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Textbook
1. General Insurance Concepts
2. Producer Roles and Receipt Types
3. Underwriting
4. Health Insurance Basics
5. Required Policy Provisions
6. Optional Policy Provisions
7. Medical Expense Insurance
8. Group Health Insurance
9. The Affordable Care Act (ACA)
10. Disability Income Insurance
11. Accidental Death and Dismemberment Insurance
12. Long Term Care Insurance
13. Dental Insurance
14. Section 125 Plans and Limited Policies
15. Federal Government Programs
16. Medigap and Medicaid
17. Health Insurance Taxation
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New Hampshire State Regulations & NAIC Insurance Law

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Licensing

Any individual applying for a New Hampshire resident producer’s license must be at least 18 years old and must be a resident of New Hampshire before submitting an application.

Pre-licensing course and exam

New Hampshire does not have specific pre-licensing requirements, but a resident applicant must pass the examinations for the line or lines of authority applied for (N.H. Rev. Stat. Ann. § 402-J:6, I).

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

Non-resident license

A producer licensed in another state can obtain a New Hampshire nonresident license without taking New Hampshire’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

Each state sets its own renewal cycle.

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license. In New Hampshire, a producer whose license lapses may reinstate it within 24 months of the renewal fee’s due date without an exam, with a penalty of double the unpaid renewal fee (N.H. Rev. Stat. Ann. § 402-J:7, III).

Continuing education

All states, including New Hampshire, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in New Hampshire must complete continuing education before renewing their license. The number of hours required is set by state law and published by the state insurance department.

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Insurance Department to conduct business in New Hampshire. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in New Hampshire must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In New Hampshire, the Commissioner may revoke or restrict an insurer’s license for the causes and in the manner the law prescribes, and must revoke the license of a foreign company whose affairs are, in the Commissioner’s opinion, in an unsound or failing condition (N.H. Rev. Stat. Ann. §§ 405:13, 405:14).

Medigap policies

To reduce confusion among the many types of Medicare supplement policies, federal law requires national standardization of Medigap policies. Insurers must offer a limited number of standardized Medigap plans developed by the NAIC.

Currently, the available plans are A, B, C, D, F, G, K, L, M, and N. Plans E, H, I, and J have been eliminated. In addition, Plans C and F are not available to individuals who became newly eligible for Medicare on or after January 1, 2020.

Plan A includes the “core” benefits (Parts A and B co-payments, 365 additional days of hospitalization, and the first 3 pints of blood). If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage are delivered at the time of application, before accepting any premium payment.

Duties of the Insurance Commissioner

The New Hampshire Insurance Commissioner is an appointed state executive position in New Hampshire state government. The commissioner serves five-year terms, oversees the Insurance Department, and is responsible for enforcing and executing the insurance laws of the state.

The Commissioner is responsible for establishing and enforcing regulations in the New Hampshire insurance market in a manner that protects consumers and encourages economic development.

Those duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony.

  • Having admitted or been found to have committed any insurance unfair trade practice or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than New Hampshire.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner may order the producer to cease and desist.

A cease and desist order does not suspend or revoke the recipient’s registration. However, it does require the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by New Hampshire law, and may ask a court to review the final order. In New Hampshire, the Commissioner issues orders upon hearing, with written notice at least 10 days in advance (N.H. Rev. Stat. Ann. §§ 400-A:14, I, 400-A:18, I).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes.

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”).

If a policy provision conflicts with New Hampshire law, the policy is read as amended to conform to the law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

New Hampshire requires the producer of record, where the insurer does not keep the information, to keep a file for each policy sold for the current year plus 5 years (N.H. Rev. Stat. Ann. § 400-B:3, IV).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in New Hampshire, but has not passed the appropriate licensing examination, is in violation of regulation.

This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in New Hampshire in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited.

False financial statements

In New Hampshire, knowingly filing with a public official, or knowingly making, publishing or circulating, a false statement of an insurer’s financial condition is an unfair practice (N.H. Rev. Stat. Ann. § 417:4, VI), and so is making false or fraudulent statements on or relative to an application for insurance to obtain a fee, commission, money or benefit (N.H. Rev. Stat. Ann. § 417:4, II).

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit. New Hampshire allows promotional items with a fair market value of $100 or less per consumer per year (N.H. Rev. Stat. Ann. § 417:4, IX(b)(13)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind.

Errors & omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers negligence and unintentional mistakes that cause financial harm to clients. It does not cover intentional misconduct, criminal acts, or regulatory fines.

Children covered as dependents

Under the Affordable Care Act, a plan that offers dependent coverage must make it available to an adult child until age 26, whether or not the child is married, a student or financially dependent on the parent.

State law generally requires a policy that covers dependents to cover a newborn from the moment of birth and an adopted child from placement, and may let the insurer require notice and any added premium within a set period to continue the child’s coverage. Policies also generally continue coverage past the age limit for a dependent child who cannot support themselves because of a mental or physical disability that began before that age.

