Revision: Jan. 15, 2010, midnight
SB 352 – AS INTRODUCED
2010 SESSION
01/10
SENATE BILL 352
AN ACT relative to student insurance.
SPONSORS: Sen. Reynolds, Dist 2
COMMITTEE: Commerce, Labor and Consumer Protection
This bill clarifies blanket accident and health insurance and defines student insurance policies.
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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
10-2854
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Ten
AN ACT relative to student insurance.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Paragraphs; Insurance; Group. Amend RSA 415:18 by inserting after paragraph I the following new paragraphs:
I-a. “Blanket accident and health insurance” means that form of accident and health insurance that is not “health coverage” under RSA 420-G:2, IX, that does not require individual applications from covered persons, and that does not require a carrier to furnish each person with a certificate of coverage. Blanket health coverage shall be issued only to the following groups and cover only the following defined persons in the groups:
(a) A common carrier, which shall be deemed the policyholder, and which shall cover a group defined as all or any of the class of persons who may become passengers on such a common carrier.
(b) An employer, which shall be deemed the policyholder, and which shall cover all employees or any subset of employees defined solely by reference to exceptional hazards incident to such employment.
(c) A volunteer fire department, first aid, or other such volunteer group, which shall be deemed the policyholder, and which shall cover all the members of such department or group.
(d) A sports team or a camp, which team or camp shall be deemed the policyholder and which shall cover all members or campers.
(e) A travel agency, or other organization that provides travel-related services, which organization shall be deemed the policyholder and which shall cover all persons for whom travel-related services are provided.
I-b. The benefits payable under blanket accident and health insurance shall not be assigned to a health care provider.
2 New Section; Student Insurance Policies. Amend RSA 415 by inserting after section 19 the following new section:
415:19-a Student Insurance Policies. Student major medical expense coverage is hereby declared to be that form of accident and health insurance issued as large group coverage to enrolled students at an accredited college, university, or other educational institution. No coverage other than student major medical expense coverage shall be issued as student large group coverage. Student major medical expense plan coverage shall:
I. Provide the same form of major medical expense coverage under an arrangement whereby the premiums for such policies are paid to the insurer by the college, the university, or other educational institution.
II. Not include a pre-existing condition exclusion period.
III. Be considered large group coverage, subject to all applicable laws and rules that generally apply to large group accident and health insurance coverage, except those set forth in RSA 420-G and RSA 415:18, VII, VII-a, VII-b, XVI, and XVII.
3 New Subparagraph; Accident and Health Insurance; Minimum Standards. Amend RSA 415-A:3, I by inserting after subparagraph (k) the following new subparagraph:
(l) Student major medical expense coverage.
4 Accident and Health Insurance; Reference Changes. Amend RSA 415-A:3, II and III to read as follows:
II. Nothing in this section shall preclude the issuance of any policy or contract which combines 2 or more of the categories of coverage enumerated in subparagraphs I(a) through [(k)] (l).
III. No policy shall be delivered or issued for delivery in this state which does not meet the prescribed minimum standards for the categories of coverage listed in subparagraphs I(a) through [(k)] (l) which are contained within the policy unless the commissioner finds such policy will be in the public interest and such policy meets the requirements set forth in RSA 415. The commissioner may disapprove specific policy forms pursuant to RSA 415:2 and 3.
5 Accident and Health Insurance; Group. Amend RSA 415:18, VII to read as follows:
VII.(a) If a group [or blanket] policy affecting a resident of New Hampshire is delivered or issued for delivery in this state or any other state, and such policy provides hospital or surgical expense insurance or major medical expense insurance for other than specific diseases, accidents only, or [short-term] student major medical expense coverage insurance where the policyholder is the school, the policy and any certificate issued under such policy to a New Hampshire resident shall contain a provision to the effect that in case of termination for any reason whatever of coverage, including termination of eligibility for continuation coverage, provided any employee while insured under a group policy issued to his or her employer, if the employee or member is not then covered by another policy of hospital or surgical expense insurance or hospital service or medical expense indemnity corporation subscriber contract providing similar benefits or if the employee or member is not covered by or eligible to be covered by a group contract or policy providing similar benefits or is not provided with similar benefits required by any statute or provided by any welfare plan or program, the employee or member, if he or she has been insured under the group policy for at least 60 days, shall be entitled to have issued to him or her by the New Hampshire high risk pool without evidence of insurability upon application to the New Hampshire high risk pool within 31 days after such termination and upon payment of the applicable premium, an individual policy of insurance under RSA 404-G or shall be entitled to elect the 39-week extension period pursuant to RSA 415:18, XVII.
