NH| The New Hampshire Insurance Department Bulletin INS 26-051-AB, reiterates the statutory floors — a minimum annual individual attachment point of $20,000, and aggregate attachment points set at the greatest of $4,000 per member, 120% of expected claims, or $20,000 for groups of 50 or fewer, and at least 110% of expected claims for groups of 51 or more — while noting the Commissioner may adjust those minimums for medical CPI with at least six months’ advance publication, and that the currently effective administrative-rule figures for small groups are the greatest of $6,200 × covered lives, 120% of expected claims, or $31,000. The bulletin stresses that expected claims must be developed under generally accepted actuarial principles with internal documentation of every component, that an annual actuarial certification signed by an appointed qualified actuary is due each March 15 addressing attachment point minimums, expected claims methodology, declinations, significant renewal increases, and driving factors, that allowable case characteristics are limited to attained age, group size, and industry type, and that mid-year rate changes from shifting case characteristics are prohibited under Ins 4105.04(e). Its central clarification distinguishes “covered employee members” (employees only, used solely to classify small groups of 50 or fewer versus large groups of 51 or more, with no reclassification based on total covered lives) from “covered lives” (employees plus spouses and dependents, used in the small-group per-life attachment calculation, meaning dependents raise the minimum attachment point) and directs carriers to count and document both separately.
Home » Bulletins » New Hampshire clarifies the stop-loss counting rule: group size is set by employees only, but small-group attachment points are calculated on all covered lives — including spouses and dependents.