CHAPTER Ins 1800 CONTINUING CARE RETIREMENT COMMUNITIES
Statutory Authority: RSA 400-A:15; RSA 420-D:17
PART Ins 1801 PURPOSE AND SCOPE
Ins 1801.01 Purpose. The
purpose of this chapter is to implement RSA 420-D wherein the general court has
provided for the regulation of continuing care retirement communities in order
to protect the older citizens of the state.
Source. #4666, eff 8-22-89; ss by #5654, eff 7-1-93;
ss by #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
Ins 1801.02 Scope.
This chapter shall apply to all
continuing care retirement communities.
Source. #4666, eff 8-22-89; ss by #5654, eff 7-1-93;
ss by #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1802 DEFINITIONS
Ins 1802.01 Definitions.
(a) For the purposes of this chapter, the
definitions appearing under RSA 420-D:1 shall apply whenever any word or phrase
defined under RSA 420-D:1 is used in this chapter.
(b) With
respect to the following words or phrases used in this rule, but which are not
defined under RSA 420-D:1, the following
definitions shall apply:
(1) "Escrow date", as used in RSA
420-D:10, IV, means the date entrance fees subject to RSA 420-D:10 are placed
in an escrow account pursuant to RSA 420-D:10, I.
(2)
"Continuing Care Retirement Community (CCRC)" means any facility
or other entity providing continuing care and soliciting
(3)
"General court" means the assembled senate and house of
representatives of the state of
(4)
"Health care provider" means any physician, hospital, nursing
home, visiting nurse association or any other institution, organization or
person who furnish health care services as defined in RSA 420-C:2.
(5) "Major
changes", for the purposes of RSA 420-D:7, II(c), means any change in or
affecting the operation of the CCRC which causes or is estimated to cause an
increase or decrease of 10 percent or more in any line item appearing on either
the balance sheet, statement of income and expenses or the statement of changes
in financial position submitted as part of the CCRCs annual report required by
RSA 420-D:7, I. The term does not include an increase or decrease in any line
item of less than $1,000, the percentage increase or decrease notwithstanding.
(6)
"Market value" means, with respect to any security or other
asset which is tradable on a recognized financial exchange, the closing price
as of the last day the security or other asset was traded on the exchange where
the majority of trading in the security or other asset takes place.
(7)
"National Association of Insurance Commissioners (NAIC)" means
the organization of insurance regulators from the 50 states, the
Source. #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1803 CERTIFICATE OF AUTHORITY
Ins 1803.01 Application Procedures.
(a) All CCRCs
seeking a certificate of authority shall file an application on insurance
department form Ins-CCRC-2, described in (c) below.
(b) In addition
to the information specified by the application form described in (c) below,
the following additional
information or supporting material shall accompany each application:
(1) The
disclosure statement as described under RSA 420-D:4 and Ins 1808;
(2) A statement
indicating any other state or federal licensure or certification which the
continuing care facility may have or be required to have and the current status
of such licensure or certification;
(3) The
appropriate application fee pursuant to Ins 1809; and
(4) Notarized
documents, which shall include the name, address, telephone number and
principal business activities of the escrow agent, indicating that an escrow
account for entrance fees has been established, when RSA 420-D:10 requires an
escrow account for these fees.
(c) The applicant
shall provide the following on Ins-CCRC-2:
(1) The name of
the continuing care facility;
(2) The type of business organization of the
continuing care facility;
(3) Under which
state's laws the facility is organized:
(4) The
facility's home address, if within the
(5) The
principal mailing address;
(6) Whether the
department ever issued a temporary certificate of authority to the applicant
and, if yes, the date of expiration;
(7)
Certification that the applicant, if issued a certificate of authority,
will abide by the applicable rules of the department;
(8)
Certification that the applicable requirements of RSA 420-D have been
met;
(9) Whether the
license or authority of the CCRC facility, or affiliated facility of a
controlling organization, has ever been revoked, suspended or canceled in any
jurisdiction;
(10) Whether
any previous application of the CCRC facility, or affiliated facility of a
controlling organization, for a license or authority has been denied in any
jurisdiction;
(11) If an
affirmative answer is given to the information requested in (9) or (10) above,
the details of any revocation, suspension, cancellation or denial; and
(12) Authorized
signature indicating that, to the best of the signer's knowledge and belief,
the information in the application is true and complete.
(d) A biographic affidavit pursuant to the
provisions of Ins 1811.01.
(e) The commissioner shall act upon applications
received within a reasonable time, as set forth in RSA 541-A:29,II(a).
(f) CCRCs who have applications pending shall
keep their application and any accompanying information or supporting material
current, and file any amendments or other changes on a timely basis.
(g) Any applicant whose application is rejected
shall be entitled to a hearing in accordance with the provisions of RSA 541,
RSA 541-A and rule Ins 200 and shall be so notified.
Source. #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
Ins 1803.02 Revocation or
Suspension.
