New Jersey Revised Statutes Title 17b - Insurance
- Section 17b:17-1 - Scope Of Act
This Subtitle 3 of Title 17B shall be known as the "Life and Health Insurance Code," sometimes referred to herein as this "Code," and...
- Section 17b:17-2 - Insurer Defined
"Insurer" includes every person engaged as indemnitor or contractor in the business of life insurance, health insurance or of annuity. L.1971, c. 144, s.
- Section 17b:17-3 - Life Insurance Defined
"Life insurance" is a policy or contract whereby an insurer is obligated to pay or allow a benefit of pecuniary value with respect to...
- Section 17b:17-4 - Health Insurance Defined
"Health insurance" is a contract or agreement whereby an insurer is obligated to pay or allow a benefit of pecuniary value with respect to...
- Section 17b:17-5 - Annuity Defined
"Annuity" is a contract not coming within the definition of life insurance as set forth in section 17B:17-3, or health insurance as set forth...
- Section 17b:17-5.1 - Definitions; Funeral Insurance Policies
24. a. As used in this section: "At need funeral arrangements" means funeral arrangements made with the survivors or personal representative of a person...
- Section 17b:17-6 - Person Defined
"Person" includes any individual, insurer, company, association, organization, society, partnership, syndicate, trust, business trust, corporation and every legal entity. L.1971, c. 144, s. 17B:17-6.
- Section 17b:17-7 - Domestic Insurer, Foreign Insurer, Alien Insurer Defined
a. A "domestic" insurer is one formed under the laws of this State. b. A "foreign" insurer is one formed under the laws of...
- Section 17b:17-8 - State Defined
When used in context signifying a jurisdiction other than the State of New Jersey, "State" means any State, district, territory, commonwealth, or possession of...
- Section 17b:17-9 - Domicile Defined
The "domicile" of an insurer means: a. As to Canadian insurers, the province in which the insurer's head office is located. b. As to...
- Section 17b:17-10 - Principal Office Defined
"Principal office" means: a. As to Canadian insurers, the office in Canada from which the general affairs of the insurer are directed or managed....
- Section 17b:17-11 - Authorized Insurer, Unauthorized Insurer Defined
a. An "authorized insurer" is one duly authorized by a current certificate of authority issued by the commissioner pursuant to this code to act...
- Section 17b:17-12 - Certificate Of Authority; License Defined
a. A "certificate of authority is a certificate issued by the commissioner evidencing the authority of an insurer to transact insurance in this State....
- Section 17b:17-12.1 - Change Of Domicile For Insurers
2. a. An insurer that is formed under the laws of another state and is admitted to transact the business of insurance in this...
- Section 17b:17-13 - Misdemeanor To Do Business Unless Authorized
a. No person shall act as an insurer in this State without complying with the applicable provisions of this Code. b. No person by...
- Section 17b:17-13.1 - Charitable Annuities.
17B:17-13.1. a. The commissioner may, in his discretion, issue a special permit to a qualified nonprofit domestic or foreign corporation or association organized without...
- Section 17b:17-14 - General Penalty
Each violation of this Code as to which a penalty is not provided by another provision of this Code or by other applicable laws...
- Section 17b:17-15 - Conflict With Other Laws
All laws and parts of laws of this State inconsistent with this Code are hereby superseded with respect to matters covered by this Code....
- Section 17b:17-16 - Separability Of Provisions
If any provision of this Code or the application thereof to any person or circumstance is held invalid, the invalidity shall not affect other...
- Section 17b:17-17 - Short Title
This act shall be known and may be cited as the "Life and Health Insurance Policy Language Simplification Act." L.1979, c. 167, s. 1,...
- Section 17b:17-18 - Purpose
The purpose of this act is to establish minimum standards for language used in policies, contracts and certificates of life insurance, health insurance, annuity,...
- Section 17b:17-19 - Definitions
As used in this act: a. "Policy" or "policy form" means any policy, contract, certificate, or agreement of life or health insurance, including credit...
- Section 17b:17-20 - Application Of Act; Exclusions
a. This act shall apply to all policies delivered or issued for delivery in this State by any company on or after the dates...
- Section 17b:17-21 - Policy Forms
a. In addition to any other requirements of law, no policy forms, except as stated in section 4, shall be delivered or issued for...
- Section 17b:17-22 - Issuance Of Policy Forms After Filing; Construction With Other Laws
Nothing in this act shall be construed to negate any law of this State permitting the issuance of any policy form after it has...
- Section 17b:17-23 - Flesch Reading Ease Score; Authorization Of Lower Score
The commissioner may authorize a lower score than the Flesch reading ease score required in section 5a. (1) whenever, in his sole discretion, he...
- Section 17b:17-24 - Content Of Policy Forms; Construction With Other Laws
A policy form meeting the requirements of section 5a. shall be filed or approved notwithstanding the provisions of any other law which specifies the...
- Section 17b:17-25 - Date Of Application
a. Except as provided in section 4, this act applies to all policy forms filed on or after 2 years after the effective date...
- Section 17b:18-1 - Scope Of Chapter
This chapter shall be applicable only to domestic stock and domestic mutual insurers, authorized to do one or more of the kinds of business...
- Section 17b:18-2 - Stock Insurer Defined
A domestic stock insurer is an insurer incorporated in accordance with the laws of this State with its capital divided into shares and owned...
- Section 17b:18-3 - Mutual Insurer Defined
A domestic mutual insurer is an insurer incorporated in accordance with the laws of this State without permanent capital stock, the governing body of...
- Section 17b:18-4 - Organization Of Stock Or Mutual Insurer
a. Ten or more persons may form a domestic stock or domestic mutual insurer to engage in the business of writing any or all...
- Section 17b:18-5 - Approval Of Certificate By Commissioner; Recording And Filing
The certificate of incorporation shall be proved or acknowledged as required for deeds of real estate and be submitted to, and examined by, the...
- Section 17b:18-6 - Stipulations In Stock Subscriptions And Applications
Every subscription to the capital stock of a stock insurer shall contain the stipulation that no sum shall be used for commission, promotion or...
- Section 17b:18-7 - Certificate Of Incorporation Of Mutual Insurer; Election Of Directors
a. The certificate of incorporation of any mutual insurer of this State hereafter incorporated may contain provisions for the elections of directors in the...
- Section 17b:18-8 - Loan To Mutual Insurer For Organizational Expenses
A mutual insurer organized under this Code may borrow or assume a liability for the repayment of a sum of money sufficient to defray...
- Section 17b:18-10 - Election Of Directors Of Mutual Insurer Pursuant To Provision In Certificate Of Incorporation
If the certificate of incorporation or charter of a mutual insurer, or any amendment thereto contains provisions for the election of directors in the...
- Section 17b:18-11 - Nomination Of Candidates For Director
At least seven months before the day fixed for any election of directors, the board of directors shall by a vote of a majority...
- Section 17b:18-12 - Death, Withdrawal Or Incapacity Of Candidates For Director
In case of the death, withdrawal or incapacity of any candidate nominated by the board of directors prior to election, the board of directors...
- Section 17b:18-13 - Qualified Voters; "Policyholder" Defined
The qualified voters of the insurer shall consist of every policyholder who is 18 years of age or more and whose policy has been...
- Section 17b:18-14 - Elections Of Directors Of Mutual Insurers; Procedure, Ballots
Each qualified voter of the insurer at such election shall be entitled to cast one vote in person or by proxy. The president, or,...
- Section 17b:18-15 - Nominations By Others Than Board Of Directors; Notice Of Election
In case any nomination shall have been made by others than by the board of directors, the insurer shall cause notice of the time...
- Section 17b:18-16 - Canvass Of Votes; Tie Vote
All ballots voted shall be received by the tellers subject to verification and ascertainment of the validity thereof and of the qualification of the...
- Section 17b:18-17 - Report Of Result Of Election
At the conclusion of the canvass the tellers shall report in writing to the secretary of the corporation the result thereof and he shall...
