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ERI DisclaimerNew Hampshire - Compensation & Benefit Legislation
NEW HAMPSHIRE - AASHOWME
Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.
NEW HAMPSHIRE - ADOPTED CHILD HEALTH CARE MANDATE
OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.
Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.
Preventive care for children: No.
(New Hampshire Rev. Stat. Ann. Sections 415:18, 415:22, 415:22a.)
NEW HAMPSHIRE - ALCOHOLISM & DRUG ABUSE
State reports no statutory requirements.
NEW HAMPSHIRE - CAFETERIA PLAN TAX LAWS
State income tax, unemployment insurance tax on salary reduction: New Hampshire has no personal income tax. For New Hampshire State Unemployment Insurance purposes, the total amount of employees' salary reductions and any cash that the employee has the option to receive (whether or not the employee chooses the cash option) is taxable. Employer contributions are taxable if employee has option of receiving cash.
NEW HAMPSHIRE - CONTINUATION OF COVERAGE CONVERSIONS
Events Triggering Continuation of Coverage:
Death: Yes, 36 months of maximum continuation coverage, if spouse is under 55. If over 55, spouse continues coverage until he/she becomes eligible for another group plan or for Medicare.
Job Termination: Yes, unless terminated for gross job misconduct. (To be eligible, employee must 6 months of continuous coverage prior to termination.)
Reduction of Hours: No, unless reduction of hours terminates membership in the group.
Divorce or Legal Separation: Yes. (36 months of maximum continuation coverage if spouse is under 55. If over 55, spouse continues coverage until he/she becomes eligible for another group plan of for Medicare.)
Medicare Eligibility: Yes, 36 months of continuation coverage.
Other Provisions: Termination of coverage for any other reason than non-payment.
Early Termination of Continuation of Coverage: Becoming eligible for Medicare; becoming eligible for similar benefits, including coverage for pre-existing conditions under another group policy; failure to make a timely payment. (New Hampshire Stat. Ann. Section 415:18).
NEW HAMPSHIRE - COORDINATION OF BENEFITS
Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (New Hampshire Code Admin. R. Ann. Ins. 1904.05 et seq.)
NEW HAMPSHIRE - COST-OF-LIVING
ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.
NEW HAMPSHIRE - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS
State has no statutory requirements.
NEW HAMPSHIRE - GROUP HEALTH CODE ADDITIONS (MANDATED)
Breast Reconstruction: Effective January 1, 1998, group health insurers which provide coverage for mastectomy must provide benefits for reconstructive surgery of the breast on which the mastectomy is performed and of the other breast to product symmetry. (H442, 1997) (New Hampshire Rev. Stat. Ann. Section 417-D:2-b.)
Coverage Continuation and Conversion: Policies must provide continuation rights for up to 39 weeks and subsequent conversion rights to employees terminating coverage for themselves and their dependents and for surviving spouses and dependents of a deceased employee; continuation rights for up to six months and subsequent conversion rights for employees suspended or terminated in connection with a strike, lockout, or other labor dispute; continuation and conversion rights to divorced spouses, and conversion rights to dependents reaching the age limit for coverage. (New Hampshire Rev. Stat. Ann. Sections 27-415:18(VII)(a), (b), (e), (g), 27-415:18(IV-a).)
Diabetes: Effective January 1, 1998, health care insurers (HMOs included) must provide coverage to individuals with diabetes for medically appropriate and necessary outpatient self-management training and educational services. These services must be ordered in writing by a primary care physician or practitioner and must include but not be limited to nutrition therapy provided by a certified, registered, or licensed health care professional with expertise in the treatment of diabetes. Also, insurers which provide prescription benefits must cover medically appropriate or necessary insulin, oral agents, and equipment used to treat diabetes; insurers which cover durable medical equipment must include that needed for diabetes care. (H511, 1997) (New Hampshire Rev. Stat. Ann. Section Section 415:18-F, 258:6.)
Disclosure of Information: Effective January 1, 1998, positive results from blood, urine, or oral specimens, and for FDA approved tests for the presence of antibodies or antigens to human immunodeficiency viruses (HIV) must be disclosed to individuals tested and to those whom an individual has given written authorization to receive their test results. (S165, 1997) (New Hampshire Rev. Stat. Ann. Section 282:4.)
