[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6542572,"mediaKeyId","3425751-8442a4b4ff7f5f2e1bff293f0664da65","parentId",3425751,"title","Subcommittee debates moving municipal risk pools to insurance regulation amid solvency and disclosure concerns","audioSeconds",4116,"startMs",1059000,"endMs",5175000,"viewUrl","/Search/View?dp=1&key=3425751-8442a4b4ff7f5f2e1bff293f0664da65&start=1059&end=5175","thumbnailUrl","https://assets.pipeline.soar.com/3425751-8442a4b4ff7f5f2e1bff293f0664da65/thumbnail_1059000.jpg","articleUrl","/articles/6542572/New-Hampshire/Subcommittee-debates-moving-municipal-risk-pools-to-insurance-regulation-amid-solvency-and-disclosure-concerns","mediaUrl","https://secure.pipeline.soar.com/6542572-affc423fbb86049ab143cbe125696146/orig.mp4?Expires=1770996892&Signature=FVmGrr4nquoFh3kvwlenzsPz1WjLS10VKJtaa-YiR7~cIf7za642MacqaDeKV3DSKAtSmhwyKokZ-TWIDbWDFGl-H6S-awoN6L25kRSaKRgRRyQ1HylzQbrEThPWc4HXCRpvVxFwF8EvmN130j6thdj5gGtZLh4nUHqGpFRaM1PsoFwZeo~oIR~WHVjOIOZWLIdd-CsEHx4IXEJNyjSmH676UF2-0ZB6D9e4O5QSF~IC4ZwSoXLafAUrQZyk36rqEifAAN2lYesNS8FBVzimN96XD1~m-A26cvd3QxEZw5-Vr4~XOIRBlfFcEsnzH9cAtNMajodEtimwRm9X7KL0AQ__&Key-Pair-Id=KUT5TJCACFTXG","author","New Hampshire Legislature","date","2025-05-21T00:00:00Z","article","The Commerce and Consumer Affairs subcommittee on Senate Bill 297 spent a lengthy session weighing whether pooled public-entity risk programs — municipal and school “risk pools” — should be regulated under an insurance licensure model rather than the Secretary of State’s statutory model.

The question before members was whether an amendment (referred to in session as the Carson amendment) that places pooled risk-management programs under the Department of Insurance and subjects them to licensure, reporting and solvency rules should replace the Senate version of SB 297. The hearing drew officials from risk pools, Department of Insurance staff and municipal officials.

The issue matters because the bill would change who enforces financial and consumer protections for programs that provide health and other benefits to towns, schools and counties. Those programs manage taxpayer dollars and, if undercapitalized, can produce midyear assessments that local budgets cannot easily absorb.

Department of SchoolCare executive director Lisa Duquette told the panel she was concerned the amendment’s language “seems to allow commingling of public entity risk funds,” citing past problems when different program funds were subsidized from other lines. Duquette also raised licensing and producer‑license language that, she said, could require individuals who merely provide information to be treated like insurance producers: “It seems…we would need to go through a, study process, an examination process, and we\u0000\u0000\u0000'd all receive producer licenses.”

Insurance Department staff answered detailed questions on the draft language. The department said the pooled risk programs themselves would be exempt from individual producer licensing but that third-party sellers would need producer licenses; the department described licensure as a standard regulatory tool that enables administrative oversight, corrective orders and, ultimately, license denial or nonrenewal for noncompliance. The Department also explained why its draft uses statutory (insurance) accounting principles, why it includes a March 1 deadline for financial statements to fit the department’s analysis cycle, and why it preserved confidentiality language drawn from RSA 5‑b to protect medical- and claims-related data in smaller pools.

HealthTrust, the largest risk pool discussed, told the committee the Senate bill as passed would not allow its operating model to continue. Scott Daroach, executive director of HealthTrust, said the Senate bill “explicitly does not allow our model to exist” and that, as written, HealthTrust’s board had voted it would not issue coverage if the Senate language became law. Daroach described a multi‑year rebuild plan: the trust returned about $57 million in surplus after COVID-era claims patterns, booked a low reserve point two years ago and has since rebuilt roughly $10 million in the first year of a rebuild and more than $10 million this year.

HealthTrust testified that its actuaries recommend a higher capital target than the Senate bill’s reserve band and said the Carson amendment’s approach — which uses an RBC‑style framework and allows higher reserve multiples — would permit models with “non‑assessable” policies (where the pool holds the risk rather than towns being subject to surprise midyear assessments) to continue operating under regulation.

Municipal officials warned about the practical effect of assessments. Tara Tucker, chief of police in Greenland, told the committee many New Hampshire towns are small and could not absorb surprise assessments or risk losing group coverage: “If we don’t have the health trust or if it ends up being this other type of situation…we are not going to be able to afford that.” Several lawmakers pressed both sides on whether the Department of Insurance or the Secretary of State should regulate pooled risk entities and whether an incremental or study approach would be preferable. Representative Miles and others suggested delaying any transfer or creating a study committee to review the details; others supported moving to an insurance licensure model now to address solvency expertise.

Committee staff and members asked for followup information from both the Department of Insurance and the Secretary of State’s office on several precise topics, including: whether and how the department would enforce filing requirements and what penalties or administrative steps would follow noncompliance; how the proposed confidentiality language interacts with RSA 91‑A (the Right‑to‑Know law); the fiscal cost of administrative examinations if charged to programs; the meaning and practical effect of aggregate versus specific excess insurance requirements; and the accounting framework (statutory vs. GAAP) for filings.