(a) The commissioner shall not revoke or suspend
a certificate of authority issued to any CCRC except upon notice and hearing and
written findings of fact that one or more of the conditions specified in RSA
420-D:5,I exist.
(b) Any hearing which the commissioner shall
convene in order to exercise the power granted by RSA 420-D:5 shall be
considered as an "adjudicative proceeding" as defined under RSA
541-A:1, I.
(c) Such proceedings shall be governed by the
following:
(1) In
proceeding against any CCRC for the purpose of revoking or suspending its
certificate of authority, the commissioner shall provide the CCRC with reasonable
notice of hearing. Such notice of hearing shall be in accordance with RSA
541-A:31, III and rule Ins 200.
(2) Hearings
conducted pursuant to RSA 420-D:5 and this section shall be conducted pursuant
to all relevant provisions of RSA 541-A and rule Ins 200.
(3) Any
prehearing conferences shall be held pursuant to rule Ins 203.05; and
(4) The
findings of the hearing officer and any order upon such findings shall be made
pursuant to RSA 541-A:35 and rule Ins 203.09.
(d) When the
commissioner finds that public health, safety or welfare requires emergency
action, the commissioner, as authorized under RSA 541-A:30, III shall order an
immediate suspension of a certificate of authority. In so doing, the
commissioner shall proceed according to Ins 203.02.
(e) Requests
for rehearings shall be made in writing and shall be made pursuant to the
provisions of RSA 541. All appeals from orders issued by the hearing officer
shall be made pursuant to the provisions of RSA 541.
Source. #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART
Ins 1804 ANNUAL REPORTS
Ins
1804.01 Annual Reports.
(a) Each CCRC who uses the calendar year as its fiscal
year shall submit a report on or before May 1 of each year, detailing its
fiscal status as of the close of business on December 31 of the just completed
calendar year.
(b) Each CCRC who uses an annual period other
than the calendar year as its fiscal year shall submit a report detailing its
financial status as of the close of business on the last day of its fiscal year
within 120 days after the close of the fiscal year.
(c) CCRCs holding one or more certificates of
authority shall file separate annual statements for each certificate held.
(d) The annual report required from each CCRC
pursuant to this section shall include the following:
(1) The most recent disclosure statement of the
CCRC as required under RSA 420-D:4.
(2) Financial statements audited by an
independent certified public accountant, which shall contain for 2 or more
annual periods, at a minimum, the following information:
a. A balance sheet;
b. A statement of income and expenses;
c. A statement of equity or fund balances;
d. A statement of changes in financial position;
e. The accountant's opinion; and
f. All notes to the financial statements
considered customary or necessary to full disclosure and adequate understanding
of the financial statements, the financial condition of the facility, and the
operation.
(3) For the first full fiscal year wherein the
CCRC has been occupied by one or more residents and for every two years
thereafter, an actuarial report, including a balance sheet and statement of
operations, prepared in accordance with the “Actuarial Standard of Practice No.
3, Practices Relating to Continuing Care Retirement Communities” adopted July,
1994 by the American Academy of Actuaries’ Actuarial Standards Board; and
(4) If applicable, a statement of entrance fee
escrow account balances which shall include the following:
a. The date on which the just completed fiscal
year ended;
b. The name of the provider;
c. The city or town in which the provider is
located;
d. The escrow account balances as of the
beginning of the fiscal year;
e. The escrow payments received during the
fiscal year;
f. Interest credited to account balances;
g. Payments made to residents, prospective
residents or beneficiaries;
h. Interest released to the provider;
i. Entrance fees earned; and
j. The escrow account balances as of the end of
the fiscal year.
(e) Upon written notice to the CCRC, the
commissioner shall require the CCRC to submit any one or more of the financial
statements listed under (d) above on a more frequent basis than annually, when any of the following conditions
apply:
(1) The annual reports for the most recently
completed fiscal year show that the CCRC operated a loss greater than 5 percent
of the monthly maintenance fees received;
(2) The annual reports for the most recently
completed fiscal year showed a total surplus equal to less than 10 percent of
total assets;
(3) The annual reports for the most recently completed
fiscal year estimated a loss for the succeeding year greater than 5 percent of
the estimated monthly maintenance fee revenues;
(4) The annual reports for the most recently
completed fiscal year showed a decrease in assets of more than 5 percent or an
increase in liabilities of more than 10 percent; and
(5) An audit conducted by the commissioner
results in a change in surplus of 25 percent or more.
(f) Upon written notice to the CCRC, the
commissioner shall require the CCRC to submit any journals, ledgers or other
records which serve as back-up material for any one or more of the financial
statements listed under (d) above. The
commissioner shall make such requests whenever it is necessary to verify the
accuracy of the financial statements included as part of the CCRCs annual
report.
(g) To be considered complete upon submission,
the financial statements listed under (d) above shall include complete answers
to all general interrogatories and all notes to the financial statements which
are considered customary or necessary to full disclosure and adequate
understanding of the financial statements, the financial condition of the CCRC,
and the operation.