- Section 17b:18-18 - Choosing Of Directors For Mutual Life Insurers Having In Excess Of Ten Million Policies In Force
The directors of any mutual insurer of this State heretofore or hereafter incorporated pursuant to the provisions of the laws of this State which...
- Section 17b:18-19 - Number Of Directors; Appointment Of Public Directors; Ex Officio Directors
Subject to the provisions of section 17B:18-21 as to the number of elected directors, the number of the directors of any such mutual insurer...
- Section 17b:18-20 - Public Directors; Carry-overs; Appointments; Terms; Vacancies; Powers
Each director of any such mutual insurer heretofore appointed as a public director in accordance with P.L.1953, chapter 156 and holding office as such...
- Section 17b:18-21 - Elected Directors; Carry-overs; Terms; Vacancies
Each director of any mutual insurer, other than its president and other than the chairman of the board if he is the chief executive...
- Section 17b:18-22 - Elected Directors; Manner Of Electing
The elected directors shall be elected in the manner provided in sections 17B:18-23 to 17B:18-27, inclusive, by the qualified voters of the corporation at...
- Section 17b:18-23 - Qualified Voters; "Policyholder" For Purpose Of Election Defined
The qualified voters of the insurer shall consist of every policyholder who is 18 years of age or more and whose policy has been...
- Section 17b:18-24 - Nomination Of Candidates; Demand By Public Directors
The board of directors shall by a vote of a majority of its entire number nominate a candidate for each office of elected director...
- Section 17b:18-25 - Method Of Electing When No Demand Is Made By Public Directors
If the public directors shall file no demand that other candidates be nominated, the election shall be according to the method prescribed in this...
- Section 17b:18-26 - Method Of Election When Demand Is Made By Public Directors That Other Candidates Be Nominated
If the public directors shall file a demand pursuant to section 17B:18-24 that other candidates be nominated, the election shall be according to the...
- Section 17b:18-27 - Mailing Of Ballot; Effect
The mailing of a ballot to any person shall not be construed as an admission of the validity of any policy or that such...
- Section 17b:18-28 - Filing Certificate On Number Of Policies; Copy Delivered To Chief Justice
If any annual statement of any domestic mutual insurer heretofore or hereafter filed with the commissioner sets forth a number of life insurance policies...
- Section 17b:18-29 - Election Of Directors In Mutual Insurer Issuing Temporary Stock
A bare majority of the entire board of directors of a domestic mutual insurer which issues temporary capital stock, as provided in section 17B:18-9,...
- Section 17b:18-30 - Proxy Voting Permitted At Elections
At any election of directors, managers or other officers of a domestic insurer, except any election of directors held pursuant to N.J.S. 17B:18-18 to...
- Section 17b:18-31 - Emergency By-laws
The board of directors of any domestic insurer may at any time adopt emergency by-laws, subject to repeal or change by action of those...
- Section 17b:18-32 - Failure To Adopt Emergency By-laws; Procedure
In the event that the board of directors of a domestic insurer has not adopted emergency by-laws, the following provisions shall become effective upon...
- Section 17b:18-33 - National Emergency; Succession
At any time the board of directors of a domestic insurer may, by resolution, provide that in the event of such a national emergency...
- Section 17b:18-34 - National Emergency; Relocation Of Principal Place Of Business
At any time the board of directors of a domestic insurer may, by resolution, provide that in the event of such a national emergency...
- Section 17b:18-37 - Definitions; Deposit Prerequisite To Authorization
17B:18-37. a. As used in this section and in N.J.S.17B:18-38 and N.J.S.17B:18-39: (1) "Bank" means a State or federally chartered bank, savings bank, or...
- Section 17b:18-38 - Deposits; Interest On; Substitution Of
17B:18-38. The commissioner shall hold the securities deposited pursuant to N.J.S.17B:18-37 for the benefit and security of all the policyholders of the insurer depositing...
- Section 17b:18-39 - Deposits To Do Business In Other Jurisdictions
17B:18-39. The custodian, on behalf of the commissioner, may receive from any domestic insurer a deposit of securities necessary to enable it to transact...
- Section 17b:18-39.1 - Fees For Services Of Custodian Required Pursuant To N. J. S.17b:18-37 et Seq.
The Commissioner of Insurance shall establish, by regulation, the fees to be charged insurance companies for the services of the custodian pursuant to the...
- Section 17b:18-41 - Examination Before Commencing Business
Before issuing a certificate of authority to a domestic insurer, the commissioner shall be satisfied, by such examination and evidence as he sees fit...
- Section 17b:18-42 - Certificate Of Authority; When Issuable.
17B:18-42. When satisfied that a domestic insurer has complied with all the requirements of this code to entitle it to engage in business and...
- Section 17b:18-43 - Domestic Insurers, Powers, Duties--general Corporation Law
a. Any domestic insurer and its stockholders, members and directors, shall have all the powers granted and be subject to all the duties and...
- Section 17b:18-44 - Stock Of Other Insurance Company
A domestic insurer which purchases stock of another insurance company in compliance with section 17B:20-4 may pay therefor in cash or its equivalent or...
- Section 17b:18-45 - Authority To Acquire, Hold And Convey Real Estate
Any domestic insurer, in addition to the authority contained in sections 17B:20-1 to 17B:20-5, inclusive, may acquire, hold and convey any real estate as...
- Section 17b:18-46 - Limitation On Dividends To Stockholders
No profits on participating policies and contracts heretofore or hereafter issued by a domestic stock insurer in excess of the larger of a. 10%...
- Section 17b:18-47 - Increase Or Decrease Of Capital Stock
Any domestic stock insurer may increase its capital stock or decrease it to an amount not less than the minimum required by this code...
- Section 17b:18-48 - Advertisement Of Assets To Include Liabilities
When an insurer doing business in this State advertises its assets, it shall, in the same connection and equally conspicuously, advertise its liabilities, the...
- Section 17b:18-49 - Cash Disbursements To Be Evidenced By Voucher
No domestic insurer shall make any cash disbursement of $100.00 or more unless it is evidenced by a voucher, signed by or on behalf...
- Section 17b:18-50 - Payment Of Taxes, Charges And Fees Prior To Determination Of Invalidity
The directors of any domestic insurer are authorized to pay, and to appropriate money to pay, such taxes, charges and fees as have been...
- Section 17b:18-51 - Compensation Of Directors
The director of any domestic insurer when acting as its officer, counsel, agent or representative, and also for each occasion of his attendance at...
- Section 17b:18-52 - Insurer Payments To Senior Officers Restricted
No domestic insurer shall: a. Pay any salary, compensation or emolument to any of its senior officers, directors or trustees, unless the payment is...
- Section 17b:18-53 - Reporting Amount Of Stock Owned And Changes Therein By Director, Officer, And Principal Stockholders Of Domestic Stock Insurers
Every person who is directly or indirectly the beneficial owner of more than 10% of any class of stock of a domestic stock insurer...
- Section 17b:18-54 - Suit For Profits Realized By Director, Officer, And Principal Stockholders
For the purpose of preventing the unfair use of information which may have been obtained by such beneficial owner, director or officer by reason...
- Section 17b:18-55 - Limitation On Sale Of Stock By Director, Officer And Principal Stockholders
It shall be unlawful for any such beneficial owner, director or officer, directly or indirectly, to sell any stock of such insurer if the...
- Section 17b:18-56 - Stock Insurers; Change Of Name, Extension Of Corporate Existence Or Amendment Of Charter Or Certificate Of Incorporation
a. Any stock insurer heretofore or hereafter incorporated under any general or special law of this State may change its name, extend its corporate...
- Section 17b:18-57 - Mutual Insurers; Change Of Name, Extension Of Corporate Existence Or Amendment Of Charter Or Certificate Of Incorporation
Mutual insurers; change of name, extension of corporate existence or amendment of charter or certificate of incorporation. a. Any mutual insurer heretofore or hereafter...
