N.H. Code Admin. R. Ins 1907.06 - Application of Ins 1907.03 and Ins 1907.04 to Nonconfinement and Actively-at-Work Provisions

(a) Except to the extent permitted under (b)(2) or (c) below, in accordance with Ins 1907.03 and Ins 1907.04, a carrier subject to this chapter shall not establish a rule of eligibility or set an individual's premium or contribution rate based on:

(1) Whether the individual is confined in a hospital or other health care institution; or

(2) The individual's ability to engage in normal life activities.

(b) In accordance with Ins 1907.03 and Ins 1907.04:

(1) A carrier subject to this chapter shall not establish a rule for eligibility or set an individual's premium or contribution rate based on whether the individual is actively-at-work, including whether an individual is continuously employed, unless absence from work due to any health factor is treated, for purposes of the plan, as being actively-at-work.

(2) Notwithstanding subparagraph (1) above, a carrier subject to this chapter may establish a rule for eligibility that requires an individual to begin work for the employer sponsoring the plan before coverage under the plan becomes effective if the rule for eligibility applies regardless of the reasons for the absence.

(c) Notwithstanding paragraphs (a) and (b) above, a carrier subject to this chapter may establish a rule of eligibility or set an individual's premium or contribution rate with respect to similarly situated individuals, as those groups are determined under Ins 1907.05(d).

Notes

N.H. Code Admin. R. Ins 1907.06

#8607, eff 4-17-06