17B:27B-14 Suspension, revocation of license, registration.
14. The commissioner may suspend or revoke a license or registration issued pursuant to this act if he finds that the third party administrator:
a.is in an unsound financial condition;
b.is using methods or practices in the conduct of its business that render its further transaction of business in this State hazardous or injurious to the benefits payers with which it has contracted or the public;
c.has failed to pay any judgment rendered against it in this State within 60 days after the judgment has become final;
d.has violated any lawful rule or order of the commissioner or any provision of State law;
e.has refused to be examined or produce its accounts, records and files for examination, or if any of its officers has refused to give information with respect to its affairs or has refused to perform any other legal obligation as to an examination, when required by the commissioner;
f.has, without just cause, refused or failed to pay proper claims or perform services arising under its contracts;
g.at any time fails to meet any qualification for which issuance of the license could have been refused had that failure then existed and been known to the commissioner;
h.has been convicted of, or has entered a plea of guilty or nolo contendere to a felony or crime of the first, second or third degree in this State, without regard to whether adjudication was held;
i.is under suspension or revocation in another state; or
j.has willfully reimbursed enrollees for benefits not eligible under the benefits payer's benefits plan.
If the commissioner finds that one or more grounds exist for the suspension or revocation of a certificate of authority issued under this act, the commissioner may, in lieu of suspension or revocation, impose a fine upon the administrator.
L.2001,c.267,s.14.
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Last modified: October 11, 2016