New Hampshire Health Insurance (NH)

New Hampshire (NH)
Individual Health Insurance Regulations

Learn more about New Hampshire Individual Health Insurance

Health insurance is priceless when it comes to assuring your family's physical well-being. In the event of unforeseen circumstances of sickness or injury, suitable health coverage can save you from unanticipated medical bills. Shopping for a health insurance policy is tedious and needs evaluation of family's medical needs and finances. If you are a New Hampshire resident, you can choose from wide range of health insurance alternatives. The New Hampshire Insurance Department regulates the laws under which the New Hampshire health insurers can sell private health insurance to individuals and families.

New Hampshire law requires individual health insurance policies to be medically underwritten. The process of medical underwriting allows the health insurance carrier an opportunity to review the applicant's medical history and determine what, if any, coverage should be provided to the applicant. The health insurance carrier may then provide coverage under the terms of the health insurance plan, provide modified coverage with specific limitations or exclusions on pre-existing conditions or deny the requested coverage based upon the applicant's health history. Individual health insurance carriers are provided a 3 month look back period and a 9 month exclusionary period limit on pre-existing conditions. Credit for prior coverage is required to be given. Individual health insurance policies may also contain elimination riders which may temporarily or permanently eliminate specific health benefits under the terms of the health plan. Premiums are based on health status, age and tobacco use and are subject to rate bands. Premiums can increase at renewal based on a change in age band.

New Hampshire Small Group Health Insurance Regulations

New Hampshire law defines a small group as a company with 2-50 employees. Group or employer sponsored health insurance is guarantee issue, which provides that no group can be declined health insurance coverage based on its health status. Employers may request a waiting period from the date of hire prior to allowing qualified employees to enroll in the group plan. Waiting periods are required to be the same for all employees. Employees without prior creditable coverage may be subjected to a 3 month look back and a 9 month exclusionary period for pre-existing medical conditions. This must be waived for any employee that is HIPAA eligible. Premium amounts are based on age, type of work, geography and health status of the group, and are based on the Modified Community Rate. Renewal rates may not exceed 15 percent. To prove eligibility of each employee, the employer may be required to provide documentation, such as a quarterly wage report or the Schedule C from a federal income tax return. Minimum participation requirements are permitted by the insurance carriers, who may request that at least 75% of your eligible employees are enrolled in the group health plan. Self-employed groups of one are able to purchase a group health plan, but it is only guaranteed issue during two 30 days periods each year.

New Hampshire COBRA and Continuation Coverage

Groups of 20 or more employees must abide by federal COBRA regulations which state that a departing employee is entitled to remain on the group health plan for a period of 18 months, provided that group health plan remains in existence. An employee who has left work on his own or was terminated from the job is eligible to be covered by COBRA unless he was fired for gross misconduct. COBRA provides health coverage to individuals and their beneficiaries, spouses and dependents. The COBRA recipient will be responsible for the payment of the entire the insurance premium that the employer was paying for his coverage as well as 2% administrative costs.

New Hampshire has a state mini-COBRA regulation enacted through & CHAPTER 415 ACCIDENT AND HEALTH INSURANCE, Section 415:18 that requires employers to offer continuation of coverage under the group health plan. Small employers must offer the same level of COBRA coverage as employers with 20 or more employees under federal COBBRA law. To be eligible under New Hampshire mini-COBRA law, you must have been insured under the group health plan for at least 6 months. For groups of 20 or more, continuation of health insurance coverage falls under federal COBRA laws. Under state or federal COBRA law, you may remain on your previous employers' group health plan and receive the same level of covered benefits for a period of 18 months. You will be responsible for paying the entire premium amount, plus a 2% administration fee. Conversion plans for individuals transferring from a group health plan are not available in New Hampshire. Individual health insurance companies are not required to offer guaranteed issue coverage to HIPAA eligible persons. For those that have exhausted their COBRA option, individual coverage is only available through the New Hampshire high-risk pool, called the New Hampshire Health Plan.

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