Enteral Formulas: Providers must cover costs for non-prescription enteral formulas for the treatment of impaired absorption of nutrients caused by disorders affecting the absorptive surface, functional length, or motility of the gastrointestinal tract, and costs for non-prescription enteral formulas and low protein food products required for persons with inherited diseases of amino acids and organic acids. Costs of low protein food products must be covered up to an annual maximum of $1,800 per patient. A physician's written order, stating that the enteral formula or low protein food product is needed to sustain life, is medically necessary and is the least restrictive and most cost effective means of treatment, is required for coverage. Costs of these products must not be subject to greater deductibles than those required for other services; coinsurance payments must not exceed the amount normally paid as reasonable and customary charges for services. (H252, 1995) (New Hampshire Rev. Stat. Ann. Section (HB 252, 235, 415:18e, 419:5-f, 420:5-g, 420-A:7-i, 420B:8-ff.)
Handicapped Dependents: Coverage for dependent children cannot be terminated while a person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (New Hampshire Rev. Stat. Ann. Section 415:5(I)(3-a), 415:18(V), 420:5(IX).
Managed Care Plans: Utilization Reviews: Effective January 1, 1998, utilization reviews of managed care plans may monitor or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of provided health care services, providers, or facilities. Utilization reviews may include assessments of ambulatory care, case management procedures, concurrent hospital stays, discharge planning, pre-hospital admission certifications, pre-inpatient services, eligibility certifications, prospective reviews, second opinions, and retrospective reviews. Disclosure: Information obtained by a health carrier from an individual or from a provider which pertains to an individual's diagnosis, treatment, or health must not be disclosed to any person except as may be allowed by applicable state or federal law or upon consent from the individual (S 178, 1997) (New Hampshire Rev. Stat. Ann. Section RSA 420-J:3, 420-J:6, 420-J10.)
Maternity: Pregnant women must notify their health care insurers of their condition and, after receiving such notification, an insurer must give the women written notification of prenatal, maternity, and postpartum benefits. The duration of inpatient delivery stays and the number of allowable postpartum visits must be determined by an attending health care provider based on accepted guidelines. At the recommendation of an attending health care provider in consultation with a mother, a hospitalization stay of a shorter duration than the current minimum nationally accepted guidelines for perinatal care may be allowable. The insurer, in these cases, must pay for at least 2 postpartum visits with include a physical assessment of mother and infant; an adequate sample must be collected from a newborn for genetic and metabolic diseases screening purposes during one of the postpartum visits. An insurer also must pay for appropriate postpartum homemaker services if determined by a health care provider and a case manager to be medically necessary. (H 1352, 1997) (New Hampshire Rev. Stat. Ann. Section RSA 417-D.)
Mental Health: Group policies must cover expenses for treatment of mental illnesses and emotional disorders which are subject to significant improvement through short term therapy and for expenses arising from diagnosis and evaluation of all other mental illness and emotional disorders on terms at least as favorable as for other illnesses covered by the policy. Benefits cover up to $3,000 in expenses per year with a lifetime maximum of $10,000. At least 15 hours of outpatient treatment per year must be covered. (New Hampshire Rev. Stat. Ann. Sections 415:18-a, 419:5-a, 420:5-a.) HMOs offering mental health care must provide 2 diagnostic visits followed by up to 3 visits for treatment; subsequent mental health visits may be subject to utilization review. Under an HMO, a primary care physician may refer a patient to a psychiatrist or other mental health care provider within the
network; no economic penalty, however, shall be suffered by the primary care physician for such referral. Mental health care provided under an HMO must not be subject to deductibles, and coinsurance payments for such care must not exceed 20 percent of reasonable and customary charges. (H446, 1995.) (New Hampshire Rev. Stat. Ann. Section HB 446 245:1, 446 245:2.) Insurers must offer to group policyholders additional coverage for, treatment of mental illness rendered by a certified clinical social worker. (New Hampshire Rev. Stat. Ann. Section 415:18-a.)