- Section 17b:18-58 - Mutual Insurers; Adoption Of Amended Charter Or Certificate Of Incorporation
When any mutual insurer adopts an amendment to its charter or certificate of incorporation, as provided for in this chapter, the board of directors...
- Section 17b:18-59 - Mutualization Of Stock Insurers
a. A stock insurer may become a mutual insurer under such plan and procedure as may be approved by the commissioner after a hearing...
- Section 17b:18-60 - Merger And Consolidation Of Stock Insurers
a. A domestic stock insurer may merge or consolidate with one or more domestic or foreign stock insurers in the following manner and subject...
- Section 17b:18-61 - Merger And Consolidation Of Mutual Insurers
a. A domestic mutual insurer may merge or consolidate with one or more domestic or foreign mutual insurers in the following manner and subject...
- Section 17b:18-62 - "Reinsurance" Defined
"Reinsurance" is a contract under which an originating insurer, called the "ceding insurer" , procures insurance for itself in another insurer, called the "assuming...
- Section 17b:18-63 - Reinsurance Of Risks
An insurer may reinsure such risks as it is authorized to insure, subject to the provisions of this Code. L.1971, c. 144, s. 17B:18-63.
- Section 17b:18-64 - Prerequisites To Reinsurance
a. No domestic insurer may become a ceding insurer with respect to all or any substantial part of its outstanding insurance risks or become...
- Section 17b:18-65 - Extended Reinsurance
In addition to the reinsurance specified in 17B:18-63, an insurer authorized to do the business specified in section 17B:17-3, 17B:17-4 and 17B:17-5 may through...
- Section 17b:18-65.1 - Rules And Regulations
The commissioner is authorized to adopt, promulgate and enforce such rules and regulations as he determines to be necessary to implement this act. L.1975,...
- Section 17b:18-66 - Reinsurance Pooling
Any reinsurance authorized by sections 17B:18-63 or 17B:18-65 or any reinsurance of blanket accident insurance referred to in section 4 of Public Law 1939,...
- Section 17b:18-67 - Short Title
1. Sections 2 through 6 of this act shall be known and may be cited as the "Dynamic Capital and Surplus Act of 1993."
- Section 17b:18-68 - Surplus, Capital Required
2.Except as provided by section 3 of P.L.1993, c.235 (C.17B:18-69), no domestic insurer shall commence business in this State unless the insurer has surplus...
- Section 17b:18-69 - Temporary Waiver Of Capital, Surplus Requirements
3. An insurer authorized to transact the kind of business specified in N.J.S.17B:17-3, N.J.S.17B:17-4 or N.J.S.17B:17-5 prior to and on the effective date of...
- Section 17b:18-70 - Increase In Amount Of Required Capital, Surplus
4. The commissioner may increase the amount of capital or surplus required of any insurer pursuant to section 2 of this act, or subsequently...
- Section 17b:18-71 - Factors For Determination Of Increase, Revision, Redetermination
5. In determining any increase, revision or redetermination in the capital or surplus of an insurer pursuant to the provisions of section 4 of...
- Section 17b:18-72 - Suspension, Revocation Of Authority To Do Business
6. The commissioner may suspend or revoke the authority to do business in this State of any insurer that does not comply with the...
- Section 17b:19-1 - Expenses Of Investigation, Analyses, And Valuation Of Securities
a. The purpose of this section is to provide a means of making funds not in excess of $250,000 in any one year available...
- Section 17b:19-1.1 - Definitions.
58.For the purposes of chapter 19 of Title 17B of the New Jersey Statutes, N.J.S.17B:25-19, and sections 58, 60, 63, 64, 65 and 66...
- Section 17b:19-2 - Annual Valuation Of Reserve Liabilities For Outstanding Policies; Foreign And Alien Insurers.
17B:19-2. The commissioner shall annually value, or cause to be valued, the reserve liabilities (hereinafter called reserves) for all outstanding life insurance policies and...
- Section 17b:19-2.1 - Annual Valuation Of Reserve Liabilities.
60.The commissioner shall annually value, or cause to be valued, the reserve liabilities (hereinafter called reserves) for all outstanding life insurance contracts, annuity and...
- Section 17b:19-3 - Additional Reserves
Subject to the approval of the commissioner, any life insurer of this State may set up, in addition to the reserve liabilities required pursuant...
- Section 17b:19-4 - Preliminary Term Insurance; Amount Of Reserve
This section applies to life insurance policies, other than policies for which the reserve liabilities are valued on the basis of the provisions of...
- Section 17b:19-5 - Calculations Of Policy And Loss Reserves For Accident And Health Insurance.
17B:19-5. The commissioner shall annually make or cause to be made or shall annually require the insurer to make calculations of policy and loss...
- Section 17b:19-7 - Abandonment Of Standard Of Valuation Adopted
Except in accordance with the provisions of section 17B:19-2, a life insurer shall not abandon the standard of valuation adopted for any outstanding policies...
- Section 17b:19-8 - Standard Valuation Law
17B:19-8. This section shall be known as the standard valuation law and shall apply to all the life insurance policies, pure endowment contracts and...
- Section 17b:19-10 - Reserves, Related Actuarial Items; Annual Opinion Of Qualified Actuary.
2. a. For years ending prior to the operative date of the valuation manual, every insurer authorized to transact life, health or annuity business...
- Section 17b:19-11 - Standards For Policies Issued On Or After Operative Date Of Valuation Manual.
63. a. For policies issued on or after the operative date of the valuation manual, the standard prescribed in the valuation manual is the...
- Section 17b:19-12 - Establishment Of Reserves Using Principle-based Valuation.
64. a. A company shall establish reserves using a principle-based valuation that meets the following conditions for policies or contracts as specified in the...
- Section 17b:19-13 - Submission Of Certain Data.
65.A company shall submit mortality, morbidity, policyholder behavior, or expense experience and other data as prescribed in the valuation manual. L.2014, c.81, s.65.
- Section 17b:19-14 - "Confidential Information."
66. a. For purposes of this section "confidential information" means: (1)A memorandum in support of an opinion submitted under section 2 of P.L.1995, c.339...
- Section 17b:20-1 - Investments Of Domestic Insurers.
17B:20-1. Any domestic insurer may invest its capital, surplus and other funds, or any part thereof, in: a.Bonds, notes, or other evidences of indebtedness...
- Section 17b:20-2 - Limitation Of Investments.
17B:20-2. The amount (excluding amounts invested in the common stock of any corporation pursuant to N.J.S.17B:20-3 and N.J.S.17B:20-4) invested by a domestic insurer (a)...
- Section 17b:20-3 - Incidental Acquisition Of Corporate Stock Or Securities, Construction Of Chapter
Nothing contained in this chapter shall be construed to prohibit an insurer from accepting or acquiring corporate stock or evidences of indebtedness or other...
- Section 17b:20-4 - Stock Of Subsidiary Or Alien Corporations
17B:20-4. In addition to the authority expressly contained in this chapter and notwithstanding any limitation contained in this title, any domestic insurer may invest...
- Section 17b:20-5 - Securities Of Foreign Country Or Property Therein
Any domestic insurer lawfully doing business, directly or through any subsidiary, in any foreign country other than Canada, may also invest its funds, or...
- Section 17b:20-6 - Reasonable And Temporary Additional Restrictions
Notwithstanding any of the provisions of this chapter, if it shall appear to the commissioner that by reason of investment conditions generally or the...
- Section 17b:20-7 - Securities Of Domestic Insurers
17B:20-7. All securities of domestic insurers shall be held for safekeeping within the geographical limits of this State, except: a. Securities deposited with public...
- Section 17b:20-8 - Valuation Of Securities; Violations; Penalties
17B:20-8. Except as otherwise required by the commissioner, securities held by insurers authorized to do business in this State shall be valued in accordance...
- Section 17b:21-1 - Annual Statement; Forms
17B:21-1. a. Every insurer transacting business in this State shall annually, on or before March 1, file with the commissioner a statement subscribed and...
