161-H:2. Enrollment of Children.
I. An insurer shall not deny enrollment of a child under the health care coverage of a parent on the grounds that:
(a) The child was born out of wedlock;
(b) The child is not claimed as a dependent on the parent's federal income tax return; or
(c) The child does not reside with the parent or in the insurer's service area.
II. In any case in which a parent is required by a court or administrative order to provide health coverage for a child and the parent is eligible for family health coverage through an insurer, the insurer shall:
(a) Permit such parent to enroll under such family coverage any such child who is otherwise eligible for such coverage without regard to open season restrictions.
(b) If such a parent is eligible to enroll for family health care coverage but fails to make application to obtain coverage of such child, allow the child to be enrolled by the other parent or by the department of health and human services.
(c) Not terminate coverage of such a child, unless the insurer is provided satisfactory written evidence that:
(1) Such court or administrative order is no longer in effect, or
(2) The child is or will be enrolled in comparable health coverage through another insurer which will take effect not later than the effective date of such disenrollment.
(d) The signature of the custodial parent, guardian, or caretaker of the insured dependent child is a valid authorization to the insurer for purposes of processing an insurance reimbursement payment to the provider of medical services.
III. In any case in which a parent is required by a court or administrative order to provide health coverage for a child and the parent is eligible for family health coverage through an employer doing business in the state, the parent's employer shall:
(a) Permit such parent to enroll under such family coverage any child who is otherwise eligible for such coverage without regard to any enrollment season restrictions.
(b) If a parent is eligible to enroll for family health care coverage but fails to make application to obtain coverage of the child, allow enrollment of the child under the family coverage upon application by the child's other parent or the department of health and human services.
(c) Not disenroll or eliminate coverage of any such child unless:
(1) The employer is provided satisfactory written evidence that the court or administrative order is no longer in effect, or the child is or will be enrolled in comparable health coverage which will take effect not later than the effective date of the disenrollment; or
(2) The employer has eliminated family health coverage for all of its employees.
(d) Withhold from the employee's wages the employee's share, if any, of premiums for health coverage, except that the amount withheld shall not exceed the maximum permitted under section 303(b) of the Consumer Credit Protection Act, and rules of the commissioner of the department relative to prioritization of withholding between child support and health coverage and pay that share of premiums to the insurer.
(e) Notify the department within 15 days of the employee's termination of employment, and provide the employee's last known address and the name and address of the present employer, if known.
III-a. The department shall use the National Medical Support Notice to notify employers of a court or administrative order to provide health care coverage to a child of an employee whenever the department is responsible for enforcing the medical child support order, unless the order stipulates alternative health care coverage to employment-related health care coverage; and the National Medical Support Notice shall be deemed to be an application to enroll the child in the employment-related health care coverage.
III-b. Where the parent is a newly hired employee entered in the state directory of new hires maintained by the department of employment security pursuant to RSA 282-A:117-a, I, the department shall, where appropriate, provide to the employer a National Medical Support Notice and an income withholding notice pursuant to paragraph III-a in accordance with the timeframes required by section 466(a)(19)(B) of the Social Security Act.
III-c. The employer shall transfer a National Medical Support Notice within 20 business days after the date of the National Medical Support Notice to any insurer providing health care coverage for which the child is eligible.
IV. In any case in which a child has health coverage through the insurer of a non-custodial parent, the insurer shall:
(a) Provide such information to the custodial parent as may be necessary for the child to obtain benefits through such coverage.
(b) Permit the custodial parent (or provider, with the custodial parent's approval) to submit claims for covered services without the approval of the non-custodial parent.
(c) Make payment on claims submitted in accordance with subparagraph (b) directly to such custodial parent, the provider, or the department.
V. The department under RSA 161-H:3 may attach the wages, salary, or other employment income of any person who:
(a) Is required by court or administrative order to provide coverage of the costs of health services to a child who is eligible for medical assistance under Title XIX of the Social Security Act;
(b) Has received payment from a third party for the costs of such services to such child; and
(c) Has not used such other payments to reimburse, as appropriate, either the other parent or guardian of such child or the provider of such services, to the extent necessary to reimburse the department for expenditures for such costs under its plan under Title XIX of the Social Security Act, but any claims for current or past due child support shall take priority over any such claims for the cost of such services.
VI. An insurer shall not impose any requirements on the department in cases where the department has been assigned the rights of an individual eligible for medical assistance under Title XIX and covered for health benefits from the insurer, which are different from requirements applicable to an agent or assignee of any other individual so covered.
VII. Any employer who violates any provision of paragraph III, III-c, or V shall be guilty of a misdemeanor.
Source. 1994, 214:1. 1995, 310:175, 181. 2002, 56:2-5. 2010, 166:1, 2, eff. June 17, 2010.
