New Hampshire § 126-Q-1 - Section 126-Q:1 Definitions.

§ 126-Q-1. Section 126-Q:1 Definitions.

In this chapter: I. "Assessable coverage" means: (a) Health coverage as defined in RSA 420-G:2, IX; (b) Stop loss coverage that conforms with RSA 415-H:3, or other group excess loss insurance purchased against the risk that any particular claim, or total liability, will exceed a specified dollar amount; or (c) Group health plan, as defined by 42 U.S.C. 300gg-91(a). II. "Assessable entity" means any: (a) Health maintenance organization, as defined by RSA 420-B:1, VI. (b) Third party administrator, as defined by RSA 402-H:1, I. (c) Entity providing administrator services and required to register with the insurance commissioner under RSA 402-H:11-a or RSA 402-H:11-b. (d) Insurance company licensed pursuant to RSA 401:1, IV. (e) Health service corporation, as defined by RSA 420-A:1, III. III. "Assessable lives" means all children under 19 years of age residing in the state who have assessable coverage written or administered by an assessable entity, with the exception of children whose vaccines and respiratory syncytial virus biological product are paid for under the federal Vaccines for Children program, established under 42 U.S.C. section 1396s. IV. "Assessment" means the assessable entity's liability with respect to childhood vaccines and the respiratory syncytial virus biological product determined in accordance with this chapter. For purposes of rate setting and medical loss ratio calculations, all association assessments are considered pharmaceutical or medical benefit costs and not regulatory costs. In the event of any insolvency or similar proceeding affecting any payer, assessments shall be included in the highest priority of obligations to be paid by or on behalf of such payer. V. "Association" means the New Hampshire vaccine association. VI. "Board" means the board of directors of the New Hampshire vaccine association. VII. "Commissioner" means the commissioner of the department of health and human services. VIII. "Estimated vaccine cost" means the estimated cost to the state over the course of a state fiscal year of the purchase, distribution, and administration of vaccines and the respiratory syncytial virus biological product purchased at the federal discount rate by the department of health and human services. IX. "Provider" means a person licensed by this state to provide health care services to persons or a partnership or corporation made up of those persons. IX-a. "Respiratory syncytial virus biological product" means a respiratory syncytial virus biological product that has been approved by the federal Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention to be added to the Vaccines for Children program and has been authorized by the commissioner of the department of health and human services for administration to children of the state of New Hampshire under the age of 19 years for the purposes of protecting against the respiratory syncytial virus. X. "Total non-federal program cost" means the estimated vaccine and the respiratory syncytial virus biological product cost less the amount of federal revenue available to the state for the purchase, distribution, and administration of vaccines and respiratory syncytial virus biological product. XI. "Vaccine" means any preparations of killed microorganisms, living attenuated organisms, or living fully virulent organisms that are approved by the federal Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and have been authorized by the commissioner of the department of health and human services for administration to children of the state of New Hampshire under the age of 19 years for the purposes of producing or artificially increasing immunity to particular life-threatening and disabling diseases.