→
Previous
Latest
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES 19Feb2026...
CHAPTER 218 HB 1197-FN - FINAL VERSION 19Feb2026...
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES 19Feb2026...
CHAPTER 218 HB 1197-FN - FINAL VERSION 19Feb2026...
1 Insurance Department;
218:1 Insurance Department;
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 2 - (a) The commissioner may use documents, materials, or other information obtained through an investigation in furtherance of any regulatory or legal action brought as part of the commissioner's duties.
(a) The commissioner may use documents, materials, or other information obtained through an investigation in furtherance of any regulatory or legal action brought as part of the commissioner's duties.
(b) The commissioner may share documents, materials, or other information, including the confidential and privileged documents, materials, or other information under paragraph III, with other state, federal, and international regulatory agencies including the Bank for International Settlements, with the International Association of Insurance Supervisors or the National Association of Insurance Commissioners, their affiliates or subsidiaries, and with state, federal, and international law enforcement authorities;
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 2 - (b) The commissioner may share documents, materials, or other information, including the confidential and privileged documents, materials, or other information under paragraph III, with other state, federal, and international regulatory agencies including the Bank for International Settlements, with the International Association of Insurance Supervisors or the National Association of Insurance Commissioners, their affiliates or subsidiaries, and with state, federal, and international law enforcement authorities;
2 Annual Financial Statement.
218:2 Annual Financial Statement.
  The commissioner may impose an administrative fine in an amount not to exceed HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 3 - $5,000, or refuse to continue, or may suspend or revoke, the certificate of authority of any insurer intentionally failing to file or transmit its annual statement when due.
  The commissioner may impose an administrative fine in an amount not to exceed $5,000, or refuse to continue, or may suspend or revoke, the certificate of authority of any insurer intentionally failing to file or transmit its annual statement when due.
3 Conduct of Examinations.
218:3 Conduct of Examinations.
(b)(1) Every company or person from whom information is sought, its officers, directors, and agents must provide to the examiners timely, convenient, and free access at all reasonable hours at its offices to all books, records, accounts, papers, documents, and any or all computer or other recordings relating to the property, assets, business, and affairs of the company being examined.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 3 - (b)(1) Every company or person from whom information is sought, its officers, directors, and agents must provide to the examiners timely, convenient, and free access at all reasonable hours at its offices to all books, records, accounts, papers, documents, and any or all computer or other recordings relating to the property, assets, business, and affairs of the company being examined.
The refusal of any company, by its officers, directors, employees or agents, to submit to examination or the failure to comply with any reasonable written request of the examiners, including those pursuant to RSA 400- B:10, III, shall be grounds for suspension or refusal of, or nonrenewal of any license or authority held by the company to engage in an insurance or other business subject to the commissioner's jurisdiction, or fineThe commissioner may by written notice with an effective date 30 days thereafter order the suspension, revocation or nonrenewal of the license or authority of the individual or entity or impose an administrative penalty not to exceed $5,000 for each violation.
The refusal of any company, by its officers, directors, employees or agents, to submit to examination or the failure to comply with any reasonable written request of the examiners, including those pursuant to RSA 400-B:10, III, shall be grounds for suspension or refusal of, or nonrenewal of any license or authority held by the company to engage in an insurance or other business subject to the commissioner's jurisdiction, or fine.
The individual or entity may request a hearing pursuant to RSA 400-A:17, IIAny order shall be suspended pending a final decision of the commissioner after the hearing.
The commissioner may by written notice with an effective date 30 days thereafter order the suspension, revocation or nonrenewal of the license or authority of the individual or entity or impose an administrative penalty not to exceed $5,000 for each violation.
4 Conduct of Examination.
The individual or entity may request a hearing pursuant to RSA 400-A:17, III.
Any order shall be suspended pending a final decision of the commissioner after the hearing.
218:4 Conduct of Examination.
