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Application

Application   includes:     NHHP Residency Affidavit 06-2008     NHHP Non-Tobacco User Affidavit 06-2008	PDF	2008-06	This is a comprehensive application form which consists of the application with a Residency Affidavit and a Non-Tobacco User Affidavit.
Low Income Premium Subsidy Application	PDF	2008-12	This is an optional application to save 10% - 20% on monthly premiums.
Supplemental Family Application   includes:     NHHP Non-Tobacco User Affidavit 06-2008	PDF	2008-06	Supplemental Family Coverage for Managed Care Option H
Notice of Privacy Practices	PDF	2008-06	NH Health Plan's Privacy Policy
Applicant’s Checklist	PDF	2008-06	Helpful checklist of items needed to complete the application
How to File a Claim	PDF	2008-06	Helpful steps for Insureds on how to file a claim.

Current Policy Forms

Rates

Save 10% to 20% on monthly premiums! Find out how with our Low Income Premium Subsidy Program.
Rates 2010 Jan - Jun	PDF	2009-12
Rates 2009 Jul - Dec	PDF	2009-05
Rates 2009 Jan - Jun	PDF	2009-01
Rates 2008 Jul - Dec	PDF	2008-06
Rates 2008 Jan - Jun	PDF	2007-12
Rates 2007 Jul - Dec	PDF	2007-06
Rates 2007 Jan - Jun	PDF	2006-12
Rates 2006 Jul - Dec	PDF	2006-06
Rates 2006 Jan - Jun	PDF	2005-12
Rates 2005 Jul - Dec	PDF	2005-06
Rates 2005 Jan - Jun	PDF	2004-12
Rates 2004 Jul - Dec	PDF	2004-06
Rates 2004 Jan - Jun	PDF	2003-12
Rates 2003 Jul - Dec	PDF	2003-06
Rates 2003 Apr - Jun	PDF	2003-02

Other Forms