HB327 (2011) Detail

Relative to health care choice.






AN ACT relative to health care choice.

SPONSORS: Rep. Garcia, Rock 4; Rep. Jennifer Coffey, Merr 6; Rep. Ulery, Hills 27; Rep. Blankenbeker, Merr 11; Rep. Kappler, Rock 2

COMMITTEE: Commerce and Consumer Affairs


This bill authorizes individuals to purchase health insurance from out-of state health insurance carriers selected by the insurance commissioner. This bill grants rulemaking authority to the insurance commissioner for the purposes of the bill.

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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.




In the Year of Our Lord Two Thousand Eleven

AN ACT relative to health care choice.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Statement of Purpose. The general court recognizes the need for individual purchasers of health insurance coverage in this state to have the opportunity to choose health insurance plans that are more affordable and flexible than existing market policies offering accident and sickness insurance coverage. Therefore, the general court hereby seeks to increase the availability of health insurance coverage by allowing insurers authorized to engage in the business of insurance in selected states to issue accident and sickness policies in New Hampshire.

2 New Chapter; Health Care Choice Act for New Hampshire. Amend RSA by inserting after chapter 404-H the following new chapter:



404-I:1 Health Care Choice Act Established; Plan Requirements.

I. In this chapter “commissioner” means the insurance commissioner.

II. An individual who is a resident of this state may purchase health insurance from out-of state health insurance carriers selected by the commissioner. The commissioner shall conduct market conduct and solvency examinations of all out-of-state companies seeking to offer health benefit plans in this state or who have been given approval to offer health benefit plans in this state. Such examinations shall be conducted in the same manner and under the same terms and conditions as for companies located in this state.

III. Any plan written under this section shall be worded in clear, understandable plain English such that the meaning and intent of the document shall be clear to the reasonable person and any ambiguity in the document shall be construed against the insurer. Each written application for participation in an out-of-state health benefit plan shall contain the following language in boldface type at the beginning of the document:

1. “This policy is primarily governed by the laws of {insert state where the master policy is filed}; therefore, all of the rating laws applicable to policies filed in this state do not apply to this policy, which may result in increases in your premium at renewal that would not be permissible in a New¬†Hampshire-approved policy. Any purchase of individual health insurance should be considered carefully since future medical conditions may make it impossible to qualify for another individual health policy. For information concerning individual health coverage under a {insert state}-approved policy, please consult your insurance agent or the {insert state department of insurance or similar agency}.”

2. “The benefits of this policy providing your coverage are governed primarily by the laws of a state other than New Hampshire. While this health benefit plan may provide you a more affordable health insurance policy, it may also provide fewer health benefits than those normally included as state-mandated health benefits in policies in New Hampshire. Please consult your insurance agent to determine which state-mandated health benefits are excluded under this policy.”

404-I:2 Rulemaking. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to:

I. The procedure for selection of out-of-state insurers who may participate under this chapter.

II. Procedures for market conduct and solvency examinations of the out-of-state insurers.

III. Form and content of applications for health insurance under this chapter.

IV. Procedures for resolution of disputes, including hearing procedures.

404-I:3 Applicability. This chapter shall not be construed to require the selected out-of-state insurers to offer or provide state-mandated health benefits required by New Hampshire law or rules in health insurance policies sold to New Hampshire residents.

404-I:4 Resolution of Disputes. Resolution of disputes between the insurer and the insured shall take place in New Hampshire in accordance with rules adopted by the commissioner under RSA 541-A.

3 Effective Date. This act shall take effect 60 days after its passage.





AN ACT relative to health care choice.


      The Insurance Department states this bill will decrease state general fund revenues by an indeterminable amount in FY 2012 and in each fiscal year thereafter. The Department further states this bill may increase county and local expenditures by indeterminable amounts in FY 2012 and in each fiscal year thereafter. This bill will have no fiscal impact on state expenditures or county and local revenues.


    The Insurance Department states this bill authorizes individuals to purchase health insurance from out-of-state companies not licensed in New Hampshire, but are licensed in other states, to do business in New Hampshire. The Department assumes it will be unable to collect a premium tax from out-of-state health insurance companies on premiums written in New Hampshire as there is no licensing requirement included in this bill. The Department states it is unable to estimate this bill’s decrease on state premium tax revenues as it cannot predict the extent of New Hampshire purchasers procuring insurance from out-of-state non-licensed health insurance companies rather than health insurance companies licensed in New Hampshire, which would be subject to the premium tax.

    The Insurance Department states there are various assessments levied on insurance carriers that are passed through to New Hampshire policyholders. The Department states this bill proposes to allow individuals to purchase insurance from carriers that would not be included in the assessment base, therefore driving up assessment rates on those licensed insurance companies included in the assessment base. The Department further states as a result, municipalities and counties that procure health insurance may see costs increase by an indeterminable amount.