5 Insurance Claims Adjusters;
218:5 Insurance Claims Adjusters;
Upon satisfaction that such applicant is in all respects properly qualified and of good character after having considered the good cause factors listed in RSA 402-B:12, and that the HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 4 - granting of such license is not against the public interest, the commissioner shall, upon the payment of the required fee, issue said applicant an insurance claims adjuster's license.
Upon satisfaction that such applicant is in all respects properly qualified and of good character after having considered the good cause factors listed in RSA 402-B:12, and that the granting of such license is not against the public interest, the commissioner shall, upon the payment of the required fee, issue said applicant an insurance claims adjuster's license.
6 Insurance Claims Adjusters;
218:6 Insurance Claims Adjusters;
Any person aggrieved by said action of the commissioner or refused a license or renewal of the same by him may appeal in accordance with the provisions of RSA 541.] Good cause includes, but is not limited to, the following:
Any person aggrieved by said action of the commissioner or refused a license or renewal of the same by him CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 4 - may appeal in accordance with the provisions of RSA 541.] Good cause includes, but is not limited to, the following:
7 Public Adjusters;
218:7 Public Adjusters;
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 5 - (b) Has not committed any act that is a ground for [denial,] nonrenewal, suspension, or revocation of license set forth in RSA 402-D:10 which the commissioner determines is against the public interest.
(b) Has not committed any act that is a ground for [denial,] nonrenewal, suspension, or revocation of license set forth in RSA 402-D:10 which the commissioner determines is against the public interest.
8 Public Adjusters;
218:8 Public Adjusters;
9 Public Adjusters;
218:9 Public Adjusters;
(b) Violating any insurance laws, or violating any rule, subpoena, or order of the commissioner or of another state's insurance commissioner.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 5 - (b) Violating any insurance laws, or violating any rule, subpoena, or order of the commissioner or of another state's insurance commissioner.
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 6 - (m) Failing to comply with an administrative or court order imposing a child support obligation.
(m) Failing to comply with an administrative or court order imposing a child support obligation.
IV.] The commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and title XXXVII against any person who is under investigation for or charged with a violation of this chapter or title XXXVII even if the person's license or registration has been surrendered or has lapsed by operation of law.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 6 - IV.] The commissioner shall retain the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and title XXXVII against any person who is under investigation for or charged with a violation of this chapter or title XXXVII even if the person's license or registration has been surrendered or has lapsed by operation of law.
10 Producer Licensing;
218:10 Producer Licensing;
11 Producer Licensing.
218:11 Producer Licensing.
Unless denied licensure pursuant to RSA [402-J:12] 402-J:6, I(b), persons who have met the requirements of RSA 402-J:5 and RSA 402-J:6 shall be issued an insurance producer license.
Unless denied licensure pursuant to RSA [402-J:12] 402-J:6, I(b), persons who have met the requirements of RSA 402-J:5 and RSA 402-J:6 shall be issued an insurance producer licensAn insurance producer may receive qualification for a license in one or more of the following lines of authority:
An insurance producer may receive qualification for a license in one or more of the following lines of authority:
218:12 Producer Licensing;
12 Producer Licensing;
License Nonrenewable, Suspension, or Revocation.
License Nonrenewable Suspension, or Revocation.
Amend RSA 402- J:12 to read as follows:
Amend RSA 402-J:12 to read as follows:
The commissioner may, for good cause shown, after notice and hearing, place on probation, suspend, revoke, or refuse to [issue or] renew an insurance producer's license, and may [levy] impose an administrative fine not to exceed $2,500 per violation, [in accordance with RSA HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 7 - 400-A:15, III] or impose any combination of actions.
The commissioner may, for good cause shown, after notice and hearing, place on probation, suspend, revoke, or refuse to [issue or] renew an insurance producer's license, and may [levy] impose an administrative fine not to exceed $2,500 per violation, [in accordance with RSA 400-A:15, III] or impose any combination of actions.
(j) Forging another's name to an application for insurance or to any document related to an insurance transaction.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 7 - (j) Forging another's name to an application for insurance or to any document related to an insurance transaction.
