New Hampshire Code of Administrative Rules
Ins - Commissioner, Insurance Department
Chapter Ins 7000 - SHORT TERM LIMITED DURATION HEALTH INSURANCE
Part Ins 7001 - MINIMUM STANDARDS FOR SHORT TERM LIMITED DURATION HEALTH INSURANCE
Section Ins 7001.07 - Additional Policy Provisions

Universal Citation: NH Admin Rules Ins 7001.07

Current through Register No. 12, March 21, 2024

(a) Provisions requiring mandatory second surgical opinions shall comply with the following conditions:

(1) The provision shall include a list of the surgical procedures to which the requirements apply;

(2) The policy shall cover the second opinion obtained from a board-certified specialist;

(3) In the event that an insured receives a non-confirming second opinion, the policy shall cover a third surgical opinion from a specialist jointly chosen by the insured and the insurer, and that opinion shall be final; and

(4) The insurer shall waive the mandatory second surgical opinion requirement in the event a person is unable to obtain an appointment for a second opinion.

(b) A provision requiring an insured to have certain minor or elective surgical procedures performed at a physician's office, free-standing surgical facility, or outpatient department of a hospital shall include a list of the surgical procedures subject to this requirement. Procedures shall be available to obtain an exception to the requirement that a surgical procedure be done on an outpatient basis in those cases where the patient's medical history or other conditions dictate the advisability of having the surgery performed on an inpatient basis.

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