New Hampshire Document Library

New Hampshire New Group Documents		Miscellaneous Forms
Group Checklist (PDF) NH Small Group Employer Application (PDF) Underwriting Questionnaire (PDF) Census Form (PDF) NH Member Enrollment Application (PDF) Waiver (PDF) HIPAA Privacy Election Form with Instructions (PDF)		CAF 1 (PDF) CAF 4 (PDF) Notice of Membership Adjustment (PDF) Supply Request Form (PDF) NH Late Paperwork form (PDF) NH Administratitve Manual, VOL 6 (PDF)
New Hampshire Benefit Summaries for Open Access Plus (OAP) Plans		New Hampshire Benefit Summaries for HMO/HMO OA Plans
Quick Reference Guide to OAP Plans (PDF) Open Access Plus Plan 1 (PDF) Open Access Plus Plan 2 (PDF) Open Access Plus Plan 3 (PDF) Open Access Plus Plan 4 (PDF)		Quick Reference Guide to HMO and HMO OA Plans (PDF) HMO 1 (PDF) HMO 2 (PDF) HMO 3 (PDF) HMO 4 (PDF) HMO 5 (PDF) HMO Open Access 6 (PDF) HMO Open Access 7 (PDF) HMO Open Access 8 (PDF) HMO Open Access 9 (PDF) HMO Open Access 10 (PDF)
New Hampshire Benefit Summaries for HSA-Qualified HDHPs		Accessing Providers and Facilities Online
Quick Reference Guide to HDHP Plans High Deductible Health Plan (HDHP) 1: 90% / 2000 (PDF) High Deductible Health Plan (HDHP) 2: 90% / 2500 (PDF) High Deductible Health Plan (HDHP) 3: 90% / 3000 (PDF) High Deductible Health Plan (HDHP) 4: 100% / 3000 (PDF)		OAP Online Directory (PDF) HMO-HMOOA Online Directory (PDF)