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Private Insurance Data Requirements in New Hampshire

Medical information is confidential so health insurers may disclose medical information to third parties only with a written authorization from an enrollee.1 Health insurers may not discriminate against individuals based on their preexisting condition, genetic information, and disability. 2 Health insurers may request HIV testing of enrollees only with their written consent and are required to ensure that information regarding HIV/AIDS be kept confidential.3

New Hampshire prohibits health insurers from advertising in a fraudulent manner and requires them to disclose the terms and condition of a health plan to every new member.4 The state requires health insurers to maintain its records so that the insurance commissioner can readily ascertain its compliance with state laws including grievance procedures and claims practices.5 Health insurers must have written procedures to allow an enrollee to obtain a determination of a claim and appeal a claim denial.6 An individual has the right to an independent external review of an adverse determination of a health insurer.7

 

Footnotes

  • 1. New Hampshire Code of Administrative Rules Ins §§3005.03; 3005.05; 3006.02
  • 2. Revised Statutes Annotated of the State of New Hampshire §§420-B:12; 420-G:6; 420-G:7; 420-G:11
  • 3. New Hampshire Code of Administrative Rules Ins §§1101.01; 1103.01; 1103.02; 1103.03; 1103.04
  • 4. Revised Statutes Annotated of the State of New Hampshire §§415-I:11; 420-B:12; 420-G:11; 420-H:4
  • 5. Revised Statutes Annotated of the State of New Hampshire §§400-B:3; 400-B:4; 400-B:5; 400-B:6; 400-B:7; 400-B:10; 400-B:11; 420-B:3; 420-B:7; 420-B:10
  • 6. Revised Statutes Annotated of the State of New Hampshire §§415-A:4-a; 415-A:4-b; 420-B:11; 420-E:1; 420-E:4
  • 7. Revised Statutes Annotated of the State of New Hampshire §§420-J:5-a; 420-J-5-b; 420-J-5-c; 420-J-5-e; 420-J:6; 420-J:11; 420-J:14

 

