New Hampshire Risk Pool - Health Insurance for the Uninsurable
Risk Pool Name / Acronym
New Hampshire Health Plan / NHHP
Insurance Regulation Establishing Risk Pool
New Hampshire Legislation
Chapter 404-G
New Hampshire Health Plan (NHHP)
The New Hampshire Health Plan, a state high risk pool, provides health insurance to New Hampshire residents who are declined coverage through the private market, have a pre-qualifying condition or are otherwise eligible. NHHP also provides health insurance for individuals who are entitled for certain Trade Adjustment Act (TAA) or Pension Benefit Guaranty Corporation (PBGC) benefits. To be eligible, you must be HIPAA eligible and should not be eligible for, have not been offered, or have exhausted continuation coverage under COBRA or a similar program.
Funding
The pool is financed through participant premiums and assessments placed on insurance plans operating in New Hampshire. The insurance company assessments are based on the number of insured members on each health insurance carrier assessed under New Hampshire state law.
Plans Offered
The NHHP offers two Indemnity plans, both offering different deductible amounts and four Managed Care Plans
Plan Benefits
The Indemnity plan offers deductibles of $1,750 and $3,500. For most in-patient covered medical services, the NHHP member is required to pay a 20% coinsurance. The maximum out-of-pocket limit is $4,750 on the $1,750 deductible and $7,000 on the $3,500 deductible.
Options A, B and C of the Managed Care Plans offer In-Network annual deductibles of $1,000, $2,500, and $5,000. For most in-patient covered medical expenses, the NHHP member is required to pay 20% coinsurance. For most out-patient services, the NHHP member is required to pay a 40% coinsurance. The maximum out-of pocket limit is $3,500 on the $1,000 deductible, $5,000 on the $2,500 deductible and $7,500 on the $5,000 deductible.
Option D and H of the Managed Care Plans also offers an In-Network annual deductible of $10,000 and $5,000 respectively. For most in-patient covered medical services the NHHP member is not required to pay coinsurance. For most out-patient covered medical services, the NHHP member is required to pay 20% coinsurance. The maximum out-of-pocket limit for Option D is 10,000 and Option H is $5,000.
Maximum Benefit Limits
All NHHP plans, regardless of deductibles, have a lifetime maximum benefit of $2.5 million
Eligibility
- You must be a resident of New Hampshire
- You have applied for individual health insurance within the last 6 months
- And, you were denied for health reasons
- Or, you were quoted a premium rate higher than a substantially similar NHHP plan
- Or, were offered a policy with a rider excluding coverage for a specified condition
- Or, you are federally eligible and have exhausted any COBRA coverage offered
- Or, you have been certified as eligible for either federal trade act assistance or pension benefit guaranty corporation assistance
- Or, have one of the medical conditions as specified in the plan brochure
Enrollment Periods
You may apply for NHHP coverage at anytime and coverage will become effective on the first day of the month following the approval date of your application.
Premium Payments
Premium rates for the NHHP plans are based upon plan selection and age.
Premium Calculations
NHHP premiums are capped at 125% to 150% of the standard rate charged by other health insurance companies offering similar coverage in New Hampshire.
Pre-Existing Condition Waiting Periods
During the first nine months NHHP polices will not pay benefits for certain preexisting conditions. Any length of time that you had creditable and continuous coverage that terminated no later than 63 days prior applying with NHHP will be deducted from this waiting period.
Nebraska Comprehensive Health Association Contact Information
New Hampshire Health Plan
C/O BMI
P.O. Box 1090
Great Bend, Kansas 67530
Phone: 877-888-6447
New Hampshire Health Plan Website
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