- Section 17b:21-2 - Penalty For Not Filing Annual Statement; Penalty For Other Violations
Any insurer neglecting to make and file its annual statement in the form and within the time provided by section 17B:21-1 of this Code...
- Section 17b:21-7 - Fees
a. On filing any certificate, executed by an insurer of this State, in the department, there shall be paid to the commissioner, for the...
- Section 17b:23-1 - Translation Of Business By Foreign And Alien Insurers
17B:23-1. Any foreign insurer which by its charter or by the laws of the state in which it was incorporated, or any alien insurer...
- Section 17b:23-2 - Prerequisites To Admission
No foreign or alien insurer shall be admitted until it: a. Files with the commissioner a certified copy of its charter or certificate of...
- Section 17b:23-3 - Deposit By Alien Insurers
No alien insurer shall be admitted until, in addition to complying with the foregoing conditions, it has made a deposit or deposits with the...
- Section 17b:23-4 - Revocation Of Authority To Do Business
The authority of a foreign or alien insurer may be revoked, after notice and hearing, pursuant to the Administrative Procedure Act (P.L.1968, c. 410)...
- Section 17b:23-5 - Retaliatory Provision.
17B:23-5. a. When by or pursuant to the laws of any other state or a province of Canada any taxes, licenses and other fees,...
- Section 17b:23-6 - Purpose
Sections 17B:23-6 through 17B:23-11 are deemed and declared to be remedial legislation for the protection of the health and welfare of persons resident in...
- Section 17b:23-7 - Definitions
Whenever used or referred to in sections 17B:23-6 to 17B:23-11 the term "commissioner" shall mean the Commissioner of Insurance. L.1971, c. 144, s. 17B:23-7....
- Section 17b:23-8 - Conditions Precedent To Doing Business In State
No insurer organized or existing under the law of another State, or of a foreign country, or any employee, agent or other representative thereof...
- Section 17b:23-9 - Actions Deemed Doing Business In The State
Without limiting the generality of the foregoing, an insurer which performs, causes or suffers to be performed within this State any of the following...
- Section 17b:23-10 - Enforcement
Whenever it shall appear to the commissioner that any insurer, or any employee, agent, promotional medium, or other representative thereof, has violated, is violating,...
- Section 17b:23-11 - Excluded Actions
The provisions of this act shall not be construed to apply to: a. The investigation, settlement or litigation of claims under any policy of...
- Section 17b:24-1.1 - Insurable Interests
1. a. For the purpose of life insurance, health insurance or annuities: (1) An individual has an insurable interest in his own life, health...
- Section 17b:24-2 - Minors
a. Any minor not less than 15 years of age may, notwithstanding such minority, contract for annuities or for insurance, or affirm by novation...
- Section 17b:24-3 - Application As Evidence
a. No application for any life or health insurance policy or annuity contract shall be admissible in evidence in any action relative to such...
- Section 17b:24-4 - Assignments
a. Nothing in this Title shall prohibit any person insured under an insurance policy or annuity contract, other than group, from assigning or not...
- Section 17b:24-5 - Payment Discharges Insurer
Whenever the proceeds of or payments under a life or health insurance policy or annuity contract heretofore or hereafter issued become payable in accordance...
- Section 17b:24-6 - Exemption Of Proceeds--life Insurance
a. If a policy of insurance, whether heretofore or hereafter issued, is affected by any person on his own life, or on another life,...
- Section 17b:24-7 - Exemption Of Proceeds--annuity Contracts
a. The benefits, rights, privileges, powers and options which under any annuity contract heretofore or hereafter issued are due or prospectively due the annuitant,...
- Section 17b:24-8 - Exemption Of Proceeds--health Insurance And Disability Provisions
Except as may otherwise be expressly provided by the policy or contract, the proceeds or avails of all policies of health insurance and of...
- Section 17b:24-9 - Exemption Of Proceeds--group Insurance
a. A policy of group life insurance or group health insurance or the proceeds thereof payable to the individual insured or to the beneficiary...
- Section 17b:24-10 - Policy Settlements
Any life insurer shall have the power to hold under agreement the proceeds of any policy issued by it, upon such terms and restrictions...
- Section 17b:24-11 - Participating And Nonparticipating Policies--right To Issue; Payment Of Commissions Thereon
A stock or mutual life insurer may issue policies on both the participating and nonparticipating basis, provided that the right or absence of right...
- Section 17b:24-12 - Separate Risks And Premiums
When a policy shall insure against more than one hazard or peril, the insurance against any specific hazard or peril shall not be separately...
- Section 17b:25-1 - "Industrial Life Insurance" ; Definition
For the purpose of this code, "Industrial life insurance" is that form of life insurance, issued by an insurer which, as to such insurance,...
- Section 17b:25-2 - Standard Provisions Required
a. No policy of life insurance, other than group insurance and pure endowments with or without return of premiums or of premiums and interest,...
- Section 17b:25-2.1 - Cancellation Of Policy Within 10 Days After Receipt
No policy of life insurance, other than group insurance, shall be delivered or issued for delivery in this State unless such policy contains in...
- Section 17b:25-3 - Grace Period
There shall be a provision that a grace period of 30 days, or, at the option of the insurer, of 1 month of not...
- Section 17b:25-4 - Incontestability
There shall be a provision that the policy (exclusive of provisions of the policy or any contract supplemental thereto relating to disability benefits or...
- Section 17b:25-5 - Entire Contract
There shall be a provision that the policy, or the policy and the application therefor if a copy of such application is attached to...
- Section 17b:25-6 - Misstatement Of Age
There shall be a provision that if the age of the insured or of any other person whose age is considered in determining the...
- Section 17b:25-7 - Dividends
a. There shall be a provision in participating policies other than industrial life insurance policies that, beginning not later than the end of the...
- Section 17b:25-8 - Policy Loan
There shall be a provision that after 3 full years' premiums have been paid and after the policy has a cash surrender value and...
- Section 17b:25-9 - Reinstatement
There shall be a provision that unless: a. the policy has been surrendered for its cash surrender value, or b. its cash surrender value...
- Section 17b:25-10 - Payment Of Premiums
There shall be a provision relative to the payment of premiums. L.1971, c. 144, s. 17B:25-10.
- Section 17b:25-10.1 - Notice Mailed To Holders Of Life Insurance Policy
An insurer shall give written notice by regular mail to the holder of a life insurance policy when, to prevent lapse of the policy,...
- Section 17b:25-11 - Payment Of Claims
17B:25-11. a. There shall be a provision that when benefits under the policy shall become payable by reason of the death of the insured,...
- Section 17b:25-12 - Beneficiary; Industrial Policies
An industrial life insurance policy shall have the name of the beneficiary designated thereon, or in the application or other form if attached to...
- Section 17b:25-13 - Nonforfeiture Benefits And Cash Surrender Values
There shall be a provision for nonforfeiture benefits and cash surrender values in accordance with the requirements of section 17B:25-19. L.1971, c. 144, s.
- Section 17b:25-14 - Title
There shall be a title on the policy, briefly describing it. L.1971, c. 144, s. 17B:25-14.
- Section 17b:25-15 - Provision Prohibited
No policy of life insurance shall be delivered or issued for delivery in this State which limits the time within which any action may...
- Section 17b:25-16 - Excluded Or Restricted Coverage
A clause in any policy of life insurance providing that such policy shall be incontestable after a specified period shall preclude only a contest...
- Section 17b:25-17 - Incontestability; Limitation Of Liability After Reinstatement
a. A reinstated policy of life insurance may be contested on account of fraud or misrepresentation of facts material to the reinstatement only for...
- Section 17b:25-18 - Filing Of Forms
17B:25-18. a. No life insurance policy, or application, if a written application is required and is to be made a part of the policy,...