(h) The financial statements required by (d) (3) above shall be accompanied by a statement
of actuarial opinion indicating whether the data and assumptions used are
appropriate, whether the methods employed are consistent with sound actuarial
principles and practices and whether provision has been made for all actuarial
liabilities and related statement items which ought to be established.
(i) The actuarial opinion shall also contain
appropriate comment on the CCRCs perceived ability to operate the CCRC as a
going concern and the impact of any actuarial deficit. If the actuary is unable to form a needed
opinion, or if the opinion is adverse or qualified, the statement of actuarial
opinion shall specifically state the reason.
The actuarial opinion shall be rendered by a qualified actuary as
defined in Ins 901.04.
Source. #7014, eff 7-1-99; amd by #7994, eff 12-1-03;
ss by #8991, eff 10-1-07
PART Ins 1805 LIQUID RESERVES
Ins 1805.01 Liquid Reserves.
(a) When a CCRC
calculates whether the value of its liquid reserves meets the amount RSA
420-D:8 requires, the CCRC may include the values of the assets listed below:
(1) Cash held
in an interest-bearing account of a financial institution;
(2) The
following assets that can be liquidated, based upon the net value after
liquidation:
a. Certificates
of deposit issued by a financial institution;
b. Money-market
funds issued by an "investment company" as defined by U.S.C. Title
XV, Section 80a-3;
c. Acceptable
negotiable securities which shall include only United States government
obligations and corporate debt obligations rated AA or AAA in Moody's or
Standard and Poor's corporate bond rating publication or a 1 or 2 rating by the
NAIC valuation of securities publication; and
d. Commercial
paper in the form of promissory obligations of an issuer with an original
maturity date not exceeding 9 months from the date of issuance, having the
highest rating in a rating publication indicated in c. above.
(b) For the
purpose of determining whether the assets included in the liquid reserve
account of a CCRC satisfy the liquid reserve requirement of RSA 420-D:8, such
assets held in the form of cash shall be valued at their actual value in U.S.
currency. Assets held in any other form shall be valued at their market value.
(c) For the purpose
of determining the amount of the liquid reserve that a CCRC shall maintain, the
term "12 months principal and interest payments" appearing in RSA
420-D:8 means the CCRCs liabilities which would be reported to show the
statutory liquid reserve as of the end of current year on the balance sheet
that would be included with the actuarial report, as required by Ins 1804, as
if an actuarial report had been prepared for the 12 calendar months ending on
the last day of the previous month.
(d) For the
purpose of determining the amount of the liquid reserve that a CCRC shall
maintain, the term "that portion of 2 months' operating expenses which
relates to life care residents" appearing in RSA 420-D:8 mean those
expenses which are reported on Schedule K of the annual statement blank
required by Ins 1804 and which would be included in the amount of the estimated
expenses for the 2 calendar months following the current month.
(e) The liquid
reserve required at any point in time shall be the sum of the amounts determined
in accordance with (c) and (d) above. This amount shall be referred to as the
minimum liquid reserve.
(f) The
commissioner shall require placement of the liquid reserve in an escrow account
whenever the commissioner finds through an audit or examination that a CCRC is
experiencing financial difficulty.
(g) For the
purpose of this provision, financial difficulty includes, but shall not be
limited to, any one or more of the following circumstances:
(1) Payments on
accounts payable or notes payable being made on average 45 days or more after
the due date;
(2) A major
supplier places the CCRC on a C.O.D. basis;
(3) A tax lien
is filed against the CCRC;
(4) 50 percent
of accounts receivable, except Medicare or Medicaid, average more than 45 days;
(5) Expenses
exceed revenues for 3 or more consecutive months.
(h) All such
escrow accounts shall comply with the rules for entrance fee escrow accounts as
set forth under Ins 1807. In the course of establishing an escrow account,
the CCRC shall advise the commissioner as to the name, address, telephone
number and principal business activities of the escrow agent. The CCRC shall
notify the commissioner of any subsequent change in escrow agent by providing
the name, address, telephone number and principal business activities of the
new escrow agent within 5 business days.
Source. #7014, eff 7-1-99, EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1806 PROCEDURES FOR OBTAINING AND EXTENDING LIENS
Ins 1806.01 Procedures for Obtaining and Extending
Liens.
(a) The
commissioner shall file a lien on all real and personal property of a CCRC
whenever the commissioner has evidence
showing that the CCRC has breached its contracts with residents or is engaged
in activity which is harmful to residents' physical or mental well-being. Any
such lien shall be filed and administered in accordance with all applicable
laws respecting such liens.
(b) When the
commissioner forecloses a lien, the commissioner shall prepare a plan to
distribute any proceeds from the
foreclosure in a manner that will best permit the satisfaction of any resident
contracts in effect at that time. The commissioner shall give a written copy of
this plan to each contractholder affected by the foreclosure, and shall allow
contractholders to comment on the plan before the commissioner distributes any
proceeds. The commissioner shall allow affected contractholders to submit
comments for a period of at least 15 days after the date on which the
commissioner mailed copies of the plan.
