Is unmarried;
(3) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(4) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(5) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(6) Is a qualifying child as that term is defined in the Internal Revenue Code, section 152, subsection (c).
8 Health Services Corporations. Amend RSA 420-A:10-a, I to read as follows:
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(e) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(f) Is a qualifying child as that term is defined in the Internal Revenue Code, section 152, subsection (c).
9 Health Maintenance Organizations; Dependent Coverage. Amend RSA 420-B:8-aa, I to read as follows:
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(e) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(f) Is a qualifying child as that term is defined in the Internal Revenue Code, section 152, subsection (c).
10 Preferred Provider Agreements; Dependent Coverage. Amend RSA 420-C:4-a, I to read as follows:
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(e) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(f) Is a qualifying child as that term is defined the Internal Revenue Code, section 152, subsection (c).
11 Delta Dental; Dependent Coverage. Amend RSA 420-F:5-a, I to read as follows:
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(e) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(f) Is a qualifying child as that term is defined in the Internal Revenue Code, section 152, subsection (c).
12 Managed Care; Dependent Coverage. Amend RSA 420-J:8-d, I to read as follows:
I. A policy may insure, originally or by subsequent amendment, upon the application of an adult member of a family who shall be deemed the policyholder, any 2 or more eligible members of that family, including husband, wife, dependent children or any dependent under age 26. In this section “dependent” means a subscriber’s child by blood or by law, who:
(a) Is less than 26 years of age;
(b) Is unmarried;
(c) Is a resident of New Hampshire or is enrolled as a student at a public or private institution of higher education; and
(d) Is not provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, church plan, or health benefits plan, or entitled to benefits under Title XVIII of the Social Security Act, Public Law 89-97, 42 U.S.C. 1395 et seq.; or
(e) Is mentally or physically incapable of earning his or her own living on the date as of which such dependent’s status as a covered family member would otherwise expire because of age, shall continue under such policy while such policy remains in force or is replaced by another policy as long as such incapacity continues and as long as such dependent remains chiefly financially dependent on the policyholder or the employee or his or her estate is chargeable for the care of such dependent; provided, that due proof of such incapacity is received by the insurer within 31 days of such expiration date. If such coverage is continued in accordance with this subparagraph, such dependent shall be entitled upon the termination of such incapacity to a converted policy in accordance with and subject to the terms and conditions of the conversion privilege clause if such privilege is afforded by the policy; provided, that such dependent has not attained the limiting age, if any, for coverage of adults specified in the policy; or
(f) Is a qualifying child as that term is defined in the Internal Revenue Code, section 152, subsection (c).
13 Effective Date. This act shall take effect January 1, 2009.
LBAO
08-2482
Revised 01/18/08
HB 1605 FISCAL NOTE
AN ACT making certain technical changes in the insurance laws.
FISCAL IMPACT:
The Insurance Department and the Department of Administrative Services state this bill will have no fiscal impact on state, county, and local revenue and expenditures in FY 2009 and each fiscal year thereafter.
METHODOLOGY:
The Insurance Department states this bill makes certain technical corrections to various insurance laws. The State collects premium tax on certain insurance products. The Department states the changes contained in this bill are not expected to impact the aggregate level of taxable premium collected. The Department further states the changes contained in this bill are not expected to impact coverages purchased by municipalities.
The Department of Administrative Services states this bill makes changes to laws relating to health insurance. The Department administers the State’s self-funded employee and retiree health benefit program. Since the program is self-funded, it is not generally subject to insurance laws; therefore, the Department does not anticipate this bill will have any fiscal impact on State health insurance expenditures.