New Hampshire Code of Administrative Rules
Lab - Commissioner, Department of Labor
Chapter Lab 400 - WORKERS' COMPENSATION SELF-INSURANCE
Part Lab 408 - REGULATION OF THIRD PARTY ADMINISTRATORS
Section Lab 408.06 - Written Agreement Necessary
Universal Citation: NH Admin Rules Lab 408.06
Current through Register No. 12, March 21, 2024
(a) A TPA shall not act on behalf of a self-insurer without a written agreement with that self-insurer.
(b) A TPA shall complete and submit "Notice of Contract Between Third Party Administrator and Self-Insurer" form WC-TPA-CBP (3/2019). The form may be obtained at https://www.nh.gov/labor/documents/tpa-contract.pdf.
(c) In addition to the "Notice of Contract Between Third Party Administrator and Self-Insurer" form, a TPA shall submit the following documents to the department:
(1)
A copy of the contract between the administrators and insurers; and
(2) A copy of the notification which will be
sent to policyholders informing them of this arrangement.
#7142, eff 11-24-99, EXPIRED: 11-24-07
New. #9878-A eff 2-25-11
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