6 Accident and Health Insurance; Group. Amend RSA 415:18, XVI(a) to read as follows:
(a) Carriers shall provide continuation of coverage when an individual covered by a plan of group health insurance or a health maintenance organization that provides medical, hospital, dental, and/or surgical expense benefits, except [short-term] student [insurance] major medical expense coverage where the policyholder is the school, loses coverage under the plan. Any group [or blanket] policy of health insurance that affects a resident of New Hampshire that is delivered or issued for delivery in this state or any other state shall contain a provision that allows each subscriber or member on the policy who is a resident of New Hampshire to obtain continuation coverage under this section. Coverage shall be provided in accordance with the procedures described in this section.
7 Coverage for Nonprescription Enteral Formulas; “Blanket” Deleted. Amend RSA 420-A:17 to read as follows:
I. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group [blanket] accident or health insurance providing benefits for medical or hospital expenses shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.
II. Every health service corporation and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group [blanket] accident or health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.
8 Coverage for Dental Procedures. Amend the introductory paragraph of RSA 420-A:17-b, I to read as follows:
I. Every health service corporation and every similar corporation licensed under the laws of another state that issues or renews any group policy [or blanket] of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certificate holder who is a resident of New Hampshire coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:
9 Prompt Payment Required; “Blanket” Deleted. Amend RSA 420-A:17-d, I(a) to read as follows:
I.(a) Every health service corporation, and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group [blanket] accident or health insurance providing benefits for medical or hospital expenses for its insured persons shall pay for services rendered by New Hampshire health care providers within 30 calendar days upon receipt of a clean non-electronic claim or 15 calendar days upon receipt of a clean electronic claim.
10 Coverage for Dental Procedures; “Blanket” Deleted. Amend the introductory paragraph of RSA 420-B:8-ee, I to read as follows:
I. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any group policy [or blanket] of accident or health insurance providing benefits for medical or hospital expenses, shall provide to each covered individual or certificate holder who is a resident of New Hampshire coverage for the medically necessary hospital or surgical day care facility charges and administration of general anesthesia administered by a licensed anesthesiologist or anesthetist for dental procedures performed on a covered person who:
11 Coverage for Nonprescription Enteral Formulas; “Blanket” Deleted. Amend RSA 420-B:8-ff, I and II to read as follows:
I. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group [blanket] health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the provision of nonprescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula is needed to sustain life, is medically necessary, and is the least restrictive and most cost effective means for meeting the needs of the patient.
II. Every health maintenance organization and every other similar corporation licensed under the laws of another state that issues or renews any policy of individual or group [blanket] health insurance providing benefits for medical or hospital expenses, shall provide to each individual or group, or to the portion of each group comprised of certificate holders of such insurance who are resident of this state, coverage for the provision of nonprescription enteral formulas and food products required for persons with inherited diseases of amino acids and organic acids. Such coverage shall be provided when the prescribing physician has issued a written order stating that the enteral formula or food product is medically necessary and is the least restrictive and most cost effective means for meeting the needs of the patient. Coverage for inherited diseases of amino acids and organic acids shall, in addition to the enteral formula, include food products modified to be low protein in an amount not to exceed $1,800 annually for any insured individual.
12 Portability, Availability, and Renewability of Health Coverage; Scope. Amend RSA 420-G:3, I(b) to read as follows:
(b) This chapter shall not apply to [short-term] student [insurance where the policyholder is the school] major medical expense coverage, except student [insurance] major medical expense coverage shall be given credit and shall count as credit for previous health coverage as defined in RSA 420-G:7, III.
13 Delete Term. Delete the words “or blanket” in the following RSAs: 408:16, H; 415:18, IV, V, VII-a, VII-b, XII, XIII, XIV; 415:18-a, I(a) introductory paragraph, III(b) and IV-a; 415:18-c; 415:18-d; 415:18-e; 415:18-f; 415:18-g, I introductory paragraph; 415:18-i; 415:18-j, I; 415:18-k, I(a); 415:18-n; 415:18-o, I; 415:18-q; 415:18-r; 415:18-s; 415:18-t; 417-E:1, II; 420-A:17-a; 420-A:17-c; 420-A:17-f; 420-A:17-g; 420-B:8-gg; 420-B:8-k; 420-B:8-p; and 420-B:8-r.
14 Effective Date. This act shall take effect 60 days after its passage.