2020 New Hampshire Revised Statutes
Title XXXVII - Insurance
Title 415-E - Multiple-Employer Welfare Arrangements
Section 415-E:8 - Policy Forms.

[RSA 415-E:8 effective until 60 days after certification by the insurance commissioner that 29 C.F.R. section 2510.3-5(b) is valid and that issues raised in State of New York v. United States Department of Labor have been resolved, but not later than December 1, 2021; see also RSA 415-E:8 set out below.]     415-E:8 Policy Forms. –
I. No policy or contract form, application form, certificate, rider, endorsement, summary plan description, or other evidence of coverage shall be issued by an arrangement unless the form and all changes to it have been filed with the commissioner by or on behalf of the arrangement which proposed to use such form and have been approved by the commissioner.
II. The commissioner shall disapprove any form filed under this section, or withdraw any previous approval, only if the form:
(a) Is in any respect in violation of, or does not comply with, this chapter.
(b) Contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.
(c) Has any title, heading, or other indication of its provisions which is misleading.
(d) Is printed or otherwise reproduced in such manner as to render any material provision of the form substantially illegible.
(e) Contains provisions which are unfair or inequitable, or contrary to the public policy of this state or which encourage misrepresentation.

[RSA 415-E:8 effective 60 days after certification by the insurance commissioner that 29 C.F.R. section 2510.3-5(b) is valid and that issues raised in State of New York v. United States Department of Labor have been resolved, but not later than December 1, 2021; see also RSA 415-E:8 above.]

415-E:8 Policy Forms. –
I. Whether an arrangement is self-funded or fully insured, no policy or contract form, application form, certificate, rider, endorsement, summary plan description, or other evidence of coverage shall be sponsored or issued by an arrangement unless the form and all changes to it have been filed with the commissioner by or on behalf of the arrangement which proposed to use such form and have been approved by the commissioner.
II. The commissioner shall disapprove any form filed under this section, or withdraw any previous approval, only if the form:
(a) Is in any respect in violation of, or does not comply with, this chapter.
(b) Contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous, or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract.
(c) Has any title, heading, or other indication of its provisions which is misleading.
(d) Is printed or otherwise reproduced in such manner as to render any material provision of the form substantially illegible.
(e) Contains provisions which are unfair or inequitable, or contrary to the public policy of this state or which encourage misrepresentation.
III. Each self-funded arrangement shall issue to each covered employee a policy contract, certificate, summary plan description, or other evidence of the benefits and coverages provided. The evidence of the benefits and coverages provided shall contain in boldfaced print in a conspicuous location, the following statement: "The benefits and coverages described herein are provided through a trust fund established and funded by a group of employers."
IV. Each self-funded arrangement shall provide to each covered employee, on request, a written statement of the dollar amount of allowable benefit for any procedure which is requested by the appropriate procedure code.

Source. 1991, 246:1, eff. Jan. 1, 1992. 2019, 346:407.