hb 0580

CHAPTER 120

HB 580 - FINAL VERSION

AN ACT requiring health insurance carriers to provide loss information to large employers at least once every 6 months.

SPONSORS: Rep. Stone, Rock 7; Rep. Almy, Graf 14; Rep. L. Fraser, Merr 9; Sen. Wheeler, Dist 21

This bill requires health insurance carriers to provide loss information to large employers at least once every 6 months.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

AN ACT requiring health insurance carriers to provide loss information to large employers at least once every 6 months.

Be it Enacted by the Senate and House of Representatives in General Court convened:

120:1 New Paragraphs; Definitions Added; "Loss Information"; "Loss Ratio." Amend RSA 420-G:2 by inserting after paragraph XII the following new paragraphs:

XII-a. "Loss information" means the aggregate claims experience and shall include, but not be limited to, the number of covered lives, the amount of premium received, the amount of total claims paid, and the claims loss ratio. "Loss information" shall not include any information or data pertaining to the medical diagnosis, treatment, or health status that identifies an individual covered under the group contract or policy. Catastrophic claim information shall be provided as long as the provision of this information would not compromise any covered individual's privacy.

XII-b. "Loss ratio" means the ratio between the amount of premium received and the amount of claims paid by the health carrier under the group insurance contract or policy.

120:2 New Section; Loss Information Provided to Large Employers. Amend RSA 420-G by inserting after section 12 the following new section:

I. Upon written request, every health carrier shall provide loss information concerning a large employer policy or contract at least once every 6 months from the date the policy becomes effective.

II. If a policyholder requests loss information from an insurance agent or other authorized representative, the representative or agent shall transmit the request for loss information to the health carrier within 4 working days.