No formal vote was taken. Members discussed procedural options — advancing the amendment, retaining the bill for further work, or asking for a delay of any transfer — and the committee agreed to reconvene with a draft amendment and additional responses next Tuesday. Several members indicated they might file a minority report if they want the original Senate language considered separately on the floor.

Why it matters now: committee members said the urgency comes from recent insolvency and receivership events in New Hampshire pooled risk programs and a desire to avoid a repeat of prior costly legal and fiscal outcomes. Several witnesses, including the Department of Insurance and risk pool executives, told the committee they were willing to continue negotiations but wanted clearer statutory or rule authority before any transfer of oversight took effect.

Next steps: the Department of Insurance will provide written followups and the draft amendment for the committee’s next meeting; the subcommittee plans to consider retention or a vote after those materials are available.

","mediaType","Video","parentTitle","House Commerce and Consumer Affairs (05/21/2025)","oneSentenceSummary","The Commerce and Consumer Affairs subcommittee on Senate Bill 297 spent a lengthy session weighing whether pooled public‑entity risk programs should be regulated under an insurance licensure model rather than the Secretary of State’s statutory model.","taxTitle","Commerce and Consumer Affairs, House of Representatives, Committees\t, Legislative, New Hampshire","taxId",17743,"location","New Hampshire","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6542567,"Department outlines two‑year compromise to ban ambulance balance billing, set temporary rates and launch deeper cost study",1720,7240000,8960000,"/Search/View?dp=1&key=3425751-8442a4b4ff7f5f2e1bff293f0664da65&start=7240&end=8960","https://assets.pipeline.soar.com/3425751-8442a4b4ff7f5f2e1bff293f0664da65/thumbnail_7240000.jpg","/articles/6542567/New-Hampshire/Department-outlines-twoyear-compromise-to-ban-ambulance-balance-billing-set-temporary-rates-and-launch-deeper-cost-study","https://secure.pipeline.soar.com/6542567-f246d145ee43650fc1c9e640a0db7d2d/orig.mp4?Expires=1770996892&Signature=gN5W8tastqvvg05wb4rBjoIpY-yijQkKlV~NBLlofXKdJCUZAeZVw7KNsZ3omtAaLEBYzKXrGlBWWwpvuVAfaLs0f7B3VBHDdmbEF5VSD~NgDT~9t42fTB0OEVVb7Ri6nOXeVmYFpqZPHwKIgIRsR67Ocx~YxNEyudCaSvs6pMpF7QDVoLd~KMpsfx4qwl0y2AO8zhLVC2uEyVxocaQFGYYh0FUigE~pbDE5DxYajV5MgWoAjVEF3AyAx6JbdGCBOpTIGgOnYSH4YSnTv6p8cHunEw4czIuTNbUkD-VNxnrF2UmcWGjT~Ex~rkAYfWUWjULOksmcc8LYxeTKNSMPng__&Key-Pair-Id=KUT5TJCACFTXG","The subcommittee heard a compromise plan from Department of Insurance staff intended to end surprise ambulance balance bills while stabilizing emergency medical services (EMS) providers.

Under the outline presented, balance billing would be prohibited. A temporary two‑year rate structure would apply while the department conducts an expanded cost study and prepares rulemaking for a permanent rate: an in‑network payment set at 325% of Medicare and an out‑of‑network benchmark at 100% of Medicare. To encourage providers to contract with carriers, the draft would include an “any willing ambulance provider” provision and a standardized provider contract for use in negotiations.

Department staff said the in‑network rate would be available once providers file required paperwork with a carrier and copy the department; carriers would have roughly 45 days to finalize the contract after receiving complete materials. Providers would have 60 days to respond to carrier requests for additional information or they revert to the out‑of‑network rate until they reengage. The department will track negotiations and can take enforcement action where carriers or providers do not proceed in good faith.

The plan also calls for a second, deeper cost study that would take longer than the department’s initial study this year and allow additional stakeholder collaboration and data verification. The department said the initial study was constrained by time and that a more detailed study should better capture provider cost nuances across municipal, private and volunteer providers. After the second study, rates would be set through rulemaking and thereafter adjusted annually for health care inflation.

Department staff framed the compromise as a two‑part win: immediate consumer protection from surprise bills and a two‑year stabilization and analytic period so EMS providers can examine business models and negotiate network contracts. “For the first time in 40 years, we've put forward something that stops some immediate problems and puts in place a process to which we can get to a permanent sustainable solution to these issues,” a Department representative told the committee.

Lawmakers asked practical questions about implementation. Representative Gibbs said contracts and network participation historically reduce administrative friction and questioned how the compromise would incentivize providers to join networks; the department responded that being in contract reduces overhead and the uncertainty that leads to billing disputes. Representative Sharissa asked about the new cost study and why it was needed when the department produced an earlier study; department staff said the vendor for the earlier study worked under a tight deadline and the new study would have more time to validate data, audit submissions and incorporate provider feedback.

The subcommittee did not take a vote. The Department of Insurance will draft the amendment reflecting the compromise language and provide it to the committee before the next meeting; members plan to resume consideration next Tuesday.

","The Department of Insurance presented a negotiated compromise to prohibit ambulance balance billing and adopt temporary in‑network and out‑of‑network rates while a second, more detailed cost study is completed. The amendment will be drafted and returned to the subcommittee next week; no formal vote was taken.","actionData","errors"]

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Subcommittee debates moving municipal risk pools to insurance regulation amid solvency and disclosure concerns

Department outlines two‑year compromise to ban ambulance balance billing, set temporary rates and launch deeper cost study