Section Ins 7001.09 - Outline of Coverage(a) An outline of coverage, in the format prescribed below, shall be issued in connection with policies meeting the standards of this part.(b) The items included in the outline of coverage must appear in the following sequence: (1) A brief specific description of the benefits provided;(2) A description of any policy provisions that exclude, eliminate, restrict, reduce, limit, delay, or in any other manner operate to qualify payment of the benefit described in paragraph (1) above shall be included; and(3) A description of policy provisions with respect to renewability or continuation of coverage, including age restrictions or any reservation of right to change premiums shall be included.(c) The notice required by paragraphs (a) - (b) above shall be in the same form as follows: "[COMPANY NAME]
INDIVIDUAL SHORT TERM LIMITED DURATION HEALTH INSURANCE
OUTLINE OF COVERAGE
(1) Read Your Policy Carefully. This outline of coverage provides a brief description of the important features of your policy. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth in detail the rights and obligations of both you and your insurance company. It is, therefore, important that you READ YOUR POLICY CAREFULLY!(2) Individual short term limited duration health insurance coverage is designed to provide, to persons insured, comprehensive coverage for major hospital, medical, and surgical expenses incurred as a result of a covered accident or sickness. Coverage is provided for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care, subject to any deductibles, copayment provisions, or other limitations that may be set forth in the policy."(d) The notice shall include a brief specific description of the benefits, including dollar amounts, contained in this policy, in the following order:(1) Daily hospital room and board;(2) Miscellaneous hospital services;(3) Professional services including surgical and anesthesia services;(4) In-hospital medical services;(5) Out-of-hospital care;(6) Maximum dollar amount for covered charges;(7) Coverage mandated by statute; and(8) Other benefits, if any;(e) The notice shall include a listing of exclusions and limitations; and(f) The notice shall include a statement that short term limited duration health insurance is not renewable and is not a replacement for individual health insurance as defined in state and federal law.N.H. Admin. Code § Ins 7001.09
Derived from Volume XXXIX Number 24, Filed June 13, 2019, Proposed by #12798, Effective 6/10/2019, Expires 6/10/2029.