N.H. Code Admin. R. Ins 6202.04 - Prohibited Policy Provisions

(a) Coordination of benefits shall not be permitted.
(b) Managed care and network requirements shall not be permitted. The policy shall not include a provision requiring pre-certification.
(c) Expense based benefits and riders shall not be permitted.
(d) Group coverage shall not include benefits on a per service basis, except for coverage that is provided to associations, but not related to employment, and sold to individuals.
(e) Policies or certificates providing hospital confinement indemnity or other fixed indemnity coverage shall not contain provisions excluding coverage because of confinement in a hospital operated by the federal government.
(f) Benefits for "skilled nursing facility", as defined in Ins 6001.04(b), services shall not be contingent upon a hospital stay.
(g) A benefits waiting period shall not be permitted.
(h) Any eligibility waiting period shall not exceed 12 months.
(i) Coverage shall not be stated on an "up to" basis.


N.H. Code Admin. R. Ins 6202.04
Derived From Volume XXXVIII Number 50, Filed December 13, 2018, Proposed by #12659, Effective 11/5/2018, Expires 11/5/2028. Amended by Volume XL Number 50, Filed December 10, 2020, Proposed by #13137, Effective 11/24/2020, Expires 11/24/2030.

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