N.H. Admin. Code § Ins 403.03

Current through Register No. 35, August 29, 2024
Section Ins 403.03 - Definitions

For the purposes of this chapter:

(a) "Care navigator" means an informed decision-making resource provided by the carrier that is designed to provide members with information about treatment options, identify and assist members in navigating through the healthcare system and to direct the member to related resources within the healthcare community.
(b) "Carrier" means any entity that offers health coverage in the small employer market in this state and has at least 1,000 covered lives as of the first day of the calendar year and that is subject to the requirement of offering the standard wellness plan.
(c) "Commissioner" means the insurance commissioner.
(d) "Department" means the New Hampshire insurance department.
(e) "Health coverage plan target rate" means the health coverage plan rate that is set at or below 10 percent of the prior year's median wage based on the occupation employment statistics maintained by the U.S. Department of Labor and adjusted by the state department of labor to reflect the median hourly wage of full time New Hampshire employees.
(f) "HealthFirst benefit plan" means the HealthFirst standard benefit design, including the HealthFirst wellness incentives as set forth in the HealthFirst benefit description.
(g) "Prescription drugs" means covered medications, diabetic supplies and contraceptive devices purchased at a network pharmacy.
(h) "Preventive care services" mean:
(1) Immunizations;
(2) Lead screening;
(3) PSA tests;
(4) Routine physical exams, including family planning, pre-natal visits and well child care;
(5) Annual ob-gyn visits, including mammography;
(6) Routine hearing tests;
(7) Routine laboratory tests; and
(8) Annual care plan for chronic illnesses.
(i) "Standard wellness plan" means the benefit plan developed by the commissioner pursuant to RSA 420-G:4-b.

N.H. Admin. Code § Ins 403.03

#9511, eff 7-10-09