- Section 17b:25-18.1 - Life, Health Insurance Policy, Contract; Compliance
15. No life insurance policy, health insurance policy, annuity, or variable contract subject to the provisions of Title 17B of the New Jersey Statutes,...
- Section 17b:25-18.2 - Filing Of Policy, Contract Or Related Form
16. a. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.) and P.L.1992, c.162 (C.17B:27A-17 et seq.), any life insurance policy or contract,...
- Section 17b:25-18.3 - Policies, Contract Forms; Certification Memorandums; Exceptions
17. a. Pursuant to the provisions of this section, an insurer authorized to do business in this State may file with the commissioner and...
- Section 17b:25-18.4 - Filing Of Certain Forms Of Life Insurance Approved In Other States.
1. a. Notwithstanding the provisions of any other law to the contrary and pursuant to the provisions of this section, an insurer authorized to...
- Section 17b:25-18.5 - Certain Actions Taken By Department Employees To Result In Termination.
2. a. An officer or employee of the Department of Banking and Insurance shall not take or threaten any action or omission in retaliation...
- Section 17b:25-19 - Standard Nonforfeiture Law For Life Insurance.
17B:25-19. This section shall be known as the standard nonforfeiture law for life insurance. a.No policy of life insurance, except as stated in subsection...
- Section 17b:25-20 - Standard Nonforfeiture Law For Individual Deferred Annuities.
5.This section shall be known as the standard nonforfeiture law for individual deferred annuities. a.No contract of annuity or pure endowment, except as stated...
- Section 17b:25-20.1 - Supersedure Of Standard Nonforfeiture Law, Certain.
13. Effective on the second anniversary of the effective date of the "Indexed Standard Nonforfeiture Law for Individual Deferred Annuities," P.L.2005, c.194 (C.17B:25-21 et...
- Section 17b:25-21 - Short Title.
1.This act shall be known and may be cited as the "Indexed Standard Nonforfeiture Law for Individual Deferred Annuities." L.2005,c.194,s.1.
- Section 17b:25-22 - Inapplicability Of Act.
2.This act shall not apply to any reinsurance, group annuity purchased under a retirement plan or plan of deferred compensation established or maintained by...
- Section 17b:25-23 - Required Provisions For Contract Of Annuity.
3. a. No contract of annuity to which this act applies shall be delivered or issued for delivery in this State on or after...
- Section 17b:25-24 - Minimum Values.
4.The minimum values provided by sections 5, 6, 7, 8 and 10 of this act of any paid-up annuity, cash surrender or death benefits...
- Section 17b:25-25 - Paid-up Annuity Benefit.
5.Any paid-up annuity benefit available under a contract shall be such that its present value on the date annuity payments are to commence is...
- Section 17b:25-26 - Cash Surrender Benefits, Determination Of Present Value.
6.For contracts that provide cash surrender benefits, the cash surrender benefits available prior to maturity shall not be less than the present value as...
- Section 17b:25-27 - Determination Of Present Value.
7.For contracts that do not provide cash surrender benefits, the present value of any paid-up annuity benefit available as a nonforfeiture option at any...
- Section 17b:25-28 - Determination Of Benefits.
8. a. For the purpose of determining the benefits calculated under sections 6 and 7 of this act, in the case of annuity contracts...
- Section 17b:25-29 - Notice Of Benefits Not Provided In Contract.
9.A contract that does not provide cash surrender benefits or does not provide death benefits at least equal to the minimum nonforfeiture amount prior...
- Section 17b:25-30 - Benefits Allowance For Lapse Of Time And Payments Beyond Schedule.
10. Any paid-up annuity, cash surrender or death benefits available at any time, other than on the contract anniversary under any contract with fixed...
- Section 17b:25-31 - Minimum Nonforfeiture Benefits.
11. For a contract which provides, within the same contract by rider or supplemental contract provision, both annuity benefits and life insurance benefits that...
- Section 17b:25-32 - Rules.
12. The Commissioner of Banking and Insurance may adopt rules to implement the provisions of this act pursuant to the "Administrative Procedure Act," P.L.1968,...
- Section 17b:25-33 - Effective Date, Applicability.
14. This act shall take effect immediately and shall apply as follows: a.Before the second anniversary of the effective date of this act, on...
- Section 17b:25-34 - Findings, Declarations Relative To Certain Annuity Products.
1.The Legislature finds and declares that it is a valid public purpose to set forth standards and procedures regarding annuity products directly solicited to...
- Section 17b:25-35 - Definitions Relative To Certain Annuity Products.
2.As used in this act, except as otherwise specified: "Annuity" means an annuity as defined by N.J.S.17B:17-5 directly solicited to a consumer. "Consumer" means...
- Section 17b:25-36 - Use Of Certain Terms Regulated; Exceptions.
3. a. (1) Consistent with the unfair trade practices set forth in N.J.S.17B:30-1 et seq., an insurance producer, or an agent, representative or member...
- Section 17b:25-37 - Certain Annuities Excluded; Annuities Buyer's Guide; Annuity Contract Disclosure Statement.
4. a. An annuity, for purposes of this section, concerning disclosure requirements, shall not include any annuity directly solicited to a consumer, that is:...
- Section 17b:25-38 - Certain Annuities Excluded, Information Recorded; Determination As To Suitability Of Annuity For Consumer; System Of Supervision.
5. a. An annuity, for purposes of this section concerning the suitability of an annuity for a particular consumer, shall not include any annuity...
- Section 17b:25-39 - Cancellation Provision For Certain Annuities.
6.An annuity directly solicited to a consumer, except for any annuity that is excluded pursuant to the provisions of section 5 of this act,...
- Section 17b:25-40 - Certain Annuities Excluded; Report To Owner.
7. a. An annuity, for purposes of this section, shall not include any annuity directly solicited to a consumer that is excluded pursuant to...
- Section 17b:25-41 - Collection, Maintenance Of Information.
8.Any information required to be collected and maintained in order to fulfill the requirements of this act shall be done in accordance with the...
- Section 17b:25-42 - Violations, Penalties.
9. a. A violation of this act shall be a violation of N.J.S.17B:30-1 et seq. b.Pursuant to the authority provided to the commissioner under...
- Section 17b:26-1 - Filing Of Forms
17B:26-1. a. No health insurance policy, or application, if a written application is required and is to be made a part of the policy,...
- Section 17b:26-2 - Form Of Policy; Requirements.
17B:26-2. a. No such policy of insurance shall be delivered or issued for delivery to any person in this State unless: (1)The entire money...
- Section 17b:26-2.1 - Treatment Of Alcoholism; Benefits
No health insurance contract providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State, or approved for issuance...
- Section 17b:26-2.1a - Reconstructive Breast Surgery; Benefits
1. Every health insurance policy providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or...
- Section 17b:26-2.1b - Health Insurance Policies
Every health insurance policy providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or renewal...
- Section 17b:26-2.1c - Benefits For Equipment For Home Treatment Of Hemophilia
Every health insurance policy providing hospital expense benefits to any policy holder or other person covered thereunder for expenses incurred in connection with the...
- Section 17b:26-2.1d - Individual Health Insurance Policy To Pay Benefits For Treatment Of Wilm's Tumor
Every individual health insurance policy providing hospital or medical expense benefits shall provide benefits to any named insured or other person covered thereunder for...
- Section 17b:26-2.1e - Individual Health Insurance Policy, Mammogram Examination Benefits.
4. a. No individual health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or...
- Section 17b:26-2.1f - Individual Health Insurance Benefits For Certain Nursing Services
1. a. Notwithstanding any provision of a policy of individual health insurance, whenever such a policy provides for reimbursement for any service which is...
- Section 17b:26-2.1g - Individual Health Insurance Policy, Benefits For "Off-label" Drugs Required
5. a. Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et al.), no individual health insurance policy which provides benefits for expenses incurred in...
- Section 17b:26-2.1h - Individual Health Insurer, Benefits For Health Promotion
6. a. Every individual policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:26-2.1i - Requirements For Individual Health Insurer Providing Benefits For Pharmacy Services.