Rebating

New Hampshire licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Unfair marketing practices

The Insurance Department is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department also requires the standardization and simplification of the terms used to describe insurance coverage.

Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators for these financial industries.

It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories.

Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Granite Advantage

Although it is all Medicaid, states use different names for their medical welfare programs. New Hampshire’s Granite Advantage Health Care Program provides coverage for the newly eligible Medicaid population (RSA 126-AA:3); it is one part of Medicaid, not another name for all of it. Medicaid is a state-administered health care program for those in financial need, funded by federal and state money.

Licensing

  • Minimum age 18, must be NH resident before applying
  • No specific pre-licensing course required, but must pass exam for line(s) of authority

Pre-licensing course and exam

  • NH has no pre-licensing course requirement
  • Must pass exam per N.H. Rev. Stat. Ann. § 402-J:6, I

Fingerprints/background check

  • Commissioner reviews background before licensing
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • States restrict licenses used principally for controlled business

Non-resident license

  • Can get NH nonresident license without NH exam if licensed in home state
  • Requires reciprocity, current good standing, application and fees
  • Address change: file within 30 days; moving to new state: apply for resident license within 90 days (no repeat of prelicensing/exam)

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military service)
  • May require licensed sponsor
  • Limited to 180 days under NAIC model

Military service

  • Can request waiver of renewal requirements/exams/fines due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • Must renew on schedule (fee + CE)
  • NAIC model: reinstate within 12 months, penalty = double fee
  • NH: reinstate within 24 months, penalty = double fee (N.H. Rev. Stat. Ann. § 402-J:7, III)

Continuing education

  • Required in all states including NH to renew major lines licenses
  • Hours set by state law/insurance department

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative/criminal actions within 30 days of final disposition/initial hearing
  • Must notify regulator before using assumed business name

Company regulations

  • Insurers must be authorized (certificate of authority) by NH Insurance Department
  • Must file charter, financials, meet capital/surplus requirements

Capital and surplus requirement

  • Must maintain minimum capital/surplus to keep certificate of authority
  • Commissioner must revoke license of foreign insurer in unsound/failing condition (N.H. Rev. Stat. Ann. §§ 405:13, 405:14)

Medigap policies

  • Federal law standardizes Medigap plans (NAIC-developed)
  • Current plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C and F unavailable to those newly eligible for Medicare on/after Jan 1, 2020
  • Plan A = core benefits; insurers selling Medigap must offer Plan A
  • Buyer’s Guide and Outline of Coverage given at application, before premium payment

Duties of the Insurance Commissioner

  • Appointed position, 5-year term, enforces state insurance laws
  • Duties: investigate complaints, monitor insurers, audit producer records, collect fees, issue fines, approve forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time (needs law officer/court)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction, misappropriation of funds, unfair trade practices, prior license revocation in another state, exam cheating

Cease and desist

  • Ordered when producer violates insurance laws
  • Does not suspend/revoke license, but stops/limits specific activity

Hearing and penalties

  • Entitled to notice and hearing; NH requires 10 days written notice (N.H. Rev. Stat. Ann. §§ 400-A:14, I, 400-A:18, I)
  • Civil penalties possible in addition to license action; higher penalties for knowing/flagrant violations

Unfair claims settlement practices

  • Violations when flagrant/frequent: delaying claims, failing to investigate, denying without investigation, using altered application info, settling below fair market value

Policy forms

  • Insurers file forms with Commissioner
  • May require prior approval or allow “file and use”
  • Conflicting provisions read as amended to match law

Record maintenance

  • Producers keep transaction records for Commissioner inspection
  • NH requires records kept for current year + 5 years (N.H. Rev. Stat. Ann. § 400-B:3, IV)

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all public communications (ads, cards, letterhead)
  • Can result in suspension/revocation of other licenses

Misrepresentation

  • Prohibited: inaccurate policy illustrations, incomplete benefit comparisons, inducing lapse/surrender via false info (twisting)

False advertising

  • Untrue, deceptive, or misleading statements about insurance business are unfair trade practice
  • Applies across all media
  • Test: whether statement is misleading, not intent

Defamation

  • False or maliciously critical statements about insurer’s financial condition, intended to injure, is unfair trade practice
  • Classic example: false rumor of insurer failing

Boycott, coercion and intimidation

  • Prohibited: agreements/actions causing unreasonable restraint or monopoly in insurance business

False financial statements

  • NH: illegal to knowingly file/publish false insurer financial statements (§ 417:4, VI)
  • Also illegal: false statements on applications to obtain fee/commission (§ 417:4, II)

Illegal inducements

  • Cannot offer unlisted value (money, gifts) to induce insurance purchase unless expressly allowed
  • NAIC model allows reasonable non-cash gifts if not conditioned on purchase
  • NH limit: $100 fair market value per consumer per year (§ 417:4, IX(b)(13))