(c) With
respect to the lien property, liens established by the commissioner shall not
have priority over mortgages, security
agreements, lease agreements, or installment sales agreements on property not
otherwise encumbered which a CCRC has entered into with an issuer of bonds or
notes and bonds which are secured by resolution, ordinance, or indenture of
trust if such mortgages or agreements were duly recorded at least 4 months
prior to the institution of rehabilitation or liquidation proceedings.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1807 ENTRANCE FEE ESCROW ACCOUNTS
Ins 1807.01 Entrance Fee Escrow Accounts.
(a) Escrow
accounts established to hold entrance fees pursuant to RSA 420-D:10, I or
accounts required by the commissioner to hold liquid reserves, shall comply
with each of the following:
(1) Escrow account
funds shall be kept and maintained in an account separate and apart from the
business account(s) of the CCRC;
(2) All escrow
account funds derived from entrance fees shall remain the property of the
resident, prospective resident, or other person making payment on behalf of a
resident or prospective resident and shall not be subject to any liens or
charges by the escrow agent, or judgments, garnishments, or creditor's claims
against the CCRC, until the funds have been released to the CCRC as provided in
RSA 420-D:10, III;
(3) Interest in
an escrow account may be released to a CCRC when any portion of the
corresponding entrance fee is released to the CCRC or when the resident makes
his or her first monthly payment, whichever occurs first;
(4) All records
pertaining to the escrow account shall be available for inspection or audit by
the commissioner at any time;
(5) Any CCRC
that establishes an escrow account with an escrow agent shall enter into a
written agreement with the escrow agent which:
a. States that
its purpose is to protect the resident or prospective resident;
b. Authorizes
the commissioner to inspect the records of the escrow agent relating to the
escrow account; and
c. Provides
that, upon order of the commissioner or a court of competent jurisdiction, the
escrow agent shall release and pay over the funds, or a portion thereof, to the
CCRC, resident, prospective resident, or other person entitled thereto as
ordered;
(6) A copy of
each escrow agreement entered into by the CCRC shall be filed with the
commissioner for approval; and
(7) Any
interest payable on entrance fees placed in escrow pursuant to RSA 420-D:10, I
shall be paid at a rate of interest equal to the rate then charged member banks
by the Federal Reserve Bank, plus one percent.
(b) The release
of any funds from an escrow account pursuant to RSA 420-D:10, III shall be
subject to the following:
(1) When the
escrow agent releases funds to a CCRC, the agent shall adhere to the
requirements of RSA 420-D:10, III; and
(2) Upon the
release of any funds from an escrow account to either a CCRC or the resident or
to another person who paid an entrance fee on behalf of a resident, the escrow
agent shall obtain a signed and dated receipt from the person receiving the
funds. If the funds released exceed $10,000, a notary public or a justice of
the peace shall witness the receipt.
(c) In lieu of
maintaining entrance fee payments in escrow accounts, a CCRC may, upon the
commissioner's approval, post bond, negotiable securities, or a letter of
credit, with the commissioner.
(d) Approval of
the commissioner shall be subject to the following conditions:
(1) The
institution providing the bond or the letter of credit shall be acceptable to
the commissioner. In the case of a letter of credit, the institution issuing
the letter of credit shall be a qualified
(2) The amount
of the bond, negotiable securities, or line of credit specified in the letter
of credit shall be set by the commissioner as provided in (5) below;
(3) Negotiable
securities posted in lieu of escrow shall, for the purpose of determining if
they satisfy the amount set by the commissioner, be valued at 75 percent of
their market value. After posting the initial negotiable securities, the CCRC
shall be responsible for monitoring the market value of the negotiable
securities on deposit;
(4) Should the
negotiable securities on deposit at any time be valued at less than 133.3333
percent of the amount required, the CCRC shall post additional negotiable
securities as required so that the negotiable securities posted shall at all
times be equal to 133.3333 percent of the amount required. Negotiable
securities posted shall be securities that are tradable on the New York Stock
Exchange, the American Stock Exchange or other comparable securities exchange;
(5) In setting
the initial amount required for the bond, negotiable securities, or the line of
credit specified in the letter of credit, whichever is to be posted, the
commissioner shall take into consideration the amount of the entrance fees, interest
accrued thereon, and other fees to be charged in addition to the number of life
interest or long-term leases to be offered, granted or sold. The commissioner
shall revise the amount required to be held in escrow using the same procedure
used to set the initial amount required upon review of the CCRCs most recent
financial statements; and
(6) The CCRC
requesting that the commissioner approve posting of a bond, negotiable
securities, or letter of credit in lieu of maintaining escrow accounts shall demonstrate
to the commissioner that it meets a high standard of financial worthiness;
(7) To
demonstrate that it meets the required standard, the CCRC shall provide the
commissioner with data showing either:
a. That its
standard financial statement ratios are better than the industry-wide
continuing care facility average by 25 percent or more; or
b. That its
liquid assets as shown on the most recent balance sheet, but not including the
liquid reserve as determined under Ins1805, are equal to 300 percent of the
amount set by the commissioner for the bond, negotiable securities, or letter
of credit to be posted;
(8) The
commissioner shall be a party to any bond posted;
(9) No bond
posted shall be cancelable except with 90 days prior notice to the commissioner;
and
(10) CCRCs
posting negotiable securities with the commissioner shall enter into a
custodian agreement. The custodian agreement shall be executed on insurance
department form Ins-CCRC-3 described in (f) below.
