Section Ins 2601.03 - Definitions(a)(1) "Accident and health insurance policy" means a policy, plan, certificate, contract, agreement, statement of coverage, rider or endorsement that provides accident or health benefits or medical, surgical or hospital benefits, whether on an indemnity, reimbursements, service or prepaid basis, except when issued in connection with another kind of insurance other than life and except disability, waiver of premium and double indemnity benefits included in life insurance and annuity contracts. An accident and health insurance policy does not include a Medicare supplement policy, or any other type of accident and health insurance with advertising guidelines covered by a separate statute or rule.(2) The language "except disability, waiver of premium and double indemnity benefits included in life insurance and annuity contracts" means it does not include disability, waiver of premium or double indemnity benefits included in life insurance, endowment or annuity contracts or contracts supplemental to the above contracts that contain only provisions that: a. Provide additional benefits in case of death or dismemberment or loss of sight by accident; orb. Operate to safeguard the contracts against lapse or to give a special surrender value, special benefit or an annuity in the event that the insured or annuitant shall become totally and permanently disabled as defined by the contract or supplemental contract. (b)(1) "Advertisement" means: a. Printed and published material, audio visual material, and descriptive literature of an insurer used in direct mail, newspapers, magazines, radio scripts, TV scripts, websites and other Internet displays or communications, other forms of electronic communications, billboards and similar displays;b. Descriptive literature and sales aids of all kinds issued by a producer for presentation to members of the insurance-buying public, such as circulars, leaflets, booklets, depictions, illustrations, form letters and lead-generating devices of all kinds; andc. Prepared sales talks, presentations and material for use by producers whether prepared by the insurer or the producer.(2) The definition of "advertisement" includes advertising material included with a policy when the policy is delivered and material used in the solicitation of renewals and reinstatements.(3) The definition of advertisement extends to the use of all media for communications to the general public, to the use of all media for communications to specific members of the general public, and to the use of all media for communications by producers.(4) The definition of advertisement does not include: a. Material used solely for the training and education of an insurer's employees and producers;b. Material used in-house by insurers;c. Communications within an insurer's own organization not intended for dissemination to the public;d. Individual communications of a personal nature with current policyholders other than material urging the policyholders to increase or expand coverages;e. Correspondence between a prospective group or blanket policyholder and an insurer in the course of negotiating a group or blanket contract;f. Court-approved material ordered by a court to be disseminated to policyholders; org. A general announcement from a group or blanket policyholder to eligible individuals on an employment or membership list that a contract or program has been written or arranged; provided that the announcement clearly indicates that it is preliminary to the issuance of a booklet and that the announcement does not describe the specific benefits under the contract or program nor describe advantages as to the purchase of the contract or program. This does not prohibit a general endorsement of the program by the sponsor.(c) "Certificate" means a statement of the coverage and provisions of a policy of group accident and sickness insurance, which has been delivered or issued for delivery in this state and includes riders, endorsements and enrollment forms, if attached.(d) "Exception" means any provision in a policy whereby coverage for a specified hazard is entirely eliminated; it is a statement of a risk not assumed under the policy.(e) "Insurer" means an individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds, fraternal benefits society, health maintenance organization, hospital service corporation, medical service corporation, prepaid health plan and any other legal entity that is defined as an insurer under Title XXXVII, and is engaged in the advertisement of itself or an accident and health insurance policy.(f) "Institutional advertisement" means an advertisement having as its sole purpose the promotion of the reader's, viewer's or listener's interest in the concept of accident and health insurance, or the promotion of the insurer as a seller of accident and health insurance.(g) "Invitation to contract" means an advertisement that is neither an invitation to inquire nor an institutional advertisement.(h) "Invitation to inquire" means: (1) An advertisement having as its objective the creation of a desire to inquire further about accident and health insurance and that is limited to a brief description of the loss for which benefits are payable but may contain: a. The dollar amount of benefits payable; andb. The period of time during which benefits are payable.(2) An invitation to inquire may not refer to cost.(3) An invitation to inquire shall contain a provision in the following or substantially similar form: "This policy has [exclusions] [limitations] [reduction of benefits] [terms under which the policy may be continued in force or discontinued]. For costs and complete details of the coverage, call [or write] your insurance producer or the company [whichever is applicable]."
(i) "Lead-generating device" means any communication directed to the public that, regardless of the form, content or stated purpose, is intended to result in the compilation or qualification of a list containing names and other personal information to be used to solicit residents of this State for the purchase of accident and health insurance.(j) "Limitation" means a provision that restricts coverage under the policy other than an exception or a reduction.(k) "Limited benefit health coverage" is health insurance that provides certain health related benefits, including income replacement coverage for certain health related events, that is not health coverage under RSA 420-G:2,IX.(l) "Person" means a natural person, association, organization, partnership, trust, group, discretionary group, corporation or any other entity.(m) "Prominently" or "conspicuously" means that the information to be disclosed prominently or conspicuously shall be presented in a manner that is noticeably set apart from other information or images in the advertisement.(n) "Reduction" means a provision that reduces the amount of the benefit; a risk of loss is assumed but payment upon the occurrence of the loss is limited to some amount or period less than would be otherwise payable and the reduction has not been used.N.H. Admin. Code § Ins 2601.03
Amended by Volume XXXVI Number 36, Filed September 8, 2016, Proposed by #11173, Effective 12/5/2016, Expires 12/5/2026.