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New Hampshire Risk Pool - Health Insurance Provided for the Uninsurable

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Acronym or name of the risk pool: New Hampshire health plan or NHHP.

Regulation establishing risk pool: New Hampshire legislation, under chapter 404-G.

Funding: The funding is obtained from premiums got from the participants and assessments on insurance plans operating in the US. The company assessments are based on the number of members under a carrier under New Hampshire state law.

Plans offered: NHHP offers 2 indemnity plans. Both have different deductibles and four Managed Care Plans.

Plan benefit: Deductibles of $2000 and $3500 are offered by the indemnity plans. Members of NHHP are required paying a coinsurance of 20% for covered medical expenses. The rate is 20% for outpatient services. The out of pocket maximum is $5000 on a deductible of $2000 and it is $7000 on a deductible of $3500.

The managed care programmes offer options A, B, and C. This offers in network services at annual deductibles of $1000, $2500 and $5000. Members are expected to pay a coinsurance rate of 20% on covered expenses of inpatient services. The rate is 20% for outpatient services. The out of pocket maximum is $3500 on a deductible of $1000 and it is $5000 on a deductible of $2500. The $5000 deductible has an out of pocket limit of $7500.

Option H of the managed care programme offers in network services at a deductible of $5000. Members are not expected to pay coinsurance for most of the in network services. This is the same for out of pocket services. The maximum out of pocket limit is $5000 for option H.

NHHP plan summary:

Maximum benefit limits: Regardless of deductibles, al NHHP plans have a lifetime maximum of $200000.

Eligibility: (1) The person must be a resident of New Hampshire. (2) The person must have received a notice rejecting his application for insurance from an admitted company in the state within the last 6 months. (3) You are not receiving benefits from any other plans, state or federal. (4) No other health coverage is being provided to the individual. (5) You are paying premiums at a rate that is more than the rate for NHHP. (6) You have federal eligibility under COBRA and have exhausted it. (7) You have one of the conditions included in the plan brochure. (8) You were declared eligible by either Federal Trade Act Assistance or Pension Benefit Guarantee Association.

Enrollment periods: You can apply for the plans at any time. NHHP covers become effective on the first of the month following approval.

Premium payments: The rates of premium are determined by your age, gender and your plan.

Premium calculations: The rate assigned is 125% to 150% of the standard rate charged by insurance companies in the state.

Pre existing condition waiting period: For all policies under NHHP, benefits are not payable for the first 9 months of coverage under a preexisting condition. Exceptions apply under waivers. Waivers are usually given to people having continuous cover till at least 63 days before application.

Contact information: New Hampshire health plan. C/O BMI. Great bend, Kansas 67530. Phone-8778886447. NHHP Website.

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