IRS 990 Nonprofit Profile

New Hampshire Individual Health Plan Benefit Association

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 or legislative changes. in 2024, the association consolidated all prior amendments to its amended and restated plan of operation and made additional amendments to conform to the revisions to rsa 404-g (which became effective january 1, 2024) by replacing its amended and restated plan of operation with a second amended and restated plan of operation (sometimes referred to as the "second restated plan"). the second restated plan, as subsequently amended, governs the association's administration of each of its programs. the association received exemption for the irs as a tax exempt social service organization as described under section 501(c)(4) effective june 24, 2021.

Filing year

2024

Total revenue

$68.2M

Total expenses

$68.2M

Program expenses

$67.9M

Administration

$305K

Fundraising

$0

Program share of expenses

100%

EIN

20499340

Location

Concord, NH

www.nhhp.org