New Jersey Revised Statutes § 17b:27b-8 - Payment To Third Party Administrators Not Based Solely On Claims Denials.

17B:27B-8 Payment to third party administrators not based solely on claims denials.

8.If a third party administrator adjudicates claims under a health benefits plan, the commissions, fees or charges that the benefits payer pays the administrator, shall not be based solely on the number or amount of claims denied by the administrator. This provision shall not prohibit an administrator from receiving performance-based compensation if that compensation is not predicated on denial of claims or coverage.

L.2001,c.267,s.8.


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Last modified: October 11, 2016