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RSA 402-H:6 · Responsibilities of the Insurer
402-H:6 Responsibilities of the Insurer. –
Copy linkIf an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria, and claims payment procedures applicable to the coverage and for securing reinsurance, if any. The rules pertaining to these matters shall be provided, in writing, by the insurer to the administrator. The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer.
Copy linkIt is the sole responsibility of the insurer to provide for competent administration of its programs.
Copy linkIn cases in which an administrator administers benefits for more than 100 certificate holders on behalf of an insurer, the insurer shall, at least semi-annually, conduct an on-site or virtual audit of the operations of the administrator.
Copy linkFor purposes of this section, "insurer" means a licensed insurance company, prepaid hospital or medical care plan, or a health maintenance organization. Source. 1993, 253:1. 2006, 271:5, eff. Aug. 8, 2006. 2023, 210:1, eff. Oct. 3, 2023.
Copy linkSource note
Source. 1993, 253:1. 2006, 271:5, eff. Aug. 8, 2006. 2023, 210:1, eff. Oct. 3, 2023.
Source history
- 1993, 253:1
- 2006, 271:5, eff. Aug. 8, 2006
- 2023, 210:1, eff. Oct. 3, 2023
Related materials
Bill relationships
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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 HB297-FN
reference
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 notify the emp
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2026 SB614
related · effective 2027-07-01
) RSA 400-A:17 through RSA 400-A:24, relative to hearings and appeals; (c) RSA 400-A:37, relative to examinations; (d) RSA 402-B relative to insurance claims adjusters; (e) RSA 402-H relative to third-party administrators; (f) RSA 402-J, relative to producer licensing; and (g) RSA 417:1 through 417:31 relative to unfair trade practices and fraud investigations. IV. This section does not apply
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2026 SB614-FN
related · effective 2027-07-01
) RSA 400-A:17 through RSA 400-A:24, relative to hearings and appeals; (c) RSA 400-A:37, relative to examinations; (d) RSA 402-B relative to insurance claims adjusters; (e) RSA 402-H relative to third-party administrators; (f) RSA 402-J, relative to producer licensing; and (g) RSA 417:1 through 417:31 relative to unfair trade practices and fraud investigations. IV. This section does not apply