Unfair discrimination

  • Prohibited: differing treatment of same-class/risk individuals in rates/benefits
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • Property/casualty: cannot deny based solely on geographic location or physical/mental impairment (unless justified)
  • Many states also protect blind/partially blind individuals

Errors & omissions

  • E&O = professional liability insurance for agents
  • Covers negligence/unintentional mistakes causing client harm
  • Does NOT cover intentional misconduct, criminal acts, regulatory fines

Children covered as dependents

  • ACA: dependent coverage available until age 26 regardless of marital/student/financial status
  • State law: must cover newborns from birth, adopted children from placement
  • Coverage continues past age limit for disabled dependents (disability began before age limit)

Rebating

  • NH prohibits giving refunds/discounts/credits to induce insurance purchase
  • Soliciting/negotiating insurance implies licensure

Sharing commission

  • Allowed between licensed producers in same line of business
  • NAIC model allows payment to agencies or non-selling persons

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • False critical statements about competitor = defamation
  • Prohibited: using inaccurate info to induce contract termination

Unfair marketing practices

  • Insurance Department sets disclosure/standardization requirements
  • Advertising cannot falsely imply government/organization endorsement
  • Cannot make false claims about claims payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall Act of 1933
  • Allowed consolidation of banks, investment firms, insurers
  • Established regulatory framework for merged financial services

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Limited antitrust exemption for insurers
  • Since 2021, exemption excludes health insurance (except narrow data-sharing activities)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body governed by state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, best practices, peer review, coordinates oversight
  • Forms national system of state-based insurance regulation

Fair Credit Reporting Act

  • Regulates consumer reporting agencies/reports used in underwriting
  • Investigative consumer report: must disclose to consumer within 3 days
  • Adverse action: must notify consumer; consumer has 60 days for free report copy/dispute

Privacy Act of 1974

  • Governs federal agencies’ handling of personal information only (not private insurers)
  • Private insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid up to 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry restricts calls to registered numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial email must be labeled as ad, have accurate headers/subject
  • Must include sender’s physical address
  • Must offer opt-out, honored within 10 business days

Granite Advantage

  • NH’s Medicaid program name for newly eligible population (RSA 126-AA:3)
  • Part of Medicaid, not synonym for entire program
  • Medicaid = state-administered program funded by federal/state money

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Next  | 49. New Jersey State Regulations & NAIC Insurance Law
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New Hampshire State Regulations & NAIC Insurance Law

Licensing

Any individual applying for a New Hampshire resident producer’s license must be at least 18 years old and must be a resident of New Hampshire before submitting an application.

Pre-licensing course and exam

New Hampshire does not have specific pre-licensing requirements, but a resident applicant must pass the examinations for the line or lines of authority applied for (N.H. Rev. Stat. Ann. § 402-J:6, I).

Fingerprints/background check

The Commissioner reviews an applicant’s background before issuing a license, and many states require applicants to submit fingerprints for a state and FBI criminal history check as part of the application.

Controlled business

Controlled business is insurance written on the producer’s own life, property or interests, or on those of the producer’s family, employer or a business the producer controls. A producer may insure themselves and their family, but a license exists to sell insurance to the public, so states generally restrict obtaining or using a license principally to write controlled business.

Non-resident license

A producer licensed in another state can obtain a New Hampshire nonresident license without taking New Hampshire’s examination. Under the NAIC’s Producer Licensing Model Act, which most states have adopted in some form, a nonresident receives the license if the person:

  • Is currently licensed as a resident, and in good standing, in the home state
  • Has applied (the home-state application or the Uniform Application) and paid the fees
  • Lives in a home state that grants nonresident licenses to residents of this state on the same basis (reciprocity)

Under the same model, a producer who moves to another state files a change of address, with certification from the new home state, within 30 days. A licensed producer who moves into a state applies for a resident license there within 90 days and does not repeat prelicensing education or the examination for lines already held.

Temporary license

Most states allow the insurance regulator to issue a temporary license, without an examination, when one is needed to keep an insurance business serviced. Typical cases are:

  • The surviving spouse or personal representative of a producer who dies or becomes disabled, to allow time to sell the business or train new people
  • A member or employee of a business entity producer, on the death or disability of its designated producer
  • The designee of a producer entering active military service

The regulator may limit what a temporary licensee may do and may require a licensed sponsor who takes responsibility for the temporary licensee’s acts.

The NAIC’s model act limits a temporary license to 180 days.

Military service

Under the NAIC’s model act, a producer who cannot meet license renewal requirements because of military service, or because of another extenuating circumstance such as a long-term medical disability, may request a waiver of those requirements and of any examination, fine or sanction for missing them.

Renewal and reinstatement

A producer license stays in effect only while the producer renews it on schedule: paying the renewal fee and completing continuing education by the due date.

Each state sets its own renewal cycle.

