New Hampshire Individual Health Insurance Plans Regulations
New Hampshire allows for individual medical insurance policies to be medically underwritten. This gives the insurance company a chance to examine the applicant's medical history and a chance to decide if coverage should be given to the applicant. The medical insurance company then has the option to provide coverage, provide modified coverage with limitations on pre-existing conditions or they can deny coverage due to the applicant's health history. Health insurance companies are allowed a look back period of 3 months and an exclusionary period of 9 months when examining pre-existing conditions. Applicants must give proof of prior coverage. Elimination riders can be added to individual health insurance policies to temporarily or permanently stop coverage for specific health benefits due to the applicant's health condition. The insurance company determines premium rates by reviewing the applicant's health status, age and whether or not the person smokes. New Hampshire health insurance plan rates can also be affected by rate bands, and premiums can increase upon renewal due to an age band change.
Small Group New Hampshire Health Insurance Regulations
Any company with 2-50 employees is considered a small group employer in New Hampshire. Health insurance for small groups is on a guarantee issue basis. This ensures that no group is denied health insurance coverage due to health status. Before employers allow employees to enroll in the group plan, the employer can request a waiting period after the hire date. The waiting period must be the same for every employee. New Hampshire permits look back periods up to 3 months and 9 month exclusionary periods for pre-existing conditions if an employee has no prior creditable coverage. If an employee is eligible for HIPAA, these periods must be waived. The age, work type, location and health status of the group is considered when determining the premium rate. The health insurance rate cannot fluctuate greater than plus or minus 25%, and renewal rates cannot be greater than 15 %. In order to prove an employee's eligibility, the employer must provide documentation confirming this. This could be a document like the Schedule C form from a federal income tax return, or a quarterly wage report. Insurance companies can request minimum participation requirements, like at least 75% of eligible employees must enroll in the group health plan. In New Hampshire, self-employed groups of one can buy a group health plan in New Hampshire, but this is on a guarantee issue basis during two 30 day intervals out of the year.
New Hampshire COBRA and Continuation Coverage
New Hampshire has mini-COBRA laws that require employers to make continuation of coverage available under their New Hampshire group health insurance plan. Under federal COBRA law, small employers are required to make the same level of COBRA coverage available to employees as employers who have greater than 20 employees. Eligibility under New Hampshire mini-COBRA law requires that an employee must have been insured for at least 6 months under the New Hampshire group health insurance plan. If a group has more than 20 employees, that group must follow federal COBRA laws relating to continuation of health coverage. Under state or federal COBRA law, for a time span of 18 months, you can remain on your previous employers' group health plan and still receive the same benefits. However, you must pay the premium amount, in addition to a 2% administration fee. In New Hampshire, there are no conversion plans available for individuals that transfer from a group health insurance plan. Also, if a person is eligible for HIPAA, individual health insurance companies do not have to offer guaranteed issue coverage. Anyone that has used up their COBRA coverage can only apply for coverage through the New Hampshire high-risk pool, or the New Hampshire Health Plan.
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