New Hampshire Individual Health Plan

“During the year, J. Michael Degnan, Executive Director, and Andrew Luce, CFO, provided services to the Organization through an independent management company, Helms & Company, who appoints individuals to perform these roles. Services provided by the management company include overseeing and managing business and financial operations for the Organization. The Board of Directors selects and approves the management company and provides oversight to the services provided to the Organization. During 2024, compensation paid to the management company by the Organization for these services totaled $410,499 and is reported on Form 990, Part VII, Section B. The amounts of reportable or other compensation received by Mr. Degnan or Mr. Luce for services provided are not known by the Organization.”

“The compostion of the board of directors is established by the following: (I) 3 directors elected by writers of group health insurance; (II) 2 directors elected by writers of individual health insurance; (III) 2 additional directors if elected by both the group health insurance writers and individual health insurance writers; and (IV) 4 directors appointed by the Insurance Commissioner”

“A copy of the Form 990 is presented to the Association Board's Finance Committee before it is filed. The Finance Committee reviews the return for accuracy and reports its findings to the Board of Directors. The Board of Directors approves the Form 990 before it is filed.”

“The conflict of interest policy is part of the ethics policy which requires the organization to perform an annual update and disclosure.”

“Governing documents are held in care of Helms & Company in Concord, NH and are available upon request. Form 990 is available on the NHHP website.”

“In its 2019 session, the New Hampshire Legislature amended Section 12 of the New Hampshire Revised Statutes annotated to permit the New Hampshire Insurance Commissioner, if supported by the recommendation of actuarial experts, to request that the Association propose a plan of operation for risk sharing program, reinsurance program, or other program that will best support the availability and affordability of the individual insurance market in the State. Pursuant to the 2019 statutory amendments and based on the report of his actuarial experts, the Insurance Commissioner issued an order on February 25, 2020 requiring the Association to assess and develop a proposal for a reinsurance program with support of federal funding in the form of shared savings under a state innovation waiver under Section 1332 of the Affordable Care Act. In response to the Insurance Commissioner's order, the Association engaged its management team, in consultation with experts and legal counsel and the Insurance Commissioner, to review the actuarial analysis and determine the components of a proposed state market stabilization program and its anticipated costs and operational procedures and to develop a related Section 1332 waiver application. To document its proposed program pursuant to Section 12 of this statute, the Association adopted a second amendment to its Amended and Restated Plan of Operation (the "Second Amendment") on March 11, 2020. During 2020, all of the conditions to the implementation of the proposed program known as the "New Hampshire Reinsurance Program" (The "Reinsurance Program") were met, including federal agency approval of the State's Section 1332 waiver application and its projected "pass-through savings." On September 30, 2020, the Insurance Commissioner issued a supplemental order directing that the Association, as administrator of the reinsurance program, receive the federal grant monies under the Section 1332 waiver. The Association adopted a third amendment to its Amended and Restated Plan of Operation (the "Third Amendment") on October 20, 2020, which allows and directs the Association to become the grantee of record under the Section 1332 waiver. The reinsurance program commenced operation on January 1, 2021, and is administered by the Association. The Reinsurance program reimburses issuers who offer comprehensive, major medical plans in New Hampshire's individual market that are part of the single-risk pool. Payments to carriers are to be calculated based on a percentage (Coinsurance percentage) of the annual claims that issuers incur for coverage under such plans between a specified lower threshold (attachment points) and under threshold (reinsurance cap). The reinsurance parameters are to be determined each year by the Insurance Department by March 31st of the prior year based on recommendations of the board of directors of the Association and the Commissioner of the NH Department of Insurance. The Amended and Restated Plan of Operation, as further amended, requires that all funding collected for the reinsurance program will be paid out (for payments to issuers and for program administration) for the year for which it is collected, but no additional state funds will be provided for the reinsurance program. The Association's obligation to make payments to issuers under the reinsurance program is limited to the extent of funding received by the Association in connection with the reinsurance program. The State of New Hampshire initially was granted a Section 1332 Waiver under the Affordable Care Act, with the Association designated as the grantee responsible for its administration. The Waiver had an expiration date of December 31, 2025. In 2024 the Association filed an application with, and received from, the Centers for Medicare & Medicaid Services (CMS) an extension of the Section 1332 Waiver, ensuring the continued operation of the Reinsurance Program through December 31, 2030 absent subsequent federal administrative o”

“During the year, the Organization undertook a "Ground Ambulance Study" on behalf of the State of New Hampshire. Please see Form 990, Part III, line 4c for additional information related to this initiative.”