A producer who misses the deadline and lets the license lapse may be able to reinstate it without retaking the examination.

Under the NAIC’s model act, a lapsed license may be reinstated within 12 months of the renewal due date, for a penalty of double the unpaid renewal fee. Each state sets its own window and fee, and after the window closes the person must qualify for a new license. In New Hampshire, a producer whose license lapses may reinstate it within 24 months of the renewal fee’s due date without an exam, with a penalty of double the unpaid renewal fee (N.H. Rev. Stat. Ann. § 402-J:7, III).

Continuing education

All states, including New Hampshire, have continuing education (CE) requirements that must be met to renew any major lines (life, health, property, liability) insurance license. Individuals licensed in New Hampshire must complete continuing education before renewing their license. The number of hours required is set by state law and published by the state insurance department.

Notice of change of name or address

Under the NAIC’s model act, the licensee reports a change of address to the regulator within 30 days of the change.

The model also requires a producer to report to the regulator within 30 days any administrative action taken against the producer in another state or by another government agency, counted from the final disposition, and any criminal prosecution in any jurisdiction, counted from the initial pretrial hearing date. A producer who does business under any name other than their legal name must notify the regulator before using it.

Company regulations

An insurance company must be authorized by the Insurance Department to conduct business in New Hampshire. To receive a certificate of authority, the company applies to the Commissioner and files its charter or articles of incorporation, financial statements showing that it meets the state’s capital and surplus requirements, and the other documents and fees the state requires.

Capital and surplus requirement

A company authorized to conduct insurance business in New Hampshire must meet minimum corporate standards. The certificate of authority allows the insurer to conduct business in the state only if it maintains the minimum capital or permanent surplus required. In New Hampshire, the Commissioner may revoke or restrict an insurer’s license for the causes and in the manner the law prescribes, and must revoke the license of a foreign company whose affairs are, in the Commissioner’s opinion, in an unsound or failing condition (N.H. Rev. Stat. Ann. §§ 405:13, 405:14).

Medigap policies

To reduce confusion among the many types of Medicare supplement policies, federal law requires national standardization of Medigap policies. Insurers must offer a limited number of standardized Medigap plans developed by the NAIC.

Currently, the available plans are A, B, C, D, F, G, K, L, M, and N. Plans E, H, I, and J have been eliminated. In addition, Plans C and F are not available to individuals who became newly eligible for Medicare on or after January 1, 2020.

Plan A includes the “core” benefits (Parts A and B co-payments, 365 additional days of hospitalization, and the first 3 pints of blood). If an insurer sells any Medigap policies in the state, it must offer Plan A.

A Buyer’s Guide and an Outline of Coverage are delivered at the time of application, before accepting any premium payment.

Duties of the Insurance Commissioner

The New Hampshire Insurance Commissioner is an appointed state executive position in New Hampshire state government. The commissioner serves five-year terms, oversees the Insurance Department, and is responsible for enforcing and executing the insurance laws of the state.

The Commissioner is responsible for establishing and enforcing regulations in the New Hampshire insurance market in a manner that protects consumers and encourages economic development.

Those duties include:

  • Investigate all claims and complaints of legal violations relating to insurance.

  • If the Commissioner finds that laws have been violated, the findings and supporting documents may be referred for criminal prosecution.

  • Monitor transactions of all companies including domestic, foreign, and alien insurance companies.

  • Audit the books and records of any resident producer as frequently as necessary.

  • Collect all fees associated with producers and insurers.

  • Determine and administer fines associated with violations for insurers and producers.

  • Issue reports pertaining to the suspension and revocation of licenses of producers and certificates of authority for insurers.

  • Approve documentation used by insurance companies such as forms and rates.

Sidenote
Know this...

The Commissioner does not have the authority to arrest, issue injunctions, or sentence jail time. The Commissioner can start the process, but it takes a law officer to arrest and a judge or court of law to issue injunctions or sentence jail time.

Suspend, revoke or non-renew

The Commissioner has the authority to suspend, revoke, or refuse to renew a license for:

  • Providing false information on the application for an insurance license.

  • Omitting any relevant information on an application that would have disqualified the individual from being eligible to receive a license.

  • Being found guilty of a violation or the noncompliance of insurance regulations and laws…

  • Committing fraud while attempting to obtain an insurance license.

  • Improperly withholding, misappropriating or converting any money or property received in the course of doing insurance business.

  • Providing false information in reference to the terms and conditions of an insurance contract.

  • Having been convicted of a felony.

  • Having admitted or been found to have committed any insurance unfair trade practice or fraud.

  • Having engaged in activities of a fraudulent nature which allowed the person to involve themselves in dishonest, coercive, untrustworthy, and financially irresponsible practices.

  • Having had a prior insurance license revoked or suspended in a state other than New Hampshire.

  • Using another person’s identity and forging their name on an insurance application.

