State Law

New Hampshire Admin. Code-Chapter Ins 2700-Part Ins 2701. Health and Dental Benefit Plan Network Adequacy

08/15/2023 New Hampshire Section 2701.06

Standards for Geographic Accessibility

Network Adequacy

(a) Geographic access standards shall be calculated based on population densities of persons under the age of 65. Geographic access standards shall be measured in terms of distance or travel times for a person under normal conditions from specific zip codes.

(b) A carrier shall meet the service specific requirement by county for persons living in one of the 2 zip codes for the following counties:

(1) Coos – Lancaster 03584 or Berlin 03570;

(2) Carroll – Conway 03813 or Wolfeboro 03894;

(3) Belknap – Laconia 03246 or Alton 03809;

(4) Sullivan – Claremont 03743 or Newport 03773;

(5) Strafford – Rochester 03867 or Dover 03820;

(6) Cheshire – Keene 03431 or Jaffrey 03452;

(7) Hillsborough – Nashua 03060 or Manchester 03103; and

(8) Rockingham – Portsmouth 03801 or Derry 03038.

(c) A carrier shall meet the service specific requirement for Merrimack County for persons living in the Concord 03301 zip code.

(d) A carrier shall meet the service specific requirement for Grafton County for persons living in 2 of the following zip codes:

(1) Littleton 03561;

(2) Plymouth 03264; or

(3) Lebanon 03748.

(e) Geographic access standards are based on the following county groupings: “Rural”, “Middle”, and “Urban”. Maximum travel distances or times are based on the service type, county, and specific zip code within the county as follows:

(1) For urban counties, including Strafford, Hillsborough, and Rockingham counties:

a. Ten miles or 15 minutes driving time for core services;

b. Twenty miles or 30 minutes driving time for common services; and

c. Forty miles or one hour driving time for specialized services;

(2) For middle counties, including Merrimack, Belknap, Cheshire, Grafton, Carroll, and Sullivan counties:

a. Twenty miles or 40 minutes driving time for core services;

b. Forty miles or 80 minutes driving time for common services; and

c. Seventy miles or 2 hours driving time for specialized services; and

(3) For rural counties, including Coos county:

a. Thirty miles or one hour driving time for core services;

b. Eighty miles or 2 hours driving time for common services; and

c. One hundred twenty-five miles or 2 1/2 hours driving time for specialized services.

SeeĀ https://www.gencourt.state.nh.us/rules/state_agencies/ins2700.html