New Hampshire fines Anthem and Matthew Thornton Health Plan

CONCORD, NH (August 11, 2026) – The New Hampshire Insurance Department has issued a final order assessing a $420,000 administrative fine against Anthem Health Plans of New Hampshire, Inc. and Matthew Thornton Health Plan, Inc. following a targeted market conduct examination that identified violations involving claims processing, appeals, external reviews, and responses to Department examiners.

The examination covered the period from January 1, 2022, through June 30, 2023. Following the examination and subsequent regulatory proceedings, the Department determined that the companies committed over a hundred violations of New Hampshire insurance laws and regulations, resulting in a $420,000 administrative fine.

The examination identified claims-processing deficiencies in a limited but notable number of files reviewed, along with violations involving appeals, external reviews, claims investigation standards, and responses to Department inquiries.

The investigation further identified failures to process certain appeals within legally required timeframes, failures to adopt and implement standards necessary to ensure the prompt and reasonable investigation of certain claims, and failures to provide complete and timely responses during the Department’s examination.

“Health insurance carriers operating in New Hampshire are expected to process claims and appeals promptly, fairly, and in accordance with state law,” said Insurance Commissioner D.J. Bettencourt. “This action reflects the Department’s commitment to ensuring that all health insurance carriers meet the consumer protection standards established by New Hampshire law. When deficiencies are identified, our responsibility is to work with insurers to correct them, protect consumers, and maintain confidence in New Hampshire’s insurance marketplace.”

The examination was targeted and focused on specific regulatory issues. While the Department did not conclude that consumers were improperly denied coverage because of these violations, it determined that the identified deficiencies warranted corrective action and civil penalties. Delays in these processes can affect consumers’ ability to obtain benefits promptly and receive timely resolution of disputes.

Throughout the regulatory process, the companies participated in resolving the issues identified during the examination. The Final Order reflects both the violations identified by the Department and the comprehensive corrective actions the companies have agreed to implement going forward.

Under the Final Order, the companies will implement a corrective action plan developed in coordination with the Department to address the deficiencies identified during the examination. The Department will actively monitor implementation throughout the corrective action period and retains the authority to conduct a follow-up examination to ensure the required improvements are fully implemented.

As part of the Final Order, the Department assessed an administrative penalty of $420,000, consistent with New Hampshire law. The companies must pay $300,000 within 30 days, while the remaining $120,000 is suspended for three years and may be imposed, in whole or in part, if the companies fail to comply with the corrective action plan.

“Market conduct examinations are an important part of the Department’s responsibility to protect consumers and ensure that insurance companies comply with New Hampshire law,” said Deputy Insurance Commissioner Keith Nyhan. “The corrective action plan and continued regulatory oversight will help ensure that the issues identified through this examination are addressed and that appropriate safeguards remain in place for Granite Staters.”

“The purpose of market conduct examinations is not simply to identify violations, but to improve insurer operations, promote lasting compliance, strengthen consumer protections, and reinforce confidence in New Hampshire’s insurance marketplace,” added Commissioner Bettencourt. “The overwhelming majority of insurers operating in New Hampshire comply with these requirements, and targeted examinations remain an important regulatory tool for identifying and correcting issues when they arise while ensuring that every carrier operates under the same standards established by state law.”

The Final Order, part of Docket Number INS 24-002-MC, is a public regulatory action and will be reported to the National Association of Insurance Commissioners. The Final Order is available at https://mm.nh.gov/files/uploads/nhid/documents/2026-08-08-anthem-final-order-on-the-examination-report.pdf. The underlying market conduct examination report remains private and confidential as required by state law.