  • Being found guilty of using unethical practices or cheating on an examination for an insurance license.

Cease and desist

If the Commissioner finds that a producer has violated the state’s insurance laws, the Commissioner may order the producer to cease and desist.

A cease and desist order does not suspend or revoke the recipient’s registration. However, it does require the recipient to stop or limit the activity addressed in the order.

Hearing and penalties

A person facing action by the Commissioner is entitled to notice and an opportunity for a hearing, within time limits set by New Hampshire law, and may ask a court to review the final order. In New Hampshire, the Commissioner issues orders upon hearing, with written notice at least 10 days in advance (N.H. Rev. Stat. Ann. §§ 400-A:14, I, 400-A:18, I).

A violation of the insurance laws can bring a civil penalty in addition to action against a license. State law sets the maximum, usually per violation and often with a cap on the total, and a higher tier commonly applies to a violation that was knowing or flagrant. Some violations are also crimes.

Unfair claims settlement practices

Under the NAIC’s model act, these practices are violations when committed flagrantly and in conscious disregard of the law, or often enough to indicate a general business practice.

  • The intentional obstruction and delay of claims payment or the delay of a claims investigation is a violation of regulation.

  • Neglecting to provide a prompt response and written explanation of insurance policy terms, conditions, and laws related to the contract are examples of unfair claims settlement practices.

  • Failure to provide claims without launching a thorough investigation is a violation of regulation.

  • Making settlement claims based on information contained on an application that has been altered without the insured’s consent is a violation of regulation.

  • Denying a claim without conducting a thorough investigation.

  • Attempting to settle a claim for less than fair market value.

Policy forms

Insurers file their policy forms with the Commissioner.

Depending on the line of insurance and the form, a state may require approval before a form is used, often with a period after which a filing that has not been acted on is deemed approved, or may allow the form to be used as soon as it is filed (“file and use”).

If a policy provision conflicts with New Hampshire law, the policy is read as amended to conform to the law.

Record maintenance

A producer keeps records of each transaction (the policies placed, the insureds, the premiums received and any changes) and makes them available for the Commissioner’s inspection.

New Hampshire requires the producer of record, where the insurer does not keep the information, to keep a file for each policy sold for the current year plus 5 years (N.H. Rev. Stat. Ann. § 400-B:3, IV).

Fraudulent producer representation

An insurance producer who represents to the public that they are licensed to conduct insurance business in New Hampshire, but has not passed the appropriate licensing examination, is in violation of regulation.

This includes any public communication, such as advertisements, letterheads, circulars, business cards, and other methods of representation.

A producer found guilty of conducting business in New Hampshire in any line of insurance for which they are not properly licensed may have any other insurance license suspended or revoked.

Misrepresentation

  • Misrepresentation involving the creation or distribution of policies, quotes, and illustrations designed to provide inaccurate information about the terms and conditions of a policy is prohibited.

  • Providing inaccurate or incomplete information or comparisons regarding the benefits of a policy is an example of misrepresentation.

  • Providing inaccurate or incomplete information for the purpose of inducing, or tending to induce, the lapse, exchange, conversion, forfeiture, or surrender of a policy is a violation as well (twisting).

False advertising

Making, publishing or circulating an advertisement, announcement or statement about the business of insurance that is untrue, deceptive or misleading is an unfair trade practice under state law, based on the NAIC’s model act. The medium does not matter: the rule reaches newspapers, magazines, radio and television, and also notices, circulars, pamphlets, letters, posters and any other way of placing the statement before the public. The model act’s test is whether the statement is untrue, deceptive or misleading, not whether the person meant to deceive.

Defamation

Defamation of an insurer is an unfair trade practice under state law, based on the NAIC’s model act: making, publishing or circulating an oral or written statement that is false, or maliciously critical of or derogatory to the financial condition of an insurer, and that is calculated to injure that insurer or any other person engaged in the business of insurance. Spreading an untrue rumor that a competing insurer is about to fail is the classic example.

Boycott, coercion and intimidation

Entering into an agreement to commit, or by concerted action committing, any act of boycott, coercion or intimidation that results or tends to result in unreasonable restraint of, or monopoly in, the business of insurance is prohibited.

False financial statements

In New Hampshire, knowingly filing with a public official, or knowingly making, publishing or circulating, a false statement of an insurer’s financial condition is an unfair practice (N.H. Rev. Stat. Ann. § 417:4, VI), and so is making false or fraudulent statements on or relative to an application for insurance to obtain a fee, commission, money or benefit (N.H. Rev. Stat. Ann. § 417:4, II).

Illegal inducements

Offering anything of value not specified in the policy (money, a service, a favor or a gift) as an inducement to buy insurance is prohibited unless state law expressly allows it, and any agreement made as part of the sale must be written into the policy.