(e) A CCRC
posting negotiable securities shall deposit said securities in a custodial
account to be held by the custodian in trust for the benefit and security of
policyholders, claimants or creditors of the CCRC.
(f) A custodian
agreement shall:
(1) Be signed by
the facility and the custodian;
(2) State the
amount maintained on deposit with the custodian;
(3) Hold
securities placed in the custodian account exclusively for the commissioner as
trustee in trust for the benefit of
(4) Provide
that non-registered securities may be held as follows:
a.
Coupon/bearer form;
b. At book
entry in a federal reserve bank; or
c. At the
depository trust company as either a direct bank or indirect depository
participant;
(5) Provide
that the custodian is liable to the facility and the commissioner for the
custodian's negligence, willful misconduct or lack of good faith;
(6) Provide that
no securities in the account nor any principal is released except upon written
request of the facility and written assent to or in the name of the
commissioner;
(7) Provide
that the facility may withdraw securities from the account, with the approval
of the commissioner;
(8) Provide
that the commissioner will approve withdrawals under the circumstances in (7)
above so long as other securities are deposited with the custodian with market
value equal to those withdrawn;
(9) Provide
that the custodian may surrender any security held under the agreement for
payment upon maturity or redemption so long as the proceeds thereof are held in
a principal cash account maintained as part of the custodial account in
accordance with the custodial agreement;
(10) Provide
that all transactions and withdrawals involving deposited securities or
principal cash be consummated only upon prior receipt of instructions from the
company and written assent of the trustee;
(11) Provide
that the custodian send advice to the commissioner of security and cash
transactions within 10 days after a transaction; and
(12) Provide
that the custodian send to the commissioner a certificate of account assets by
February 1 for the preceding calendar year through December 31.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1808 STANDARDS FOR RESIDENT CONTRACT AND
DISCLOSURE STATEMENTS
Ins 1808.01 Requirements for Documents.
(a) Documents
given to residents and prospective residents, including contracts with
residents and disclosure statements, shall:
(1) Use
language that a person of average intelligence and education can read and
understand;
(2) Present information
in a logical sequence and in a clear and direct fashion;
(3) Avoid
complex and compound sentences;
(4) Use words
in a manner which shall convey their commonly understood meanings;
(5) Include definitions
for words or terms which cannot properly be explained or qualified in the text;
(6) Use
frequent section headings to permit ease in locating provisions;
(7) Be printed
in easily legible typeface; and
(8) Contain an
index, which shall be either the first page of the document or whose location
shall be noted on the first page of the document, which lists all section
headings used in the document if the document is more than one page in length.
(b) If
pre-existing conditions are excluded from the medical care and services
available from the CCRC, or limited as to coverage, the term pre-existing
condition shall not limit coverage beyond that stated in the following:
"A pre-existing condition is a disease, illness,
sickness or physical condition for which medical care, advice or treatment was
recommended by or received from a physician within the 5 year period preceding
the date the CCRC committed itself to accept the individual as a
resident."
(c) This
requirement shall apply whether or not the exclusions or limitations are
available at an additional charge.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
Ins 1808.02 Resident Contract Standards.
(a) All contracts
between a CCRC and a resident shall be executed on a form which has been
previously approved by the commissioner. To obtain approval for the contract
form, the CCRC shall provide the commissioner with duplicate copies of the
proposed contract form, a cover letter, in duplicate, a return envelope with
return postage and the examination fee required by Ins 1809. The cover letter
shall provide a brief description of the main features of the contract form.
Upon review of the proposed contract form, the commissioner shall notify the
CCRC of approval or disapproval of the form. The commissioner shall approve the
proposed contract form if he finds that it complies with all requirements of
RSA 420-D and Ins 1808.01
(b) Each
contract with resident shall have attached a separate page notifying
prospective residents of their right to rescind the contract, as follows:
(1) The notice
shall indicate the date the rescission period begins;
(2) The notice
shall include a statement to the effect that the prospective resident may
rescind and terminate his or her contract or agreement, without penalty or
forfeiture, within 10 days of the date the rescission period begins, as
specified in (1) above;
(3) The notice shall
include a statement that the prospective resident is not required to move into
the CCRC before the expiration of the 10 day rescission period and that no
other agreement or statement signed by the prospective resident shall
constitute a waiver of the right to rescind the contract or agreement within
the 10 day rescission period;
(4) The notice
shall include instructions advising the prospective resident who wishes to
rescind his contract or agreement that:
a. He or she
may do so by mailing or delivering a signed and dated copy of the notice, or
any other dated written notice, letter or telegram, stating one's desire to
rescind the contract or agreement to the CCRC; and
b. Such notice
to the CCRC must be mailed to the business address of the CCRC not later than
midnight of the date of the last day for rescission, as specified on the notice
by the CCRC; and
(5) The notice
shall include a portion that the prospective resident can use to notify the
CCRC that the prospective resident is canceling the contract or agreement, as
permitted by the notice of the right to rescind. This portion shall include a
line where the prospective resident may place his signature and write in the
date of signature.
