Section Ins 2704.02 - Definitions(a) "Annual report" means a report of the data required to be submitted annually in accordance with RSA 402-N:6.(b) "Commissioner" means the insurance commissioner.(c) "Covered benefits" means those health care services and other medical services to which a covered person is entitled under the terms of a health benefit plan, including pharmacy benefits.(d) "Covered person" means a policyholder, subscriber, enrollee, or other individual participating in a health benefit plan.(e) "Contracted copayment" means a fixed amount a covered person is responsible to pay for covered prescriptions as set forth in the health benefit plan, or the price for filling the prescription as contracted between the health carrier or its pharmacy benefits manager and the pharmacy, whichever is less.(f) "Department" means the New Hampshire Insurance Department.(g) "Health benefit plan" means a plan, policy, or certificate of insurance that constitutes health coverage as defined in RSA 420-G:2, IX.(h) "Health carrier" means an entity subject to the insurance laws and rules of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for, or reimburse any of the covered costs of health care services, including an insurance company, a health maintenance organization, a health service corporation, or any other entity providing a plan of health insurance, health benefits, or health services.(i) "New Hampshire pharmacy board" means the board established in RSA 318:2.(j) "Participating pharmacy" means a pharmacy that, under a contract with the health carrier or its contractor or subcontractor, including any pharmacy benefits manager, has agreed to provide pharmacy services to covered persons with an expectation of receiving payment, other than coinsurance, co-payments, or deductibles, directly or indirectly, from the health carrier.(k) "Pharmacist" means a person defined in RSA 402-N:1, V.(l) "Pharmacy benefits manager"' means a "pharmacy benefits manager" as defined in RSA 402-N:1, VIII.N.H. Admin. Code § Ins 2704.02
Derived From Volume XXXVII Number 10, Filed March 9, 2017, Proposed by #12121, Effective 2/24/2017, Expires 2/24/2027.Amended by Volume XL Number 28, Filed July 9, 2020, Proposed by #13059, Effective 6/29/2020, Expires 6/29/2030.