4. a. Notwithstanding any other provision of law to the contrary, no individual health insurance policy which provides benefits for pharmacy services, prescription drugs,...
- Section 17b:26-2.1j - Benefits For Certain Cancer Treatments
4. In addition to benefits provided under regulations adopted pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), an insurer shall offer under every individual policy...
- Section 17b:26-2.1k - Coverage For Birth And Natal Care; Health Insurance Policy
4. a. Every policy that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et seq., or...
- Section 17b:26-2.1l - Coverage For Diabetes Treatment By Individual Health Insurance Policy
4. a. Every individual health insurance policy providing hospital or medical expense benefits that is delivered, issued, executed or renewed in this State pursuant...
- Section 17b:26-2.1m - Coverage For Minimum Inpatient Care Following Mastectomy By Individual Hospital, Medical Expense Benefits Policy
4. a. Every individual policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:26-2.1n - Applicability Of Health Care Quality Act
21. Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued,...
- Section 17b:26-2.1o - Coverage For Treatment Of Inherited Metabolic Diseases By Individual Health Insurance Policy.
4.No individual health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State, or approved for...
- Section 17b:26-2.1p - Health Insurance Policy To Cover Certain Audiology, Speech-language Pathology Services.
4.Notwithstanding any other provision of chapter 26 of Title 17B of the New Jersey Statutes, benefits shall not be denied to any eligible individual...
- Section 17b:26-2.1q - Coverage For Treatment Of Domestic Violence Injuries By Individual Health Insurance Policy.
4.Except as otherwise provided in P.L.1992, c.161 (C.17B:27A-2 et seq.), no individual health insurance policy providing hospital or medical expense benefits shall contain any...
- Section 17b:26-2.1r - Coverage For Certain Dental Procedures For The Severely Disabled Or Child Age Five Or Under By Individual Health Insurance Policy
4. a. No individual health insurance policy providing hospital or medical benefits shall be delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:26-2.1s - Individual Health Insurers To Provide Coverage For Biologically-based Mental Illness.
4. a. Every individual health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:26-2.1t - Coverage For Hemophilia Services By Individual Health Insurers
3.Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed...
- Section 17b:26-2.1u - Individual Policy To Provide Coverage For Colorectal Cancer Screening.
4.Every individual policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:26-1 et...
- Section 17b:26-2.1v - Individual Health Insurer Prescription Drug Plans To Cover Certain Infant Formulas.
5.An individual health insurer which provides hospital or medical expense benefits for expenses incurred in the purchase of prescription drugs under a policy that...
- Section 17b:26-2.1w - Policy Issued Under Chapter 26 Of Title 17b Required To Cover Certain Out-of-network Services.
3.Notwithstanding the provisions of chapter 26 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed...
- Section 17b:26-2.1x - Individual Health Insurer To Offer Coverage For Domestic Partner.
50.An individual health insurer that provides hospital or medical expense benefits under a policy that is delivered, issued, executed or renewed in this State...
- Section 17b:26-2.1y - Individual Health Insurer, Coverage For Prescription Female Contraceptives.
5.An individual health insurer that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a policy...
- Section 17b:26-2.1z - Individual Health Insurance Policies To Provide Benefits For Orthotic And Prosthetic Appliances.
4. a. Every individual health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:26-2.1aa - Individual Health Insurance Policy To Provide Coverage For Hearing Aids For Certain Persons Aged 15 Or Younger.
5.An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:26-2.1bb - Individual Health Insurance Policy To Provide Installment Payments To Obstetrical Provider For Maternity Services.
4. a. Every individual health insurance policy that provides benefits for maternity services, and that is delivered, issued, executed or renewed in this State,...
- Section 17b:26-2.1cc - Individual Health Insurance Policy To Provide Benefits For Treatment Of Autism Or Other Developmental Disability.
4.Notwithstanding any other provision of law to the contrary, every individual health insurance policy that provides hospital and medical expense benefits and is delivered,...
- Section 17b:26-2.1dd - Individual Health Insurance Policy To Provide Coverage For Oral Anticancer Medications.
4. a. An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State...
- Section 17b:26-2.1ee - Individual Health Insurance Policy To Provide Coverage For Sickle Cell Anemia.
5.Every individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to...
- Section 17b:26-2.1ff - Individual Health Insurer To Provide Coverage For Prescription Eye Drops.
4. a. An individual health insurer which provides hospital or medical expense benefits that include coverage for prescription eye drops under a policy delivered,...
- Section 17b:26-2.1gg - Individual Health Insurance Policy, Contract, Coverage For Synchronization Of Prescribed Medications.
4. a. Every individual health insurance policy or contract delivered, issued, executed or renewed in this State, or approved for issuance or renewal in...
- Section 17b:26-2.2 - Second Surgical Opinions; Definitions
As used in this act: a. "Elective surgical procedure" means any nonemergency surgical procedure which may be scheduled at the convenience of the patient...
- Section 17b:26-2.3 - Policy Benefits For Second Surgical Opinion
Any insurer issuing an individual insurance policy in accordance with chapter 26 of Title 17B of the New Jersey Statutes which provides coverage of...
- Section 17b:26-2.4 - Benefit Payments
Benefits for a second surgical opinion shall include payment for the second surgical opinion services of an eligible physician and for essential laboratory and...
- Section 17b:26-2.5 - Third Surgical Opinion
If a second surgical opinion does not confirm that a proposed elective surgical procedure is medically advisable, benefits must be provided under the policy...
- Section 17b:26-2.6 - Excluded Surgical Procedures
The second surgical opinion benefit provisions of a policy may exclude benefits while the patient is confined in a hospital as an inpatient, any...
- Section 17b:26-2.7 - Payment For Opinion Services Of Physician
If a physician who furnishes a second or third surgical opinion also performs the surgical procedure, the policy need not provide payment for the...
- Section 17b:26-2.8 - Application Of Act
This act shall apply to all contracts in which the insurer has reserved the right to change the premium. L.1979, c. 328, s. 7.
- Section 17b:26-3 - Required Provisions
Except as provided in section 17B:26-28 each such policy delivered or issued for delivery to any person in this State shall contain the provisions...
- Section 17b:26-3.1 - Cancellation Of Policy Within 10 Days After Receipt
Except as provided in N.J.S. 17B:26-28, each health insurance policy, other than group and blanket insurance, delivered or issued for delivery to any person...
- Section 17b:26-3.2 - Individual Health Insurance Policy, Exclusion, Rates, Terms Based On Genetic Information Prohibited
14. Every individual health insurance policy providing hospital and medical expense benefits that is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:26-4 - Entire Contract; Changes
There shall be a provision as follows: Entire contract; changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire...
- Section 17b:26-5 - Time Limit On Certain Defenses
There shall be a provision as follows: Time limit on certain defenses: a. After 2 years from the date of issue of this policy...
- Section 17b:26-6 - Grace Period
There shall be a provision as follows: Grace period: A grace period of (insert a number not less than "7" for weekly premium policies,...
- Section 17b:26-7 - Reinstatement
There shall be a provision as follows: Reinstatement: If any renewal premium be not paid within the time granted the insured for payment, a...
- Section 17b:26-8 - Notice Of Claim
There shall be a provision as follows: Notice of claim: Written notice of claim must be given to the insurer within 20 days after...
- Section 17b:26-9 - Claim Forms
There shall be a provision as follows: Claim forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such...
- Section 17b:26-9.1 - Health Insurer To Receive, Transmit Transactions Relative To Individual Policies Electronically; Standards.
5. a. Within 180 days of the adoption of a timetable for implementation pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23), a health insurer...
- Section 17b:26-10 - Proofs Of Loss
There shall be a provision as follows: Proofs of loss: Written proof of loss must be furnished to the insurer at its said office...
- Section 17b:26-11 - Time Of Payment Of Claims
There shall be a provision as follows: Time of payment of claims: Indemnities payable under this policy for any loss other than loss for...