(c) The CCRC
shall submit to the commissioner for approval any revision(s) or amendment(s)
to an approved contract form. This submission shall include duplicate copies of
the revised contract or amendment form, a cover letter in duplicate, a return
envelope with return postage and the examination fee required by Ins 1809. The
cover letter shall list and describe each amendment or revision to the
previously approved contract form. Upon review of the amendment(s) or
revision(s) to the contract form, the commissioner shall notify the CCRC of
approval or disapproval of the form. The commissioner shall approve the
amendment(s) or revision(s) to the contract form if he finds that they comply
with all requirements of RSA 420-D and this part.
(d) When
submitting either a proposed contract form, amendments or revisions to a
contract form to the commissioner for approval, the CCRC shall, in a supplement
to the cover letter, list every instance where the contract form will use
variable language. In this supplement, the CCRC shall describe the complete
range of variable language that will appear in the contract form for each
instance listed.
(e) All
contracts with residents shall be printed in 10 point type or larger and shall
be prepared in a manner to ensure legibility and ease of reading.
(f) A valid and
binding contract with a resident shall be signed by the CCRC and each resident
who is admitted to the CCRC. An authorized representative may sign the contract
with resident on behalf of either party.
(g) If the
resident has agreed to purchase, at an additional price, optional products or
services beyond those included in the entrance and periodic fees, a separate
page shall be attached specifying the product or service purchased, and the
cost of each including any installation charge. Each such separate page shall
be executed by the parties identified in paragraph (f).
(h) The
contract with resident shall be distributed as follows:
(1) A copy of
the current contract with resident form shall be attached as an appendix to each
disclosure statement or amended disclosure statement filed with the
commissioner;
(2) A copy of
the current contract with resident form shall be attached to each disclosure
statement given to a prospective resident, unless the individual previously received
a disclosure statement with a current contract with resident form attached
thereto;
(3) A copy of
the current contract with resident form may be given to current residents; and
(4) If a
contract with resident form is not attached to the disclosure statement, as
authorized under paragraph (2) above, a separate page shall be attached stating
that a copy of the contract with resident form was omitted.
(i) Each CCRC
shall maintain copies of each contract with resident form it has executed with
a resident until the conclusion of the next succeeding examination by the
insurance department following the date the contract ceases to be in force.
(i) Each CCRC shall maintain copies of each contract
with resident form it has executed with a resident until the conclusion of the
next succeeding examination by the insurance department following the date the
contract ceases to be in force.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
Ins 1808.03 Disclosure Statements.
(a) A CCRC
shall submit all disclosure statements to the commissioner for prior approval.
No CCRC shall distribute a disclosure statement in any manner to prospective
residents, residents or residents' authorized representatives, until the
commissioner has approved the format of the disclosure statement.
(b) To obtain
approval for the disclosure statement, the CCRC shall submit to the
commissioner:
(1) Duplicate
copies of the proposed disclosure statement;
(2) A cover
letter in duplicate, which shall briefly describe the main features of the
disclosure statement;
(3) A return
envelope with return postage; and
(4) The
examination fee required by Ins 1809.
(c) The commissioner
shall approve the proposed disclosure statement if the commissioner finds that
it complies with all requirements of RSA 420-D and this part.
(d) The
commissioner shall notify the CCRC when the commissioner has approved or
disapproved the disclosure form.
(e) The CCRC
shall submit to the commissioner for his approval any revision(s) or
amendment(s) to an approved disclosure statement. This submission shall include
duplicate copies of the revised disclosure statement or amendment(s) thereto, a
cover letter in duplicate, a return envelope with return postage and the
examination fee required by Ins 1809. The cover letter shall list and describe
each amendment or revision made to the previously approved disclosure
statement. Upon review of the amendment(s) or revision(s) to the disclosure
statement, the commissioner shall notify the CCRC of his approval or
disapproval. The commissioner shall approve the amendment(s) or revision(s) to
the disclosure statement if he finds that they comply with all requirements of
RSA 420-D and this part.
(f) In addition
to the requirements of RSA 420-D:4 and Ins 1808.01, the disclosure statement
shall comply with the following rules:
(1) The
disclosure statement shall include a statement advising the prospective resident
that New Hampshire law requires the CCRC to provide the prospective resident
with a disclosure statement before the initial transfer of funds and before the
prospective resident consents to any contract with the CCRC; and
(2) The notice
required by RSA 420-D:4, I shall appear on the cover page of the disclosure
statement in a prominent location and typeface.