States differ on promotional gifts. The NAIC’s model act lets producers and insurers give customers non-cash gifts, meals or charitable donations up to an amount the state considers reasonable, as long as the gift is not conditioned on buying or renewing a policy and is offered without unfair discrimination. Each state sets its own limit. New Hampshire allows promotional items with a fair market value of $100 or less per consumer per year (N.H. Rev. Stat. Ann. § 417:4, IX(b)(13)).

Unfair discrimination

Unfair discrimination is treating people or risks that present the same hazard differently. The NAIC’s model act, on which state unfair trade practices laws are based, prohibits:

  • Unfair discrimination between individuals of the same class and equal expectation of life in life insurance and annuity rates, dividends, benefits or terms
  • Unfair discrimination between individuals of the same class and essentially the same hazard in health insurance premiums, benefits or terms
  • Refusing, limiting or canceling coverage because of a person’s sex, marital status, race, religion or national origin
  • In property and casualty insurance, refusing or limiting coverage solely because of a risk’s geographic location, unless sound underwriting and actuarial principles justify it, or solely because the applicant or insured is physically or mentally impaired

Many states also expressly forbid refusing or limiting coverage solely because a person is blind or partially blind.

Errors & omissions

Errors & Omissions (E&O) insurance is a type of professional liability insurance that protects insurance agents if they are sued for negligent performance of their duties. E&O covers negligence and unintentional mistakes that cause financial harm to clients. It does not cover intentional misconduct, criminal acts, or regulatory fines.

Children covered as dependents

Under the Affordable Care Act, a plan that offers dependent coverage must make it available to an adult child until age 26, whether or not the child is married, a student or financially dependent on the parent.

State law generally requires a policy that covers dependents to cover a newborn from the moment of birth and an adopted child from placement, and may let the insurer require notice and any added premium within a set period to continue the child’s coverage. Policies also generally continue coverage past the age limit for a dependent child who cannot support themselves because of a mental or physical disability that began before that age.

Rebating

New Hampshire licensed producers are prohibited from directly or indirectly giving any refund, discount, favor, or credit to reduce premiums to induce the purchase of insurance.

Sidenote
Know this...

To “solicit” or “negotiate” insurance implies that the person is licensed.

Sharing commission

The splitting or sharing of commissions with a licensed producer is allowed. Both parties must be licensed in the line of business in which the proposed commission is to be split. Under the NAIC’s model act, a commission may also be paid to an insurance agency, or to a person who does not sell, solicit or negotiate insurance.

Twisting

Providing false information or expressing derogatory ideas about the financial conditions of a competitor company with the intent to lapse or surrender an existing policy is a violation of the law.

Under the NAIC’s model act, twisting is a misrepresentation made to induce a policyholder to lapse, forfeit, surrender, exchange or convert a policy. A false or maliciously critical statement about a competing insurer’s finances, made to injure it, is defamation.

Any written or oral statements used to induce the lapse, termination, exchange, or surrender of an insurance contract based on inaccurate information is prohibited.

Unfair marketing practices

The Insurance Department is responsible for establishing minimum standards for the full and fair disclosure of policy content. The Department also requires the standardization and simplification of the terms used to describe insurance coverage.

Advertising may not involve the following:

  • Any statement or implication that policies are approved, or that the financial condition of a company is endorsed, by any government agency or by any independent group, individual, organization or society, unless that is the fact.

  • Any statements regarding advertising that are false or untrue in reference to the time frame in which claims are paid.

Gramm-Leach Bliley Act (GLBA)

This law repealed the Glass-Steagall Act of 1933, allowing consolidation of commercial banks, investment institutions, and insurance companies. GLBA established a framework of responsibilities for federal and state regulators for these financial industries.

It permits financial services companies to merge and engage in a variety of new business activities, including insurance, while attempting to address the regulatory issues raised by such combinations.

McCarran-Ferguson Act

Federal law signed in 1945 in which Congress declared that the insurance industry would be regulated at the state level. Grants insurers a limited exemption from federal antitrust legislation. Since 2021 the exemption does not cover the business of health insurance, apart from narrow activities such as sharing historical loss data (15 U.S.C. § 1013©).

National Association of Insurance Commissioners (NAIC)

The U.S. standard-setting and regulatory support organization is created and governed by the chief insurance regulators from the 50 states, the District of Columbia, and five U.S. territories.

Through the NAIC, state insurance regulators establish standards and best practices, conduct peer review, and coordinate their regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

NAIC members, together with the central resources of the NAIC, form the national system of state-based insurance regulation in the U.S.

Fair Credit Reporting Act

The Fair Credit Reporting Act (FCRA, 15 U.S.C. 1681) regulates consumer reporting agencies and the use of consumer reports, such as credit reports, MIB records and investigative reports, including in insurance underwriting.