Newborns: Policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness, including treatment of medically diagnosed congenital defects and birth abnormalities. (New Hampshire Rev. Stat. Ann. Section 415:22.)
Policies for Small Employers: A small employer is a business or organization which employed an average of at least one and up to 100 employees on business days during the previous calendar year. (S130, 1997.) (New Hampshire Rev. Stat. Ann. Sections 344:1, 420:G.)
Pre-existing Conditions: These illnesses are defined as physical or mental conditions for which medical advice, diagnosis, care or treatment is recommended or received during three months immediately preceding the effective date of health coverage. Pre-existing condition exclusions must not extend beyond 6 consecutive months -- beyond 9 months for small employers -- while individuals are continuously covered and actively at work full-time, or beyond 12 months after effective dates of coverage. Health insurers must not treat genetic information as pre-existing conditions in the absence of related diagnosed conditions; pregnancies also must not be treated as pre-existing conditions. (S130, 1997) (New Hampshire Rev. Stat. Ann. Section 344:1, 420:G.)
Providers: Osteopaths, chiropractors, podiatrists, optometrists, and registered nurse practitioners: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (New Hampshire Rev. Stat. Ann. Section 415:5(I)(8), 415:18(VI).)
NEW HAMPSHIRE - GROUP HEALTH FOR SMALL EMPLOYERS
For insurance plans offered to small employers:
Eligibility Criteria: 1 - 100 employees.
Restrictions on premiums: Yes.
Restrictions on cancellation: Yes.
Pre-existing Conditions: Shall not apply in excess of 3 consecutive months ending while the plan is effective and in which the individual incurred no medical expenses in connection with the pre-existing condition, nor for a period in excess of 9 months following the effective date of coverage. (New Hampshire Rev. Stat. Ann. Sections 420G:2, 420G:4, 420-G:7)
NEW HAMPSHIRE - GROUP LIFE CODE ADDITIONS
Employer required to pay part of premium: Yes.
Percent of employees who must elect coverage (if employees pay part of premium): 75%.
Percent of employees who must be covered if employer pays all of premium: 100%.
Minimum number of employees in group plan: 10.
Employer prohibited as beneficiary: Yes.
Grace period (days): 31.
Mandatory conversion: Yes.
Other provisions: None.
(New Hampshire Rev. Stat. Ann. Sections 408:15, 408:16)
NEW HAMPSHIRE - HOLIDAYS
January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday is not a holiday under state law but Civil Rights Day is celebrated the 3rd Monday in January, Columbus Day (or 2nd Monday in October), Thanksgiving. Other: If holiday falls on Sunday, following Monday is a holiday. (New Hampshire Rev. Stat. Ann. Sections 288:1, 288:2)
NEW HAMPSHIRE - IMMIGRATION (PREVAILING WAGE POLICY)
See U.S. Federal General Administrative Letter 1-2000
NEW HAMPSHIRE - JURY DUTY & WITNESS TIME OFF
Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.
Remedies and Penalties: Violator is in contempt of court. Employee may bring civil action within 1 year of discharge for damages equal to amount of lost wages, reinstatement, and reasonable attorney fees. Damages may not exceed lost wages.
Other Requirements: None reported. (New Hampshire Rev. Stat. Ann. 500-A:14.)
Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.
Remedies and Penalties: State reports no statutory requirements.
Other Requirements: State reports no statutory requirements.
NEW HAMPSHIRE - LEAVES OF ABSENCE
State reports no statutory requirements.
See U.S. Federal Family and Medical Leave Act
NEW HAMPSHIRE - LONG TERM DISABILITY CODE ADDITIONS
State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.
See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act
NEW HAMPSHIRE - MANDATED PROVIDERS
Optometrists, chiropractors, podiatrists, and nurse practitioners. Mandatory coverage for osteopaths. (New Hampshire Rev. Stat. Ann. Sections 317-A, 415:5)
NEW HAMPSHIRE - MENTAL HEALTH CARE
Mandatory coverage.
Minimum yearly inpatient coverage: $3,000 per covered individual for inpatient and outpatient combined.
Minimum yearly outpatient coverage: 15 hours (up to $3,000 per covered individual and outpatient combined).
