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TIN:
SCHEDULE O
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is atwww.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Inspection
Name of the organization
NEW HAMPSHIRE INDIVIDUAL HEALTH
PLAN BENEFIT ASSOCIATION
PLAN BENEFIT ASSOCIATION
Employer identification number
02-0499340
02-0499340
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION WAS ESTABLISHED BY STATE STATUTE TO FACILITATE THE AVAILABILITY OF, AND PROVIDE ACCESS TO, AFFORDABLE INDIVIDUAL HEALTH INSURANCE THROUGH A) THE SUBSIDIZATION OF CARRIERS FOR CERTAIN CLAIMS EXPERIENCED IN THE INDIVIDUAL HEALTH INSURANCE MARKET, AND B) THE PROVISION OF INDIVIDUAL HEALTH INSURANCE TO NH RESIDENTS DECLINED OR UNABLE TO OBTAIN COVERAGE IN THE COMMERCIAL MARKET. |
| FORM 990 | NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN WAS CONTRACTED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO ADMINISTER A FEDERAL HIGH RISK POOL INSURANCE PROGRAM. THE PROGRAM WAS FULLY FUNDED BY THE HEALTH AND HUMAN SERVICES AND FROM PREMIUMS. NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN HAS NO LIABILITY ASSOCIATED WITH THE FEDERAL HIGH RISK POOL FOR COSTS THAT ARE IN EXCESS OF FUNDING. IN JUNE OF 2013 ALL ENROLLMENT WAS TERMINATED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE PLAN WAS TERMINATED EFFECTIVE DECEMBER 31, 2014. THE NEW HAMPSHIRE INDIVIDUAL HEALTH PLAN'S HIGH RISK POOL TERMINATED ITS COVERAGE EFFECTIVE JUNE 30, 2014 AND PAID ALL CLAIMS WHICH WERE INCURRED BEFORE THE TERMINATION DATE UP TO THE CLAIMS SUBMISSION DEADLINE OF JUNE 30, 2015. ADDITIONALLY, FINAL SUBSIDY MECHANISM PAYMENTS WERE MADE IN 2014 AND NO PAYMENTS WERE REQUIRED IN 2015. THERE WERE NO ASSESSMENTS AGAINST ASSOCIATION MEMBERS IN 2015 BECAUSE IT WAS DETERMINED THAT THERE WERE ENOUGH CASH RESERVES TO COVER THE REMAINING CLAIMS AND COSTS REQUIRED TO CONTINUE OPERATIONS UNTIL DISSOLUTION. |
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEERS ARE ON THE BOARD OF DIRECTORS AND PERFORM EXECUTIVE DUTIES. |
| FORM 990, PAGE 2, PART III, LINE 3 | ON SEPTEMBER 30, 2013 THE ORGANIZATION WAS AWARDED A GRANT FROM THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, CENTERS FOR MEDICARE AND MEDICAID SERVICES TO EDUCATE INSURANCE CONSUMERS IN NEW HAMPSHIRE AND PROVIDE THEM WITH ASSISTANCE IN ASSESSING THE BENEFITS AVAILABLE UNDER, AND ENROLLING IN, THE NEW HAMPSHIRE INDIVIDUAL HEALTH BENEFITS MARKETPLACE ESTABLISHED UNDER THE AFFORDABLE CARE ACT. EFFECTIVE MAY 2, 2014 THE ORGANIZATION WAS AWARDED A SIMILAR SECOND GRANT OF 3,218,753 AND ON DECEMBER 17, 2014 THE ORGANIZATION WAS AWARDED A SIMILAR THIRD GRANT OF 3,385,882 TO CONTINUE SUPPORTING THE ESTABLISHMENT OF THE AFFORDABLE CARE ACT THROUGH 2015. IN NOVEMBER 2015, THE ORGANIZATION RECEIVED APPROVAL TO EXTEND UTILIZATION OF SOME OF THE THIRD GRANT PROCEEDS TO JUNE 30, 2016. |
| FORM 990, PAGE 2, PART III, LINE 4A | ..(THIS IS A CONTINUATION FROM PART III, LINE 4A) ENROLLMENT ASSISTANCE TO NEW HAMPSHIRE RESIDENTS EVALUATING COVERAGE THROUGH THE NEW HAMPSHIRE INDIVIDUAL HEALTH INSURANCE MARKETPLACE ESTABLISHED UNDER THE AFFORDABLE CARE ACT. THESE ACTIVITIES ALSO FACILITATED THE TRANSITION OF THE ENROLLEES IN THE STATE HIGH RISK POOL TO THE NEW INDIVIDUAL HEALTH INSURANCE MARKETPLACE. |
| FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION HIRES A MANAGEMENT COMPANY TO RUN ALL OF THE PROGRAMS IN THE HEALTH PLAN. THE BOARD OF DIRECTORS OVERSEES THE OPERATIONS OF THE MANAGEMENT COMPANY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PRESENTED TO THE 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 990 BEFORE IT IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS PART OF THE ETHICS POLICY WHICH REQUIRES THE ORGANIZATION TO PERFORM AN ANNUAL UPDATE AND DISCLOSURE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE HELD IN CARE OF HELMS & CO., CONCORD, NH AND ARE AVAILABLE UPON REQUEST. FORM 990 IS AVAILABLE ON NHHP WEBSITE. |
| FORM 990, PART IX, LINE 11G | ACTUARIAL FEES 5,237 0 0 ADMIN FEES - BMI 167,760 0 0 ADMIN - CAG GRANT 1,778,636 0 0 |
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015
Additional Data
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