(g) Changes in
the operation of a CCRC which require an amendment to the disclosure statement
shall include the following:
(1) Changes in
the board of directors, officers, managing or general partners, administrators
or trustees and managers which affect the management of the CCRC. The CCRC
shall file biographical affidavits by these individuals with the commissioner
at the time the CCRC submits an amended disclosure statement;
(2) Any new or
additional mortgages, liens, security interests, loan commitments, long-term
financing arrangements or leases, which materially affects the real property of
the CCRC. The CCRC shall file a copy of all pertinent documents evidencing the
transactions with the commissioner at the time the CCRC submits an amended
disclosure statement; and
(3) Other
material changes in the financial or factual information contained in the
disclosure statement or any statement in support of the CCRCs original
application for a certificate of authority. The CCRC shall file explanatory
material and copies of pertinent documents concerning the material changes with
the commissioner at the time the CCRC submits an amended disclosure statement.
(h) All
disclosure statements shall be printed in 10 point type or larger.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
PART Ins 1809 FEES
Ins 1809.01 Fees.
(a) Upon each
application for a permanent certificate of authority, the applicant shall
pay a fee of $800.00 to the state of
(b) Upon each filing of the annual report as required
pursuant to Ins 1804, the CCRC shall pay a fee of $800 to the state of
(c) Upon
submitting a contract with resident form or any amendments or revisions to the
contract with resident form to the commissioner for approval, a CCRC shall pay
a fee of $80.00 to the state of
(d) Upon each
application for a new certificate of authority required pursuant to RSA
420-D:13, II, when management control of more than 50% of the assets of a
facility are transferred to another party, the applicant shall pay a fee of
$400.00 to the state of New Hampshire.
(e) When the
commissioner audits or examines a CCRC pursuant to RSA 420-D:23 or RSA
400-A:37, the CCRC shall bear the expense of th audit or examination as
follows:
(1) The
commissioner shall present quarterly bills for the expenses charged to all CCRCs
who have been audited or who are scheduled for audits in the current fiscal
year of the insurance department. The first 3 quarterly bills shall be
estimated bills. The final quarterly bill shall be for actual charges made that
fiscal year;
(2) The CCRC
shall be liable for the expenses associated with an audit or examination in
accordance with RSA 400-A:37; and
(3) All such
expenses of an audit or examination charged and billed shall be payable to the
state of
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
PART Ins 1810 AUDITS AND INVESTIGATIONS
Ins 1810.01 Audits and Investigations.
(a) The commissioner shall audit the books
and records of each licensed CCRC at least once every 5 years.
(b) Upon
completion of any audit conducted by the commissioner, a written audit report
shall be prepared.
(c) The audit report shall be submitted to
the CCRC audited. The examined CCRC may object to the report within 30 days
from the receipt thereof. Any such objection shall take the form of a request
for a hearing in compliance with the procedures described under Ins 200.
(d) When the
examined CCRC has raised an objection, the commissioner shall hold a hearing in
compliance with the hearing procedure established by Ins 200 and RSA 541-A:30-a
through RSA 541-A:38.
(e) The commissioner
shall maintain the report on file in the department until the commissioner has
issued a final adjudication. Until such report is final, it shall be absolutely
privileged and therefore not available for public inspection.
(f) After the
commissioner has issued an adjudication after a hearing upon the objection the
commissioner shall make available those portions of the report for public
inspection in accordance with RSA 400-A:37, VI.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New. #8991, eff 10-1-07
PART Ins 1811 TRANSFER OR
Ins 1811.01 Transfer or
(a) When a
transfer or sale of interest is proposed, the commissioner shall receive notice
pursuant to RSA 420-D.
(b) Such notice
shall include:
(1) A
biographical affidavit, using department form Ins-CCRC-4 described in (d)
below, for any proposed new officer, trustee, investor, owner with more than 5%
ownership, or new CCRC manager;
(2) The most
recent balance sheet and income statement of any party who is proposed to
acquire an ownership interest of 5% or more, if the transfer or sale of
interest involves less than 50% but more than 5% of the assets of the
continuing care facility;
(3) A detailed
account of any changes that will occur in the debt structure of the continuing
care facility or the continuing care CCRC, and
(4) A detailed
account of the resulting debt service requirements, with notes explaining how
these debt service requirements differ from the requirements in existence prior
to the proposed transfer or sale.
(c) When RSA
420-D:13, II requires a new CCRC to apply for a certificate of authority, the
application procedures of Ins 1803 shall apply.