The license of a business entity may be suspended, revoked, or [refused] nonrenewed if the commissioner finds, after notice and hearing [in accordance with RSA 400-A:17], that an individual HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 8 - licensee's violation was known or should have been known by one or more of the partners, officers, or managers acting on behalf of the partnership or corporation and the violation was neither reported to the commissioner nor had any corrective action been taken.
The license of a business entity may be suspended, revoked, or [refused] nonrenewed if the commissioner finds, after notice and hearing [in accordance with RSA 400-A:17], that an individual licensee's violation was known or should have been known by one or more of the partners, officers, or managers acting on behalf of the partnership or corporation and the violation was neither reported to the commissioner nor had any corrective action been taken.
13 New Paragraph;
218:13 New Paragraph;
III-a.
III-a.An insurance company who participates in a fronting reinsurance arrangement with a captive reinsurer may deviate from filed lost costs multipliers provided an alternative rating plan for group captive insureds is filed with and approved by the commissioner and:
An insurance company who participates in a fronting reinsurance arrangement with a captive reinsurer may deviate from filed lost costs multipliers provided an alternative rating plan for group captive insureds is filed with and approved by the commissioner and:
14 Minimum Standards for Claim Review;
218:14 Minimum Standards for Claim Review;
Amend RSA 415- A:4-a, III to read as follows:
Amend RSA 415-A:4- a, III to read as follows:
Show all 71 changed rows (31 more)
Previous
Latest
Any carrier or other licensed entity that offers group health plans and employee benefit plans shall file with the department a copy of its claim determination procedure, including all forms used, and a copy of the materials designed to inform its members or insureds of the requirements of the claim determination and grievance procedure and the responsibilities and rights of the members or insureds under the plan[ each year] upon the commissioner's request.
Any carrier or other licensed entity that offers group health plans and employee benefit plans shall file with the department a copy of its claim determination procedure, including all forms used, and a copy of the materials designed to inform its members or insureds of the requirements of the claim determination and grievance procedure and the responsibilities and rights of the members or insureds CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 8 - under the plan [each year] upon the commissioner's request.
15 Standards for Accident and Health Insurance;
218:15 Standards for Accident and Health Insurance;
Every carrier or other licensed entity which offers group health insurance or employee benefit plans shall file upon the commissioner's request with the insurance department[, by April 1 of each year,] and shall maintain a written procedure by which a claimant, or a representative of the claimant, shall have a reasonable opportunity to appeal a claim denial to the carrier or other licensed entity, and under which there shall be a full and fair review of HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 9 - the claim denial.
Every carrier or other licensed entity which offers group health insurance or employee benefit plans shall file upon the commissioner's request with the insurance department[, by April 1 of each year,] and shall maintain a written procedure by which a claimant, or a representative of the claimant, shall have a reasonable opportunity to appeal a claim denial to the carrier or other licensed entity, and under which there shall be a full and fair review of the claim denial.
16 Unfair Insurance Trade Practices.
218:16 Unfair Insurance Trade Practices.
17 Public Adjuster;
218:17 Public Adjuster;
18 Licensure of Medical Utilization Review Entities;
218:18 Licensure of Medical Utilization Review Entities;
Information RequiredAmend the introductory paragraph of RSA 420-E:3, I to read as follows:
Information Required.Amend the introductory paragraph of RSA 420-E:3, I to read as follows:
19 Managed Care Law;
218:19 Managed Care Law;
(4) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits;
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 9 - (4) A statement that the claimant is entitled to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to the claimant's claim for benefits;
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 10 - (6) If the claim denial is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the denial, applying the terms of the plan to the claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request;
(6) If the claim denial is based on a medical necessity or experimental treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for the denial, applying the terms of the plan to the claimant's medical circumstances, or a statement that such explanation will be provided free of charge upon request;
If a carrier or other licensed entity provides a single mandatory level of appeal, the single mandatory level shall be completed within the 30-day time period beginning from the initial date of filing the appeal.With respect to a mandatory second level of appeal involving a claim for continuation of services or urgent care, the carrier or other licensed entity shall make a decision and notify the claimant within 72 hours after the mandatory second level appeal is filed.
