The New Hampshire Self-Insurance Questionnaire is an application form required of all employers seeking self-insurance status in the state of New Hampshire. This questionnaire is used to determine an employer’s eligibility for self-insurance, as well as the nature of its self-insured plan. There are three types of New Hampshire Self-Insurance Questionnaire: the Initial Self-Insurance Questionnaire, the Voluntary Self-Insurance Questionnaire, and the Temporary Self-Insurance Questionnaire. The Initial Self-Insurance Questionnaire must be completed by all employers applying for self-insurance. This form collects information about the employer, such as the type of business, contact information, number of employees, and insurance plan details. The Voluntary Self-Insurance Questionnaire is for employers who wish to become self-insured without the support of an insurer. This form collects similar information about the employer but also requires the employer to provide financial history and other documents to demonstrate their ability to assume the financial responsibility of self-insurance. The Temporary Self-Insurance Questionnaire is for employers who are temporarily unable to obtain coverage from an insurer and need to be self-insured until they can find an insurer. This form collects the same information as the Initial and Voluntary questionnaires but also requires additional information to demonstrate the employer’s financial capability and ability to provide coverage.
The New Hampshire Self-Insurance Questionnaire is an application form required of all employers seeking self-insurance status in the state of New Hampshire. This questionnaire is used to determine an employer’s eligibility for self-insurance, as well as the nature of its self-insured plan. There are three types of New Hampshire Self-Insurance Questionnaire: the Initial Self-Insurance Questionnaire, the Voluntary Self-Insurance Questionnaire, and the Temporary Self-Insurance Questionnaire. The Initial Self-Insurance Questionnaire must be completed by all employers applying for self-insurance. This form collects information about the employer, such as the type of business, contact information, number of employees, and insurance plan details. The Voluntary Self-Insurance Questionnaire is for employers who wish to become self-insured without the support of an insurer. This form collects similar information about the employer but also requires the employer to provide financial history and other documents to demonstrate their ability to assume the financial responsibility of self-insurance. The Temporary Self-Insurance Questionnaire is for employers who are temporarily unable to obtain coverage from an insurer and need to be self-insured until they can find an insurer. This form collects the same information as the Initial and Voluntary questionnaires but also requires additional information to demonstrate the employer’s financial capability and ability to provide coverage.