(d) The
biographical affidavit, Ins-CCRC-4, shall include the following information:
(1) The name
and address of the continuing care provider;
(2) The name of
the affiant;
(3) A listing
of, and reason for, any name changes, if any, for the affiant;
(4) A listing
of any other names used by the affiant at any time;
(5) The
affiant's social security number;
(6) The date and place of birth of the affiant;
(7) The affiant's business address and telephone
number;
(8) A listing
of the affiant's residences for the last 10 years starting with the current
address and showing the address, city or town, state and dates the affiant
resided at each address;
(9) The
educational background of the affiant, including the name and location of
colleges or universities attended, the dates of attendance, and any degrees
earned;
(10) A listing
of the affiant's membership in professional societies and associations;
(11) The
affiant's present or proposed position with the provider;
(12) A listing
of the complete employment record of the affiant up to and including present
jobs, positions, directorates, or officerships for the past 20 years giving the
dates of employment, the name and address of each employer and the job title
held;
(13) A
statement as to whether or not the present employer may be contacted;
(14) A
statement as to whether or not former employers may be contacted;
(15) A
statement as to whether or not the affiant has ever been in a position which
required a fidelity bond;
(16) If the answer
to (15) above is affirmative, and if any claims were made on the bond, the
affiant shall state the details of each such claim;
(17) A
statement as to whether or not the affiant has ever been denied an individual
or position schedule fidelity bond or if any such bond has ever been cancelled
or revoked;
(18) If the
answer to (17) above is affirmative, a statement as to the details of each
denial, cancellation or revocation;
(19) A listing
of the professional, occupational, and vocational licenses issued by any public
or governmental licensing agency or regulatory authority which the affiant
presently holds or has held in the past, including the date the license was
issued, the issuer of the license, the date the license was terminated and the
reason for termination;
(20) A
statement as to whether or not the affiant has, within the last 10 years, been
refused a professional, occupational, or vocational license by any public or
governmental licensing agency or regulatory authority, or had any such license
held suspended or revoked;
(21) If the
answer to (20) above is affirmative, the affiant shall state the details of
each denial, cancellation, or revocation;
(22) A listing
of the continuing care providers or health care facilities in which the affiant
controls, directly or indirectly, or owns legally or beneficially 10 percent or
more of the outstanding voting stock, in voting power;
(23) A
statement by the affiant as to whether the affiant or members of his or her
immediate family will subscribe to or own, beneficially or of record, any
shares of stock in the continuing care provider or in any affiliate of the
continuing care provider;
(24) If any of
the shares or stock noted in the answer to (23) above are pledged or
hypothecated in any way, the affiant shall provide an explanation of these
circumstances;
(25) A
statement by the affiant as to whether or not he or she has ever been adjudged
bankrupt;
(26) A
statement by the affiant, and details of if affirmative, as to whether the
affiant has ever been convicted or had a sentence imposed or suspended or had
pronouncement of a sentence suspended or been pardoned for conviction of or
pleaded guilty or nolo contendre to an information or indictment charging any
felony, or charging a misdemeanor involving embezzlement, theft, larceny, or
mail fraud, or charging a violation of any corporate securities statute or any
insurance law;
(27) Whether
the affiant has ever been the subject of any disciplinary proceedings of any
federal or state regulatory agency, and details if affirmative;
(28) A
statement by the affiant as to whether or not any company has ever been charged
as in (26) above, allegedly as a result of any action or conduct on the part of
the affiant;
(29) A statement
by the affiant as to whether or not the affiant has ever been an officer,
director, trustee, investment committee member, key employee, or controlling
stockholder of any company or organization which, while the affiant occupied
any such position or capacity with respect to it, became insolvent or was
placed under supervision or in receivership, rehabilitation, liquidation or
conservatorship;
(30) A
statement by the affiant, and details if affirmative, as to whether or not the
certificate or authority or license to do business of any provider or company
of which the affiant was an officer, or director or key management person ever
been suspended or revoked while the affiant occupied such position; and
(31) A dated
signature of the affiant by which the affiant certifies that he or she is
acting on his or her own behalf and that the foregoing statements are true and
correct to the best of the affiant's knowledge and belief.
(e) The
biographical affidavit described in (d) above shall be notarized by a notary
public.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
PART Ins 1812 ENFORCEMENT
In 1812.01 Violations. Any
person or CCRC knowingly violating the provisions of this chapter shall be
subject to the provisions of RSA 400-A:15.
Source. #7014, eff 7-1-99; EXPIRED: 7-1-07
New.
#8991, eff 10-1-07
APPENDIX
|
Rule |
Specific State Statute which the Rule is Intended to
Implement |
|
1801.01 |
420-D:7 |
|
1801.02 |
420-D:7 |
|
1802.01 |
420-D:7;
420-D:17 IX |
|
1803.01 |
420-D:7
I |
|
1803.02 |
420-D:17
VI |
|
1804.01 |
420-D:7
VIII |
|
Ins
1804.01 (d) |
RSA
420-D:7, VIII |
|
1805.01 |
420-D:7
IX, X |
|
1806.01 |
420-D:7
XII |
|
1807.01 |
420-D:17
XIII |
|
1808.01 |
420-D:17
V, XIV |
|
1808.02 |
420-D:17
XIV |
|
1808.03 |
420-D:17
V |
|
1809.01 |
420-D:17
III, IV, XVI |
|
1810.01 |
420-D:21;
420-D:23 |
|
1811.01 |
420-D:13 |
|
1812.01 |
420-D:26 |