If a carrier or other licensed entity provides a single mandatory level of appeal, the single mandatory level shall be completed within the 30-day time period beginning from the initial date of filing the appeal.
(2) Subparagraph (d)(1) shall not prohibit a carrier or other licensed carrier from offering additional voluntary levels of appeal in addition to any mandatory levels of appeal offered, provided that:
With respect to a mandatory second level of appeal involving a claim for continuation of services or urgent care, the carrier or other licensed entity shall make a decision and notify the claimant within 72 hours after the mandatory second level appeal is filed.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 10 - (2) Subparagraph (d)(1) shall not prohibit a carrier or other licensed carrier from offering additional voluntary levels of appeal in addition to any mandatory levels of appeal offered, provided that:
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 11 - (B) A carrier may not assert failure to exhaust administrative remedies where a claimant elects to pursue a claim through other venues rather than through the voluntary level of appeal;
(B) A carrier may not assert failure to exhaust administrative remedies where a claimant elects to pursue a claim through other venues rather than through the voluntary level of appeal;
(f) If the claimant has filed an appeal and the carrier or other licensed entity has not issued a decision within the required time frames, the carrier or other licensed entity shall promptly provide the claimant with a statement of the claimant's right to file an external appeal as provided in RSA 420-J:5-a-RSA 420-J:5-e.
(f) If the claimant has filed an appeal and the carrier or other licensed entity has not issued a decision within the required time frames, the carrier or other licensed entity shall promptly provide the claimant with a statement of the claimant's right to file an external appeal as provided in RSA 420-J:5-a- RSA 420-J:5-e.
20 Managed Care Law;
218:20 Managed Care Law;
21 Producer Licensing;
218:21 Producer Licensing;
22 Accident and Health Insurance;
218:22 Accident and Health Insurance;
HB 1197-FN - VERSION ADOPTED BY BOTH BODIES - Page 12 - 415:19-a Student Insurance Policies.
CHAPTER 218 HB 1197-FN - FINAL VERSION - Page 11 - 415:19-a Student Insurance Policies.
23 Continuing Care Communities;
218:23 Continuing Care Communities;
24 Effective Date.
218:24 Effective Date.
LBA 26-2540 3/3/26 HB 1197-FN- FISCAL NOTE AS AMENDED BY THE HOUSE (AMENDMENT #2026-0519h) AN ACT making technical corrections to certain insurance laws.
Approved:
FISCAL IMPACT:
July 02, 2026 Effective Date:
Estimated State Impact FY 2026 FY 2027 FY 2028 FY 2029 Indeterminable Indeterminable Indeterminable Revenue $0 Increase $10,000 Increase $10,000 Increase $10,000 to $100,000 to $100,000 to $100,000 Revenue Fund(s) General Fund Expenditures* $0 $0 $0 $0 Funding Source(s) None Appropriations* $0 $0 $0 $0 Funding Source(s) None *Expenditure = Cost of bill *Appropriation = Authorized funding to cover cost of bill METHODOLOGY:
January 01, 2027
This bill makes a series of technical and clarifying changes throughout New Hampshire's insurance laws, including revisions to the Commissioner’s enforcement authority, producer licensing, cancellation and nonrenewal notice requirements, rate-filing provisions, and managed- care grievance and utilization review procedures.
The Insurance Department states this bill will increase state revenues by an indeterminable amount from fines, penalties, and administrative assessments deposited into the General Fund through the Insurance Premium Tax.
The Department indicates clarifying language in RSA 400-A:16 and related enforcement sections may increase the number of consent orders and administrative hearings.
Any resulting increase in penalty revenue is expected to be modest and dependent upon compliance by insurance companies, agents, and other licensees.
The Department estimate the revenue increase will be more than $10,000 but less than $100,000 per year.
AGENCIES CONTACTED:
Insurance Department
⬇ Download PDF