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RSA 402-H:1 · Definitions

Title
XXXVII: INSURANCE
Chapter
402-H · THIRD PARTY ADMINISTRATORS
Status
current
Official source linked
Yes
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402-H:1 Definitions. –

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I.

"Administrator" or "third party administrator" or "TPA" means a person who directly or indirectly underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, in connection with life, annuity, or health coverage or property and casualty insurance, except any of the following:

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(a)

An employer, or a wholly owned direct or indirect subsidiary of an employer, on behalf of its employees or the employees of one or more subsidiaries or affiliated corporations of such employer.

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(b)

A union on behalf of its members.

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(c)

An insurer that is authorized to transact insurance in this state pursuant to RSA 401 or a subsidiary or affiliated corporation of such insurer if the insurer and the subsidiary or affiliated corporation have overlapping directorates.

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(d)

An insurance producer licensed to sell life, annuities, or health coverage or property and casualty insurance in this state, whose activities are limited exclusively to the sale of insurance.

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(e)

A creditor on behalf of its debtors with respect to insurance covering a debt between the creditor and its debtors.

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(f)

A trust and its trustees, agents, and employees acting pursuant to such trust established in conformity with 29 U.S.C. section 186.

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(g)

A trust exempt from taxation under section 501(a) of the Internal Revenue Code, its trustees and employees acting pursuant to such trust, or a custodian and the custodian's agents or employees acting pursuant to a custodian account which meets the requirements of section 401(f) of the Internal Revenue Code.

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(h)

A credit union or a financial institution that is subject to supervision or examination by federal or state banking authorities, or a mortgage lender, to the extent they collect and remit premiums to licensed insurance producers or to limited line producers or authorized insurers in connection with loan payments.

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(i)

A credit card issuing company that advances for and collects insurance premiums or charges from its credit card holders who have authorized collection.

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(j)

A person who adjusts or settles claims in the normal course of that person's practice or employment as an attorney at law and who does not collect charges or premiums in connection with life, annuity, or health coverage or property and casualty insurance.

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(k)

An adjuster licensed by this state whose activities are limited to adjustment of claims.

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(l)

A person licensed as a managing general agent in this state, pursuant to RSA 402-E, whose activities are limited exclusively to the scope of activities conveyed under such license.

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(m)

An administrator who is affiliated with an insurer and who only performs the contractual duties, between the administrator and the insurer, of an administrator for the direct and assumed insurance business of the affiliated insurer. The insurer is responsible for the acts of the administrator and is responsible for providing all of the administrator's books and records to the insurance commissioner, upon request from the insurance commissioner. For purposes of this subparagraph, "insurer" means a licensed insurance company, prepaid hospital or medical care plan, or a health maintenance organization.

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II.

"Affiliate" or "affiliated" means any entity or person who directly, or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person.

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III.

"Commissioner" means the commissioner of insurance.

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IV.

"Control" means "control" as defined in RSA 401-B:1, III.

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V.

"GAAP" means United States generally accepted accounting principles consistently applied.

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VI.

"Insurance producer" means a person who sells, solicits, or negotiates a contract of insurance as those terms are defined in this chapter.

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VII.

"Insurer" means, for the purposes of this chapter only and except as provided in RSA 402-H:6, a person undertaking to provide life, annuity, or health coverage or property and casualty insurance or self-funded coverage under a multiple employer welfare arrangement or a church plan in this state. For the purposes of this chapter, "insurer" may include an employer, a licensed insurance company, a prepaid hospital or medical care plan, or a health maintenance organization.

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VIII.

"Negotiate" means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms or conditions of the contract; provided, that the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers.

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IX.

"Overlapping directorates" as applied to insurers and subsidiaries or affiliated corporations means that an insurer and a subsidiary or affiliated corporation of such insurer share a majority of their board of directors and officers.

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X.

"Person" means an individual or a business entity.

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XI.

"Sell" means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company.

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XII.

"Solicit" means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance from a particular company.

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XIII.

"Underwrites" or "underwriting" means, but is not limited to, the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer or self-funded plan for the overall planning and coordinating of a benefits program. Source. 1993, 253:1. 1995, 161:2, 4. 1998, 159:1. 2006, 271:1, eff. Aug. 8, 2006. 2021, 50:3, 4, eff. July 24, 2021.

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Source note

Source. 1993, 253:1. 1995, 161:2, 4. 1998, 159:1. 2006, 271:1, eff. Aug. 8, 2006. 2021, 50:3, 4, eff. July 24, 2021.

Source history

  • 1993, 253:1
  • 1995, 161:2, 4
  • 1998, 159:1
  • 2006, 271:1, eff. Aug. 8, 2006
  • 2021, 50:3, 4, eff. July 24, 2021

Related materials

Bill relationships

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    S.C. section 300gg-91(a). II. "Assessable entity" means any: (a) Health maintenance organization, as defined by RSA 420-B:1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health

  • 2026 HB1323 reference · effective 2027-01-01

    d party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residing in the state who

  • 2026 HB1323 reference · effective 2027-01-01

    :1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residin

  • 2026 HB1323-FN reference · effective 2027-01-01

    d party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residing in the state who

  • 2026 HB1323-FN reference · effective 2027-01-01

    :1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residin

  • 2026 HB1323-FN reference · effective 2027-01-01

    S.C. section 300gg-91(a). II. "Assessable entity" means any: (a) Health maintenance organization, as defined by RSA 420-B:1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health

  • 2026 HB297 reference

    e data submission requirements of paragraphs II and II-a shall also apply to all health carriers, licensed third party administrators, and any entity required to be registered with the commissioner pursuant to RSA 402-H with respect to claims data for all lives covered by any other self-funded employer-sponsored plan, when the employer has opted in writing to the submission of the data. The carrier or administrator shall noti

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  • 2026 SB498 reference

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    U.S.C. section 300gg-91(a). II. "Assessable entity" means any: (a) Health maintenance organization, as defined by RSA 420-B:1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health se

  • 2026 SB498-FN reference

    rd party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residing in the state who hav