Minimum lifetime coverage: $10,000. Specified mental illnesses must be covered to the same extent physical illness is covered.
(New Hampshire Rev. Stat. Ann. Sections 415:18j-a, 417-E:1)
NEW HAMPSHIRE - MINIMUM WAGE
Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).
Exemptions: Agriculture workers, domestics, outside sales, students (if under age 16, sub-minimum wage of 75% of minimum wage), apprentices, and handicapped workers in special environments.
NEW HAMPSHIRE - NEW HIRE REPORTING
Who is required to report: All employers.
Who must be reported: All new employees and rehires; contractors for services expected to exceed $2,500.
Exempt from reporting: No exemptions.
Form(s) to file: W-4 form or equivalent. Reports may be mailed, submitted magnetically, or filed electronically.
Filing deadline: Within 20 days of hire.
Employer information to be included: Name, address, and EIN.
Employee information to be included: Name, address, and SSN.
Penalty for failure to report: Fines from $25 to $500 may be imposed.
(New Hampshire Rev. Stat. Ann. Section 282-A:117)
NEW HAMPSHIRE - NEWBORN CARE MANDATE
Mandated coverage.
Preventive care for children: No. (New Hampshire Rev. Stat. Ann. Sections 415:18, 415:22, 415:22a)
NEW HAMPSHIRE - PARENTAL LEAVE
See U.S. Federal Family and Medical Leave Act
NEW HAMPSHIRE - PRE-EXISTING CONDITIONS
For insurance plans offered to small employers, pre-existing condition provisions shall not apply for any period in excess of 3 consecutive months ending while the plan is effective and in which the individual incurred no medical expenses in connection with the pre-existing condition, nor for a period in excess of 9 months following the effective date of coverage. (New Hampshire Rev. Stat. Ann. Sections 420G:2, 420G:4)
See U.S. Federal Health Insurance Portability & Accountability Act
NEW HAMPSHIRE - PROTECTED CLASSIFICATIONS
Age: Yes.
Race: Yes.
Color: Yes.
National Origin: Yes.
Ancestry: Yes.
Religion: Yes.
Sex: Yes.
Pregnancy: Yes.
Sexual Harassment: Yes.
(N.H. Rev. Stat. Ann. Sections 354-A:2, 354-A:6, 354-A:7, 354-A:8; H.H. Code Admin. R. Hum. Sections 401.01.)
NEW HAMPSHIRE - SHORT TERM DISABILITY CODE ADDITIONS
State does not require employer or employee participation in short term disability plans.
NEW HAMPSHIRE - TERMINATION & SEVERANCE PAY
Date pay is due if employee is discharged: Within 72 hours.
Date due if employee resigns: Payday.
Wages: Yes. (Wages defined as compensation, including hourly, health and welfare, and pension fund contributions adopted for the benefit of employees.
Vacation Pay: Yes.
Holiday: Yes.
Sick leave: Yes.
Severance: Yes.
(New Hampshire Rev. Stat. Ann. Sections 275-42, 275-43, 275-44. Attorney General's opinion stating that severance is preempted by ERISA laws.)
NEW HAMPSHIRE - UNEMPLOYMENT TAX
Employer Contributions:
Tax Rate (%):
Standard 5.4
Maximum: 6.5
Minimum: 0.05
Voluntary Contribution Provision: No.
(New Hampshire Rev. Stat. Ann. Sections 282-A:82, 282-A:85, 282-A:87, 282-A:117, 282-A:118.)
NEW HAMPSHIRE - VACATION PAY
See TERMINATION & SEVERANCE PAY (above)
NEW HAMPSHIRE - VOTING TIME OFF
State reports no statutory requirements.
NEW HAMPSHIRE - WORKERS' COMPENSATION
Private Employers: Mandatory as to all employments. First 3 corporate officers not counted as employees. (Note: Fourth corporate officer and any employees must be covered.) Elective as to partners and sole proprietors.
Public Employers: Mandatory coverage to all public employments.
Exceptions: Railroad workers covered under F.E.L.A. (Jones Act).
Special Coverage Provisions: None reported.
(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)