New Hampshire Code of Administrative Rules
Ins - Commissioner, Insurance Department
Chapter Ins 2300 - THIRD PARTY ADMINISTRATORS
Part Ins 2301 - REGULATION OF THIRD PARTY ADMINISTRATORS
Section Ins 2301.03 - Application Forms

(a) An administrator shall not operate as an administrator in this state without a certificate of authority or exemption from the department. Administrators wishing to do business in this state shall complete an application, an exemption registration, which shall be filed annually on a form provided by the department pursuant to requirements in RSA 402-H:11 and attached hereto as Appendix 1, Form TPA-1. Persons or entities that are specifically excepted by RSA 402-H:1, I shall complete an exception from licensing form, which shall be filed annually on a form provided by the department pursuant to the requirements of RSA 402-H:1, I(a) through (m) and attached hereto as Appendix 2, Form TPA-2.

(b) The application shall be completed and signed by an officer or authorized representative of the administrator. The complete application shall be filed at the department. The application shall be accompanied by the filing fee required in RSA 400-A:29, I(a).

(c) For any pooled risk management program operated pursuant to RSA 5-B, a completed copy of the RSA 5-B:4 informational filing may be submitted as an exemption registration.

(d) An application or exemption registration shall not be deemed to be filed until all of the information necessary to properly process the application or exemption has been received by the commissioner.

(e) An application by a corporation, association, partnership or benefit society shall be accompanied by a current certificate of good standing as a business corporation in this state.

(f) An administrator shall notify the commissioner in writing of any change in the information required to be filed under these rules including, but not limited to, a change of address or name, no later than 30 days after the change.

(g) Where any form used for compliance with this rule mentions perjury, perjury shall mean any applicable penalty found in RSA 641, falsification in official matters, including RSA 641:3, unsworn falsification.