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RSA 420-B:1 · Definitions

420-B:1 Definitions. – In this chapter:

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I.

"Advertising" means:

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(a)

Printed and published material and descriptive literature of an insurer used in newspapers, magazines, radio and television scripts, billboards, and similar displays;

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(b)

Descriptive literature and sales aids of all kinds issued by an insurer for presentation to members of the public, including, but not limited to, marketing, educational, or information letters; and

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(c)

Sales talks, presentations and material prepared by insurers for use by agents and brokers, and representations made by agents and brokers in accordance therewith.

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II.

"Commissioner" means the insurance commissioner. II-a. "Date of enrollment" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.

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III.

"Enrolled participant" means a person who has entered into a contractual arrangement or on whose behalf a contractual arrangement has been entered into with a health maintenance organization to receive health care services.

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IV.

"Evidence of coverage" means any certificate, agreement, or contract issued to an enrolled participant setting out the coverage to which such participant is entitled including those issued pursuant to a contract under section 1876 or section 1833 of the federal Social Security Act (42 U.S.C. section 1395 et seq.) as amended.

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V.

"Health care services" means physician, hospitalization, laboratory, x-ray service and medical equipment and supplies, which may include but are not limited to: medical, surgical, and dental care; psychological, obstetrical, osteopathic, optometric, optic, podiatric, chiropractic, nursing, physical therapy services, and pharmaceutical services; health education; preventive medical, rehabilitative, and home health services; inpatient and outpatient hospital services, extended care, nursing home care, convalescent institutional care, laboratory and ambulance services, appliances, drugs, medicines, and supplies; and any other care, service, or treatment of disease, correction of defects, or the maintenance of the physical and mental well-being of enrolled participants.

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VI.

"Health maintenance organization" means a public or private organization, organized under the laws of this state or the laws of another state which:

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(a)

Provides or otherwise makes available to enrolled participants health care services;

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(b)

Is compensated for the provision of one or more health care services to an enrolled participant on a primarily predetermined periodic rate basis;

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(c)

Provides physicians' services directly through physicians who are either employees or partners of such an organization, or under arrangements with one or more physicians or groups of physicians.

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VII.

"Provider" means any physician, hospital or other institution, organization, or other person who furnishes health care services. Source. 1977, 282:1. 1997, 282:1. 2007, 289:14, eff. Jan. 1, 2008.

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Source note

Source. 1977, 282:1. 1997, 282:1. 2007, 289:14, eff. Jan. 1, 2008.

Source history

  • 1977, 282:1
  • 1997, 282:1
  • 2007, 289:14, eff. Jan. 1, 2008

Related materials

Bill relationships

  • 2026 HB1323 reference · effective 2027-01-01

    d dollar amount; or (c) Group health plan, as defined by 42 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) In

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

    d dollar amount; or (c) Group health plan, as defined by 42 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) In

  • 2026 SB498 reference

    fied dollar amount; or (c) Group health plan, as defined by 42 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) Insur

  • 2026 SB498-FN reference

    fied dollar amount; or (c) Group health plan, as defined by 42 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) Insur

  • 2026 SB646 add

    ch insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under access standards established in RSA 420-J:

  • 2026 SB646-FN add

    ch insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under access standards established in RSA 420-J: