RSA 404-G:5-a · Assessments

404-G:5-a Assessments. – The association shall establish and collect assessments for each program in accordance with the plan of operation approved by the commissioner.

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I.

Method of Determining Assessments.

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(a)

Assessments shall be calculated based on the number of lives covered by assessable entities. The number of covered lives shall be determined each month during the calendar year. Any assessment shall be calculated as the number of covered lives multiplied by a specified assessment rate. The assessment amount shall be subject to approval by the commissioner. The association shall provide a basis for recommending the specified assessment rate, including a projection of the calculated assessment amount and consideration of any prior year shortfalls or overages.

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(b)

Each covered life should be included in the assessment only once. The association shall adopt procedures by which affiliated assessable entities calculate their assessment on an aggregate basis and procedures to ensure that no covered life is counted more than once.

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II.

Unless otherwise determined by the association, the assessable entity responsible for the payment of the associated claims for the covered lives shall be the entity responsible for reporting assessable lives and payment of the corresponding assessment.

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III.

The association may establish a special assessment in addition to the regular assessment with the approval of the commissioner.

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(a)

The association shall only establish a special assessment if the association determines that its funds are or will become insufficient to fulfill the program's purpose.

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(b)

The association shall only assess, through the special assessment, at a rate necessary to fund the deficiency ascertained in subparagraph (a).

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IV.

The regular assessment rate established by the association shall be:

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(a)

Calculated on a calendar year basis and fixed throughout the calendar year;

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(b)

Established no later than the first day of November preceding the calendar year for which the rate is to be applied;

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(c)

Calculated to be sufficient to meet the funding needs for the implementation of the programs administered by the association, including the reinsurance mechanism provided for under RSA 420-N:6-a and the association's share of the costs of the New Hampshire granite advantage health care program established under RSA 126-AA in the amount described in subparagraph (d); and

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(d)

An amount not to exceed the lesser of the remainder amount, as defined in RSA 126- AA:1, V, or the amount specified in RSA 126-AA:1, V(a) plus taxes attributable to premiums written for medical and other medical-related services for the newly eligible Medicaid population. The association shall transfer all amounts collected pursuant to this subparagraph to the New Hampshire granite advantage health care trust fund established pursuant to RSA 126- AA:3.

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V.

The commissioner shall approve the regular assessment rate, and any special assessment rate, if he or she finds that the amount petitioned by the board is no greater than is necessary to fulfill the purposes of this chapter. For the purpose of making this determination, the commissioner may, at the expense of the association, seek independent actuarial certification of the need for the proposed assessment or special assessment amount. Source. 2001, 295:10. 2016, 13:10, eff. Apr. 5, 2016. 2018, 342:11, eff. Dec. 31, 2018. 2023, 79:404, eff. Dec. 31, 2023; 92:3, eff. Jan. 1, 2024.

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