  • When an insurer requests an investigative consumer report, it must disclose that to the consumer within 3 days of the request
  • When an insurer takes adverse action based on a consumer report, it must notify the consumer and identify the reporting agency. The consumer then has 60 days to request a free copy of the report and may dispute inaccurate information

Privacy Act of 1974

The federal Privacy Act of 1974 governs how federal agencies handle personal information. It does not apply to private insurers. An insurer’s use of an applicant’s personal information is governed by the FCRA, the Gramm-Leach-Bliley Act and state insurance privacy law.

In states that adopted the NAIC’s Insurance Information and Privacy Protection Model Act, an authorization to collect personal information signed with an application is valid for no more than 30 months for life, health or disability insurance and one year for property or casualty insurance.

Telemarketing

The National Do Not Call Registry is a list of telephone numbers whose owners do not want to receive telemarketing calls. Telemarketers may not call registered numbers without the person’s permission or an established business relationship, and unsolicited sales calls:

  • May be made only between 8 a.m. and 9 p.m. in the recipient’s local time
  • Must disclose the caller’s identity, the company the caller represents and that the purpose is a sale

CAN-SPAM

A commercial email must:

  • Be identified clearly as an advertisement
  • Carry accurate header information and a subject line that is not deceptive
  • Include the sender’s valid physical postal address
  • Offer a way to opt out, and the sender must honor an opt-out within 10 business days

Granite Advantage

Although it is all Medicaid, states use different names for their medical welfare programs. New Hampshire’s Granite Advantage Health Care Program provides coverage for the newly eligible Medicaid population (RSA 126-AA:3); it is one part of Medicaid, not another name for all of it. Medicaid is a state-administered health care program for those in financial need, funded by federal and state money.

Key points

Licensing

  • Minimum age 18, must be NH resident before applying
  • No specific pre-licensing course required, but must pass exam for line(s) of authority

Pre-licensing course and exam

  • NH has no pre-licensing course requirement
  • Must pass exam per N.H. Rev. Stat. Ann. § 402-J:6, I

Fingerprints/background check

  • Commissioner reviews background before licensing
  • Many states require fingerprints for state/FBI criminal history check

Controlled business

  • Insurance on producer’s own life/property/family/employer/controlled business
  • States restrict licenses used principally for controlled business

Non-resident license

  • Can get NH nonresident license without NH exam if licensed in home state
  • Requires reciprocity, current good standing, application and fees
  • Address change: file within 30 days; moving to new state: apply for resident license within 90 days (no repeat of prelicensing/exam)

Temporary license

  • Issued without exam to keep business serviced (e.g., death/disability of producer, military service)
  • May require licensed sponsor
  • Limited to 180 days under NAIC model

Military service

  • Can request waiver of renewal requirements/exams/fines due to military service or extenuating circumstances (e.g., long-term disability)

Renewal and reinstatement

  • Must renew on schedule (fee + CE)
  • NAIC model: reinstate within 12 months, penalty = double fee
  • NH: reinstate within 24 months, penalty = double fee (N.H. Rev. Stat. Ann. § 402-J:7, III)

Continuing education

  • Required in all states including NH to renew major lines licenses
  • Hours set by state law/insurance department

Notice of change of name or address

  • Report address change within 30 days
  • Report administrative/criminal actions within 30 days of final disposition/initial hearing
  • Must notify regulator before using assumed business name

Company regulations

  • Insurers must be authorized (certificate of authority) by NH Insurance Department
  • Must file charter, financials, meet capital/surplus requirements

Capital and surplus requirement

  • Must maintain minimum capital/surplus to keep certificate of authority
  • Commissioner must revoke license of foreign insurer in unsound/failing condition (N.H. Rev. Stat. Ann. §§ 405:13, 405:14)

Medigap policies

  • Federal law standardizes Medigap plans (NAIC-developed)
  • Current plans: A, B, C, D, F, G, K, L, M, N (E, H, I, J eliminated)
  • Plans C and F unavailable to those newly eligible for Medicare on/after Jan 1, 2020
  • Plan A = core benefits; insurers selling Medigap must offer Plan A
  • Buyer’s Guide and Outline of Coverage given at application, before premium payment

Duties of the Insurance Commissioner

  • Appointed position, 5-year term, enforces state insurance laws
  • Duties: investigate complaints, monitor insurers, audit producer records, collect fees, issue fines, approve forms/rates
  • Cannot arrest, issue injunctions, or sentence jail time (needs law officer/court)

Suspend, revoke or non-renew

  • Grounds include: false application info, fraud, felony conviction, misappropriation of funds, unfair trade practices, prior license revocation in another state, exam cheating

Cease and desist

  • Ordered when producer violates insurance laws
  • Does not suspend/revoke license, but stops/limits specific activity

Hearing and penalties

  • Entitled to notice and hearing; NH requires 10 days written notice (N.H. Rev. Stat. Ann. §§ 400-A:14, I, 400-A:18, I)
  • Civil penalties possible in addition to license action; higher penalties for knowing/flagrant violations

Unfair claims settlement practices

  • Violations when flagrant/frequent: delaying claims, failing to investigate, denying without investigation, using altered application info, settling below fair market value

