Section Ins 4005.03 - Opt-In by Self-Funded Private Employers(a) Each third-party administrator or carrier providing claims administration services to any self-funded private employer that maintains a business location in New Hampshire, including a branch location, shall, within 60 days of the effective date of this rule for current clients or, for new or renewing clients, within 30 days of the date its claims administration services are retained or renewed, present to each such self-funded employer a copy of the "NHID Opt-In Form" for purposes of determining whether the employer directs the carrier or third-party administrator to submit its health care claims data pursuant to Ins 4000.(b) The "NHID Opt-In Form" shall be presented at least once for each contractual period but need not be presented annually if the contractual period exceeds one year.(c) Health care claims data for each self-funded private employer that directs the submission of its data shall be included as part of the carrier's or third-party administrator's data submission as indicated on the "NHID Opt-In Form" for that employer.(d) Each carrier and third-party administrator shall provide to the department annually on March 15 an attestation of compliance with this section with respect to all accounts to which this section was applicable during the prior year. The attestation shall include a list of the self-funded private employers to whom the "NHID Opt-In Form" was presented. However, the association of a particular employer with a particular carrier or third-party administrator may be designated as proprietary information which the department shall, if so designated, hold confidential.(e) A carrier whose submission includes all relevant data under Ins 4000, without regard to whether the data relate to a self-funded private employer, shall not be required to comply with paragraphs (a) through (d).(f) The types of employers listed in RSA 420-G:11, IV shall not be considered self-funded private employers under this section, and the "NHID Opt-In Form" shall not be presented to any such employer.(g) If a self-funded private employer chooses to include the health care claims data of its employees in the state's All-Payer Claims Database (APCD), the employer, or its designee, shall:(1) Complete and sign the "NHID Opt-In Form" (2016); and(2) Submit the completed form to its claims administrator.(h) If the employer has questions about NH's APCD or the department's efforts to improve health care cost transparency, the employer may contact the department at 603-271-2261, or requests@ins.nh.gov, or visit http://www.nh.gov/insurance/.N.H. Admin. Code § Ins 4005.03
Derived From Volume XXXVI Number 49, Filed December 8, 2016, Proposed by #12044, Effective 11/17/2016, Expires 11/17/2026.Amended by Volume XL Number 50, Filed December 10, 2020, Proposed by #13136, Effective 11/24/2020, Expires 11/24/2030