Section Ins 6205.04 - Additional Minimum Standards for Benefits for Individual Policies(a) In individual policies issued with benefit periods of less than 6 months, the application of an elimination period alone or in conjunction with a qualification period shall not result in the postponement of payment of periodic income benefit amounts to a disabled insured in excess of 45 days from the commencement of a disability.(b) In individual policies issued with benefit periods of 6 months to one year, the application of an elimination period alone or in conjunction with a qualification period shall not result in the postponement of payment of periodic income benefit amounts to a disabled insured in excess of 90 days from the commencement of a disability.(c) Individual policies shall provide for at least 3 consecutive months of periodic income benefits.(d) Individual policies shall include a relation of earnings to insurance provision that complies with RSA 415:6, II(6).(e) Individual policies shall be permitted to include a provision regarding the integration of its benefits with social insurance benefits including Federal Social Security or any similar federal, state, or local government law, workers' compensation, occupational disease laws, and state disability benefit plans, subject to the following: (1) If the policy includes such integration, the policy shall describe which other social insurance benefits shall be subject to the integration and how the integration shall be administered;(2) The policy shall state that a minimum disability benefit shall be paid under the policy, regardless of the benefits received from social insurance benefits, and the minimum monthly amount shall not be less than required under RSA 415:6, II(6); and(3) The policy shall not offset, or in any other manner reduce, any benefit under the policy by the amount of, or in proportion to, any cost of living increase in social insurance benefits received by the insured.(f) Individual policies shall include a description of the process for appealing and resolving benefit determinations which shall comply with Ins 1001.N.H. Admin. Code § Ins 6205.04
Derived from Volume XLI Number 49, Filed December 9, 2021, Proposed by #13297, Effective 11/24/2021, Expires 11/24/2031