Group underwriting, federal COBRA, HIPAA and the ACA group rules are covered in the national Group Health Insurance guide. This guide covers New Hampshire's group health law:

• RSA 415:18, including a broad state continuation right
• the small employer law, RSA 420-G
• the coordination of benefits rule, Ins 1904

Group eligibility and enrollment (RSA 415:18)

• Part-time employees. A part-time employee regularly works at least half the weekly hours of full-time employees, and at least 15 hours a week.
• Enrollment. People who enroll within 31 days of first becoming eligible are covered without evidence of insurability. Later applicants are late enrollees.
• Divorced spouse. A divorced spouse stays eligible until the earliest of:
  • the third anniversary of the divorce decree
  • the remarriage of either party
  • the member's death
  • an earlier date set in the decree
• Labor disputes. During a labor dispute, an employee may pay premiums directly for up to six months. After that comes a right to 12 more months of continuation.
• Patients' bill of rights. New resident certificate holders get a copy of the patients' bill of rights (RSA 151:21).
• Notice of changes (415:18-b). Notice of cancellation, nonrenewal, or the renewal offer goes out at least 45 days before renewal. Cancellation for lack of participation needs 30 days' notice.

State continuation (RSA 415:18, XVI and XVII)

• Cost. No more than 102% of the group premium for that person.
• Notice and election. The carrier sends notice within 30 days of learning of the loss of coverage. The election period lasts at least 45 days after the notice.
• Grace period. Continuation premiums have a 30-day grace period.

Small employer health plans (RSA 420-G)

• Definition. A small employer averaged 1 to 50 employees during the prior year.

• Open enrollment. There's an annual 60-day open enrollment period before the anniversary date.

• Participation:

  • Minimum participation is 75% when the carrier's plan is the employer's only plan, or 37.5% when it isn't.
  • Employees covered as dependents on another plan, or enrolled in government or subsidized exchange plans, don't count.

• Rating:

  • Age rating is limited to 3 to 1 for adults, and tobacco rating to 1.5 to 1.
  • The whole state is one rating area.
  • Rates are guaranteed for at least 12 months.

• Renewability (420-G:6). Coverage is renewable except for:

  • nonpayment
  • fraud or intentional misrepresentation
  • failure to meet minimum participation
  • other listed reasons

  Health status and claims are never a reason.

Coordination of benefits (Ins 1904.05)

1. No COB provision. A plan without consistent order-of-benefit rules is always primary, unless both plans say the complying plan is primary.
2. Employee before COBRA. Coverage as an employee or dependent is primary over COBRA or state continuation coverage.
3. Children of married parents. The birthday rule applies: the plan of the parent whose birthday falls earlier in the calendar year. If the birthdays match, the plan that covered the parent longer is primary.

Common exam traps

• New Hampshire continuation is 18 months. It's 29 for disability, 36 for death or divorce, and spouses 55+ may continue until Medicare.
• Continuation costs up to 102%, and the election window is at least 45 days.
• A small employer has 1 to 50 employees, with 75% participation when the plan is the only plan.
• Notice of group cancellation or nonrenewal is 45 days before renewal.