- Section 17b:26-12 - Payment Of Claims
There shall be a provision as follows: Payment of claims: Indemnity for loss of life will be payable in accordance with the beneficiary designation...
- Section 17b:26-13 - Physical Examinations And Autopsy
There shall be a provision as follows: Physical examinations and autopsy: The insurer at its own expense shall have the right and opportunity to...
- Section 17b:26-14 - Legal Actions
There shall be a provision as follows: Legal actions: No action at law or in equity shall be brought to recover on this policy...
- Section 17b:26-15 - Change Of Beneficiary
There shall be a provision as follows: Change of beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change of...
- Section 17b:26-16 - Optional Policy Provisions
Except as provided in section 17B:26-28, no policy of health insurance delivered or issued for delivery to any person in this State shall contain...
- Section 17b:26-17 - Change Of Occupation
There may be a provision as follows: Change of occupation: If the insured be injured or contract sickness after having changed his occupation to...
- Section 17b:26-18 - Misstatement Of Age
There may be a provision as follows: Misstatement of age: If the age of the insured has been misstated, all amounts payable under this...
- Section 17b:26-19 - Other Insurance In This Insurer
There may be a provision as follows: Other insurance in this insurer: If an accident or sickness or accident and sickness policy or policies...
- Section 17b:26-20 - Insurance With Other Insurers
There may be a provision as follows: Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for...
- Section 17b:26-21 - Insurance With Other Insurers
There may be a provision as follows: Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for...
- Section 17b:26-22 - Relation Of Earnings To Insurance
There may be a provision as follows: Relation of earnings to insurance: If the total monthly amount of loss of time benefits promised for...
- Section 17b:26-23 - Unpaid Premium
There may be a provision as follows: Unpaid premium: Upon the payment of a claim under this policy, any premium then due and unpaid...
- Section 17b:26-24 - Cancellation
There may be a provision as follows: Cancellation: The insurer may cancel this policy at any time by written notice delivered to the insured,...
- Section 17b:26-25 - Conformity With State Statutes
There may be a provision as follows: Conformity with State statutes: Any provision of this policy which, on its effective date, is in conflict...
- Section 17b:26-26 - Illegal Occupation
There may be a provision as follows: Illegal occupation: The insurer shall not be liable for any loss to which a contributing cause was...
- Section 17b:26-27 - Intoxicants And Narcotics
There may be a provision as follows: Intoxicants and narcotics: The insurer shall not be liable for any loss sustained or contracted in consequence...
- Section 17b:26-28 - Inapplicable Or Inconsistent Provisions
If any provision of sections 17B:26-3 to 17B:26-31, inclusive, is in whole or in part inapplicable to or inconsistent with the coverage provided by...
- Section 17b:26-29 - Order Of Certain Policy Provisions
The provisions which are the subject of sections 17B:26-3 to 17B:26-27, inclusive, or any corresponding provisions which are used in lieu thereof in accordance...
- Section 17b:26-30 - Third Party Ownership
The word "insured," as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable...
- Section 17b:26-31 - Requirements Of Other Jurisdictions
a. Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any...
- Section 17b:26-32 - Other Policy Provisions
No policy provision which is not subject to sections 17B:26-3 to 17B:26-31, inclusive, of this chapter shall make a policy, or any portion thereof,...
- Section 17b:26-33 - Policy Conflicting With This Chapter
A policy delivered or issued for delivery to any person in this State in violation of this chapter shall be held valid but shall...
- Section 17b:26-34 - Time Limit On Certain Defenses With Respect To Reinstatement
A policy provision complying with the requirements of section 17B:26-5, relating to a time limit on certain defenses, shall also apply to any reinstatement...
- Section 17b:26-35 - Waiver Of Rights Of Insurer
The acknowledgment by any insurer of the receipt of notice given under any policy covered by this chapter, or the furnishing of forms for...
- Section 17b:26-36 - Age Limit
If any policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will...
- Section 17b:26-37 - Scope Of Chapter
Nothing in this chapter shall apply to or affect a. any policy of workmen's compensation insurance or any policy of liability insurance with or...
- Section 17b:26-38 - Penalty
Any person who delivers or issues for delivery to any person in this State any policy in willful violation of the provisions of this...
- Section 17b:26-39 - Legislative Findings And Declarations
The Legislature hereby finds and declares that the high cost of hospital care necessitates the establishment of alternative means of caring for patients who...
- Section 17b:26-40 - Definitions
As used in this act: a. "Home health care" means those nursing and other home health care services rendered to a person in his...
- Section 17b:26-41 - Home Health Care; Requirement For Provisions For Coverage
Notwithstanding any provision of a policy of health insurance, hereafter delivered or issued for delivery in this State, whenever such policy provides coverage for...
- Section 17b:26-42 - Benefits
Every policy shall provide benefits required by section 3 without a separate deductible or coinsurance provision for the home health care benefit. For the...
- Section 17b:26-43 - Direct Reimbursement To Home Health Care Providers
The State Commissioner of Insurance, after consultation with the State Commissioner of Health, shall provide for a system of direct reimbursement to home health...
- Section 17b:26-44 - Regulations
The State Commissioner of Insurance, after consultation with the State Commissioner of Health, is hereby empowered and directed to promulgate regulations necessary to effectuate...
- Section 17b:26-44.1 - Policy Provision For Reimbursement Of Dental Services; Payment Regardless Of Discipline Of Provider
Notwithstanding any provision of a policy or individual health insurance contract hereafter delivered, issued for delivery, amended, renewed or ratified in this State, whenever...
- Section 17b:26-44.2 - Application To Policy Or Contract Not Limited To Reimbursement Of Specific Types Of Duly Licensed Health Care Professionals Other Than Dentists
The provisions of section 1 of this act shall also apply to any policy or contract of individual health insurance already delivered or issued...
- Section 17b:26-44.3 - Renewal Date; Policy With Reservation Of Right To Change Premium
For the purposes of this act, a policy or contract in which the company has reserved the right to change the premium shall be...
- Section 17b:26-44.4 - Alternative Dental Coverage; Original Coverage Restricted To Limited Number Of Providers
Each employer or other organization which employs or has 25 or more employees or members during the full preceding calendar year and which contributes...
- Section 17b:26-44.5 - Employer Contribution
An employer or other organization shall be required to pay for or contribute towards the provision of alternative coverage an amount equal to the...
- Section 17b:26-44.6 - Rules And Regulations
Within 120 days of the effective date of this act, the Commissioner of the Department of Insurance shall promulgate rules and regulations necessary to...
- Section 17b:26-45 - Minimum Standards For Form, Content And Sale Of Individual Health Insurance; Regulations
a. The commissioner of insurance shall issue such regulations as he shall deem necessary or desirable to establish minimum standards, including standards for full...
- Section 17b:26-46 - Violations; Penalty; Collection And Enforcement
If, after notice and hearing, the commissioner finds that an insurance company, agent or broker or any other person has violated the provisions of...
- Section 17b:26-47 - Injunction
The commissioner may, through the Attorney General of this State, institute an action in the Superior Court to enjoin and restrain any insurer who...
- Section 17b:26a-1 - Definitions
1. For the purposes of this act: a. "Applicant" means: (1) In the case of an individual medicare supplement policy, the person who seeks...
- Section 17b:26a-2 - Regulations; Medicare Supplement Policies
The commissioner shall issue regulations to establish specific standards for policy provisions of medicare supplement policies, which shall be in addition to and in...
- Section 17b:26a-3 - Prohibited Provisions
3. a. No medicare supplement policy shall contain benefits which duplicate any benefits provided by medicare. b. The commissioner may issue regulations that specify...
- Section 17b:26a-4 - Preexisting Condition; Denial Of Claim For Losses
Notwithstanding any other provision of law of this State to the contrary, a medicare supplement policy may not deny a claim for losses incurred...