Policy forms

  • Insurers file forms with Commissioner
  • May require prior approval or allow “file and use”
  • Conflicting provisions read as amended to match law

Record maintenance

  • Producers keep transaction records for Commissioner inspection
  • NH requires records kept for current year + 5 years (N.H. Rev. Stat. Ann. § 400-B:3, IV)

Fraudulent producer representation

  • Illegal to claim licensure without passing exam
  • Applies to all public communications (ads, cards, letterhead)
  • Can result in suspension/revocation of other licenses

Misrepresentation

  • Prohibited: inaccurate policy illustrations, incomplete benefit comparisons, inducing lapse/surrender via false info (twisting)

False advertising

  • Untrue, deceptive, or misleading statements about insurance business are unfair trade practice
  • Applies across all media
  • Test: whether statement is misleading, not intent

Defamation

  • False or maliciously critical statements about insurer’s financial condition, intended to injure, is unfair trade practice
  • Classic example: false rumor of insurer failing

Boycott, coercion and intimidation

  • Prohibited: agreements/actions causing unreasonable restraint or monopoly in insurance business

False financial statements

  • NH: illegal to knowingly file/publish false insurer financial statements (§ 417:4, VI)
  • Also illegal: false statements on applications to obtain fee/commission (§ 417:4, II)

Illegal inducements

  • Cannot offer unlisted value (money, gifts) to induce insurance purchase unless expressly allowed
  • NAIC model allows reasonable non-cash gifts if not conditioned on purchase
  • NH limit: $100 fair market value per consumer per year (§ 417:4, IX(b)(13))

Unfair discrimination

  • Prohibited: differing treatment of same-class/risk individuals in rates/benefits
  • Cannot discriminate based on sex, marital status, race, religion, national origin
  • Property/casualty: cannot deny based solely on geographic location or physical/mental impairment (unless justified)
  • Many states also protect blind/partially blind individuals

Errors & omissions

  • E&O = professional liability insurance for agents
  • Covers negligence/unintentional mistakes causing client harm
  • Does NOT cover intentional misconduct, criminal acts, regulatory fines

Children covered as dependents

  • ACA: dependent coverage available until age 26 regardless of marital/student/financial status
  • State law: must cover newborns from birth, adopted children from placement
  • Coverage continues past age limit for disabled dependents (disability began before age limit)

Rebating

  • NH prohibits giving refunds/discounts/credits to induce insurance purchase
  • Soliciting/negotiating insurance implies licensure

Sharing commission

  • Allowed between licensed producers in same line of business
  • NAIC model allows payment to agencies or non-selling persons

Twisting

  • Misrepresentation to induce policy lapse/surrender/exchange
  • False critical statements about competitor = defamation
  • Prohibited: using inaccurate info to induce contract termination

Unfair marketing practices

  • Insurance Department sets disclosure/standardization requirements
  • Advertising cannot falsely imply government/organization endorsement
  • Cannot make false claims about claims payment timeframes

Gramm-Leach Bliley Act (GLBA)

  • Repealed Glass-Steagall Act of 1933
  • Allowed consolidation of banks, investment firms, insurers
  • Established regulatory framework for merged financial services

McCarran-Ferguson Act

  • 1945 law: insurance regulated at state level
  • Limited antitrust exemption for insurers
  • Since 2021, exemption excludes health insurance (except narrow data-sharing activities)

National Association of Insurance Commissioners (NAIC)

  • Standard-setting body governed by state insurance regulators (50 states, DC, 5 territories)
  • Establishes standards, best practices, peer review, coordinates oversight
  • Forms national system of state-based insurance regulation

Fair Credit Reporting Act

  • Regulates consumer reporting agencies/reports used in underwriting
  • Investigative consumer report: must disclose to consumer within 3 days
  • Adverse action: must notify consumer; consumer has 60 days for free report copy/dispute

Privacy Act of 1974

  • Governs federal agencies’ handling of personal information only (not private insurers)
  • Private insurer privacy governed by FCRA, GLBA, state law
  • NAIC model: authorization valid up to 30 months (life/health/disability) or 1 year (property/casualty)

Telemarketing

  • National Do Not Call Registry restricts calls to registered numbers
  • Calls allowed only 8 a.m.–9 p.m. local time
  • Must disclose caller identity, company, and sales purpose

CAN-SPAM

  • Commercial email must be labeled as ad, have accurate headers/subject
  • Must include sender’s physical address
  • Must offer opt-out, honored within 10 business days

Granite Advantage

  • NH’s Medicaid program name for newly eligible population (RSA 126-AA:3)
  • Part of Medicaid, not synonym for entire program
  • Medicaid = state-administered program funded by federal/state money

Related readings

  • Producer Roles and Receipt Types
  • Underwriting
  • Health Insurance Basics
  • Required Policy Provisions
  • Optional Policy Provisions