431:10-207

Alteration of application

[§431:10H-207] Premiums charged–group and individual policies. (a) The premium charged to an insured shall not increase due to either:

(1) Increasing age of the insured at ages beyond sixty-five; or

(2) The duration the insured has been covered under the policy.

(b) The purchase of additional coverage shall not be considered a premium rate increase, but for purposes of the calculation required under section 431:10H-233, the portion of the premium attributable to the additional coverage shall be added to and considered part of the initial annual premium.

© A reduction of benefits shall not be considered a premium change, but for purpose of calculation required under section 431:10H-233, the initial annual premium shall be based on reduced benefits. [L 1999, c 93, pt of §2];

(3) The premium for the policy shall be paid either from the association’s own funds or from charges collected from the insured members specifically for the insurance, or from both. Any charges collected from the insured members specifically for the insurance, and the dues of the association if they include the cost of insurance, may be collected through deductions by the employer from the salaries of the members. The deductions from salary may be paid by the employer to the association or directly to the insurer. No policy may be placed in force unless and until at least seventy-five per cent of the then eligible members of the association, excluding any as to whom evidence of individual insurability is not satisfactory to the insurer, have elected to be covered and have authorized their employer to make the required deductions from salary, or have otherwise assigned pay or arranged for payment of their individual contributions to the association. Except as provided in paragraph (4), a policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance shall insure all eligible members, except those who reject such coverage in writing;

(4) An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer;

(5) Charges collected from the insured members specifically for the insurance, and the dues of the association if they include the cost of insurance, may be determined according to each attained age or in not fewer than four reasonably spaced attained age groups. This provision, however, shall not preclude an average rate for the whole group with charges to the individual members based on a schedule of insurance graded by rank, salary bracket, or by length of service or seniority;

(6) The policy shall cover at least twenty-five persons at date of issue; and

(7) The amounts of insurance under the policy shall be based upon some plan precluding individual selection either by the members or by the association.

As used in this section, “public employees” means employees of the United States government, any state, any political subdivision, instrumentality, department, bureau, board, or commission of the United States government or any state, or the national guard as an association in nature under its existing form. [L 1987, c 347, pt of §2; am L 2004, c 122, §50]