New Hampshire Insurance Department Issues Bulletin with Updated Guidance on Coverage for Newborn Children

CONCORD, NH (January 9, 2025) – The New Hampshire Insurance Department has released new guidance to clarify coverage requirements for newborn children under RSA 415:22, I. This update, issued as Docket #INS 25-002-AB, provides detailed instructions on the coordination of benefits (COB) and cost-sharing rules during the first 31 days following a newborn's birth, as well as additional guidance for coverage thereafter.

“This updated guidance reaffirms our steadfast commitment to protecting Granite State families by ensuring that newborns receive seamless and comprehensive health coverage from the moment of birth,” said Insurance Commissioner DJ Bettencourt. “By clarifying the coordination of benefits and cost-sharing rules, we are providing essential certainty to both consumers and insurers, reinforcing fairness and transparency in the health insurance process. The health of women and their newborns is paramount, and we are dedicated to ensuring that every child has the opportunity for a healthy start in life.”

Under state law, all major medical health insurance policies in the individual and group markets must provide automatic coverage for newborns of the insured for the first 31 days following birth. During this period, the newborn’s coverage is included under the birth mother’s policy. Coordination of benefits cannot rely on the dependent status of the newborn, ensuring primary coverage remains under the mother’s plan.

Cost-sharing rules have also been clarified to prevent duplicate charges for care related to the birth. Insurers may not apply separate cost-sharing for both the birth mother and the newborn for the same episode of care. For subsequent medical services provided to the newborn within this initial period, cost-sharing amounts will apply to the parent’s individual cost-sharing limits.

To maintain coverage beyond the initial 31-day period, parents must enroll the newborn as a permanent dependent. At that point, the child may be treated as a distinct dependent for purposes such as calculating separate deductibles and out-of-pocket limits, and standard COB rules between applicable plans will be applied.

“Health coverage during the critical early days of a newborn's life is essential,” said Deputy Insurance Commissioner Keith Nyhan. “These updates strengthen protections for families while promoting consistent practices among insurers.”

This bulletin builds upon previous guidance issued in 2017 under INS-17-001-AB, which prohibited additional cost-sharing during the newborn coverage period.

The complete bulletin, Docket #INS 25-002-AB, can be viewed at https://mm.nh.gov/files/uploads/nhid/documents/bulletin-ins-25-002-ab.pdf.

For questions or concerns, the Department encourages individuals and health carriers to contact the Consumer Services Unit by email at consumerservices@ins.nh.gov or by phone at 603-271-2261. 

The New Hampshire Insurance Department Can Help

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. Contact us with any questions or concerns you may have regarding your insurance coverage at 1‐800‐852‐ 3416 or (603) 271‐2261, or by email at consumerservices@ins.nh.gov. For more information, visit https://insurance.nh.gov/.