Private Insurance Data Requirements in New Hampshire

Subtopic Statute/Regulation Description
Private Insurance Data Requirements N.H. Rev. Stat. § 420-G:11 Disclosure Health carriers must disclose the following information in their marketing materials to individuals and small employers: The...
New Hampshire Code of Administrative Rules Ins §1101.01 “Purpose under the Insurance Department regulations” The purpose of these regulations is to establish rules regarding human...
New Hampshire Code of Administrative Rules Ins §1103.01 “Informed consent and forms pertaining thereto under the Insurance Department regulations” An insurer must only test any individual for...
New Hampshire Code of Administrative Rules Ins §1103.02 “Confidentiality and disclosure of test results under the Insurance Department regulations” All information in possession of an insurer...
New Hampshire Code of Administrative Rules Ins §1103.03 “Penalties under the Insurance Department regulations” Any insurer, agent, or any other person that violates an individual’s right...
New Hampshire Code of Administrative Rules Ins §1905.25 “Prohibition against use of genetic information and requests for genetic testing under the insurance department regulations” A Medicare...
New Hampshire Code of Administrative Rules Ins §1907.01 “Purpose and scope under the insurance department regulations” The purpose of the following regulations is to prohibit health issuers...
New Hampshire Code of Administrative Rules Ins §1907.03 “Prohibited discrimination in rules for eligibility under the insurance department regulations” A health carrier offering group health...
New Hampshire Code of Administrative Rules Ins §1907.04 “Prohibited discrimination in premium and contribution rates under the insurance department regulations” A health insurer offering group...
New Hampshire Code of Administrative Rules Ins §1907.05 “Application of Ins §1907.03 to plan benefits; preexisting condition exclusions; similarly situated individuals under the insurance...
New Hampshire Code of Administrative Rules Ins §3005.01 “When authorization required for disclosure of nonpublic personal health information under the Insurance Department regulations” An...
New Hampshire Code of Administrative Rules Ins §3005.02 “Authorizations under the Insurance Department regulations” A valid authorization to disclose used by an insurer must be in written or...
New Hampshire Code of Administrative Rules Ins §3005.03 “Authorization request delivery under the Insurance Department regulations” An authorization request and an authorization form may be...
New Hampshire Code of Administrative Rules Ins §3005.05 “Relationship to state laws under the Insurance Department regulations” New Hampshire’s insurance regulations do not preempt...
New Hampshire Code of Administrative Rules Ins §3006.02 “Nondiscrimination under the Insurance Department regulations” An insurer may not unfairly discriminate against an enrollee that refused...
New Hampshire Code of Administrative Rules Ins §3601.30 “Appealing an insurer’s determination that the benefit trigger is not met under the insurance department regulations” If a long-...
New Hampshire Code of Administrative Rules Ins §401.07 “Group and blanket accident and health under the insurance department regulations” (b)(1) Health insurance policies must not contain...
New Hampshire Code of Administrative Rules Ins §401.11 “Applications under the insurance department regulations” Applications for health insurance must not contain:  questions regarding...
Revised Statutes Annotated of the State of New Hampshire §400-B:10 “Time limits to provide records and to respond to examiners under the insurance law” Health insurers must respond to initial data...
Revised Statutes Annotated of the State of New Hampshire §400-B:11 “Confidential materials under the insurance law” Original records provided during a market conduct examination must be returned to the...
Revised Statutes Annotated of the State of New Hampshire §400-B:3 “Records required for market conduct purposes under the insurance law” A health insurer must maintain its records in a manner that...
Revised Statutes Annotated of the State of New Hampshire §400-B:4 “Policy record file under the insurance law” A health insurer must maintain records for all policies issued and retain them for five...
Revised Statutes Annotated of the State of New Hampshire §400-B:5 “Claim file under the insurance law” Health insurers must maintain records on all claims filed by enrollees which must be retained for...
Revised Statutes Annotated of the State of New Hampshire §400-B:6 “Licensing records under the insurance law” Health insurers must maintain records relating to compliance with licensing requirements,...
Revised Statutes Annotated of the State of New Hampshire §400-B:7 “Complete records under the insurance law” Health insurers must maintain complaint records which must include a complaint or grievance...
Revised Statutes of the State of New Hampshire §137-K:6 “Reporting under the public health law” All facilities must provide a report to the brain and spinal cord injury registry containing...
Revised Statutes of the State of New Hampshire §415-A:4-a “Minimum standards for claim review; accident and health insurance under the insurance law” A health insurer offering group health plans...
Revised Statutes of the State of New Hampshire §415-A:4-b “Appeal procedure under the insurance law” Every health insurer that offers group health insurance or employee benefit plans must...
Revised Statutes of the State of New Hampshire §415-I:11 “Marketing restrictions and disclosure requirement under the insurance law” A discount medical plan organization’s advertisements...
Revised Statutes of the State of New Hampshire §420-B:12 “Prohibited practices under the insurance law” No health maintenance organization may advertise in a false or misleading manner.  A...
Revised Statutes of the State of New Hampshire §420-B:3 “Records required for market conduct purposes under the insurance law” A health insurer must maintain its records in a manner that the...
Revised Statutes of the State of New Hampshire §420-B:7 “Complaint records under the insurance law” Every health insurer must retain records of complaints submitted by enrollees.
Revised Statutes of the State of New Hampshire §420-E:1 “Definitions under the insurance law”  “Utilization review” means a system for reviewing the appropriate and efficient...
Revised Statutes of the State of New Hampshire §420-E:4 “Minimum standards; licensure of medical utilization review entities under the insurance law” All licensed medical utilization review...
Revised Statutes of the State of New Hampshire §420-G:11 “Disclosure under the insurance law” Health insurers offering health plans to small employers and individuals must make the following...
Revised Statutes of the State of New Hampshire §420-G:6 “Guaranteed issue and renewability under the insurance law”  (I) Health insurers must not establish rules of eligibility for health...
Revised Statutes of the State of New Hampshire §420-G:7 “Preexisting condition exclusion periods under the insurance law” A health insurer offering health coverage to individuals, small...
Revised Statutes of the State of New Hampshire §420-H:4 “Requirements under the insurance law” Health insurers must provide enrollees with the following information: An explanation of...
Revised Statutes of the State of New Hampshire §420-J:11 “Confidentiality of insurance department records under the insurance law” All information and records obtained by the insurance...
Revised Statutes of the State of New Hampshire §420-J:14 “Penalties under the insurance law” A health insurer violating the state’s grievance and external review laws may be fined up to $2...
Revised Statutes of the State of New Hampshire §420-J:5 “Grievance procedures under the insurance law” Every health insurer must establish a written procedure that allows enrollees to have a...
Revised Statutes of the State of New Hampshire §420-J:5-a “Right to external review under the insurance law” An enrollee of a health plan has the right to an independent external review of a...
Revised Statutes of the State of New Hampshire §420-J:5-b “Standard external review under the insurance law” The insurance commissioner must complete a preliminary review of an external review...
Revised Statutes of the State of New Hampshire §420-J:5-c “Expedited external review under the insurance law” An enrollee of a health plan is entitled to expedited external review when the...
Revised Statutes of the State of New Hampshire §420-J:5-e “General provisions regarding external review under the insurance law” A health insurer is responsible for paying the cost of each...
Revised Statutes of the State of New Hampshire §420-J:6 “Utilization review under the insurance law” Each health insurer that does not contract with a utilization review entity must establish...