- Section 17b:26a-5 - Regulations
5. The commissioner shall promulgate regulations to effectuate and enforce the provisions of P.L.1982, c.94 (C. 17B:26A-1 et seq.) and any regulations which are...
- Section 17b:26a-6 - Medicare Supplement Policy Or Certificate, Requirements
6. a. No insurer shall deliver or issue for delivery to a resident of this State a medicare supplement policy or certificate, or any...
- Section 17b:26a-7 - Outline Of Coverage, Regulations
7. a. In order to provide for full and fair disclosure in the sale of medicare supplement policies, no medicare supplement policy or certificate...
- Section 17b:26a-8 - 30-day Examination Period, Refunds
8. Medicare supplement policies or certificates shall have a notice prominently printed on the first page of the policy or certificate or attached thereto...
- Section 17b:26a-9 - Applicability
1. Except as otherwise specifically provided: a. The provisions of P.L.1982, c.94 (C.17B:26A-1 et seq.) shall apply to all medicare supplement policies delivered or...
- Section 17b:26a-10 - Filing Of Copies Of Advertising Materials, Regulations
8. a. Every insurer shall file with the Department of Insurance a copy of all advertising materials to be used in promoting medicare supplement...
- Section 17b:26a-11 - Additional Remedies
9. In addition to any other applicable penalties for violation of the provisions of Title 17B of the New Jersey Statutes, the commissioner may...
- Section 17b:26a-12 - Findings, Declarations On Medicare Supplement Insurance
1. The Legislature finds and declares that: a. As of April 1, 1995, individuals in the State of New Jersey under age 65 who...
- Section 17b:26a-13 - Medicare Supplement Plan C Offered
2. a. No later than 60 days after the effective date of this act, every carrier issuing or renewing Medicare supplement insurance policies or...
- Section 17b:26a-14 - Rules, Regulations; Rates; Plan Provision
3. a. The commissioner shall adopt rules and regulations establishing a plan to provide Medicare Supplement Plan C coverage of the standardized Medicare supplement...
- Section 17b:26a-15 - Procedures For Equitable Sharing Of Losses; Conditions; Filing Statement
4. The plan shall establish procedures for the equitable sharing of any losses incurred by the contracting carrier providing coverage under the plan pursuant...
- Section 17b:26a-16 - Audit Required, Conditions
5. a. Whenever the contracting carrier reports a net loss to the commissioner pursuant to paragraph (2) of subsection a. of section 4 of...
- Section 17b:26a-17 - Definitions
6. As used in this act: "Carrier" means an insurance company or service corporation authorized to issue health benefits plans in this State. "Financially...
- Section 17b:26b-1 - Health Insurers To Offer Basic Health Care Policies
Every health insurer authorized to do business in this State which delivers or issues for delivery policies in accordance with the provisions of chapter...
- Section 17b:26b-2 - Provisions Of Basic Health Care Policy
57. a. A basic health care policy offered pursuant to section 56 of P.L.1991, c.187 (C.17B:26B-1) shall provide: (1) Basic hospital expense coverage for...
- Section 17b:27-26 - Definitions And Requirements
Any policy or contract of health insurance which covers more than one person, other than a blanket insurance policy, or a policy issued pursuant...
- Section 17b:27-27 - Employer, Trustee, Labor Union, Association Groups
A policy issued to an employer or to the trustees of a fund established by one or more employers, or issued to a labor...
- Section 17b:27-28 - Other Groups As Permitted Under Group Life Insurance
Group health insurance may also be provided under a policy issued to cover such other groups as may be covered for group life insurance....
- Section 17b:27-29 - Discretionary Groups
A policy issued to insure any other group which, in the opinion of the commissioner, may be insured for group health insurance in accordance...
- Section 17b:27-30 - Dependents.
17B:27-30. Benefits of group health insurance, except benefits for loss of time on account of disability, may be provided for one or more members...
- Section 17b:27-30.1 - Benefits Provided By Group Policy To Subscriber's Child
11. a. A policy which provides hospital or medical expense benefits under which dependent coverage is available shall not deny coverage for an insured's...
- Section 17b:27-30.2 - Requirements Applicable To State Medicaid
12. An insurer shall not impose requirements on the Division of Medical Assistance and Health Services in the Department of Human Services which has...
- Section 17b:27-30.3 - Coverage Provided By Group Health Plan To Subscriber's Child
15. a. A group health plan as defined in section 607(1) of the "Employee Retirement Income Security Act of 1974," 29 U.S.C.1167(1) which provides...
- Section 17b:27-30.4 - Requirements Applicable To State Medicaid
16. A group health plan as defined in section 607(1) of the "Employee Retirement Income Security Act of 1974," 29 U.S.C.1167(1) shall not impose...
- Section 17b:27-30.5 - Coverage For Certain Dependents Until Age 31 By Group Health Insurance Policy.
4. a. As used in this section, "dependent" means an insured's child by blood or by law who: (1)is 30 years of age or...
- Section 17b:27-31 - "Employees" Defined
The policy may provide that the term "employees" shall include as employees of a single employer the employees of one or more subsidiary corporations...
- Section 17b:27-32 - Blanket Insurance
a. Any policy or contract of insurance against death or injury resulting from accident or from accidental means which conforms with the description and...
- Section 17b:27-33 - Standard Provisions
No policy of group health or blanket insurance and no certificate thereunder shall be delivered or issued for delivery in this State unless the...
- Section 17b:27-34 - Application; Statements
There shall be a provision that a copy of the application, if any, of the policyholder shall be attached to the policy when issued,...
- Section 17b:27-35 - Policy Changes
There shall be a provision that no agent has authority to change the policy or to waive any of its provisions and that no...
- Section 17b:27-36 - New Entrants
There shall be a provision that all new employees or new members, as the case may be, in the groups or classes eligible for...
- Section 17b:27-36.1 - Eligibility For Enrollment Under Policy Providing Hospital, Medical Expense Benefits.
6.Notwithstanding any other provision of law to the contrary, an insurer shall not consider a person's eligibility for medical assistance pursuant to P.L.1968, c.413...
- Section 17b:27-36.2 - Group Health Insurance, Policy, Exclusion, Rates, Terms Based On Genetic Information Prohibited
15. Every group health insurance policy providing hospital or medical expense benefits that is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27-37 - Payment Of Premiums
There shall be a provision that all premiums due under the policy shall be remitted by the employer or employers of the persons insured,...
- Section 17b:27-38 - Certificate
There shall be a provision that the insurer shall issue to the employer, the policyholder, or other person or association in whose name such...
- Section 17b:27-39 - Age Limits
There shall be a provision specifying the ages, if any there be, to which the insurance provided therein shall be limited; and the ages,...
- Section 17b:27-40 - Notice Of Loss
There shall be a provision that written notice of sickness or of injury must be given to the insurer within 20 days after the...
- Section 17b:27-41 - Proof Of Loss
There shall be a provision that in the case of claim for loss of time for disability, written proof of such loss must be...
- Section 17b:27-42 - Forms For Proof
There shall be a provision that the insurer will furnish to the person making claim, or to the policyholder for delivery to such person,...
- Section 17b:27-43 - Examination, Autopsy
There shall be a provision that the insurer shall have the right and opportunity to examine the person of the insured when and so...
- Section 17b:27-44 - Time Of Benefit Payment
There shall be a provision that all benefits payable under the policy other than benefits for loss of time will be payable not more...
- Section 17b:27-44.2 - Health Insurer To Receive, Transmit Transactions Relative To Group Policies Electronically; Standards.
6. a. Within 180 days of the adoption of a timetable for implementation pursuant to section 1 of P.L.1999, c.154 (C.17B:30-23), a health insurer...
- Section 17b:27-45 - Beneficiary; Direct Payment To Hospitals And Other Purveyors Of Services
There shall be a provision that indemnity for loss of life of the insured shall be payable to the beneficiary or beneficiaries designated by...
- Section 17b:27-46 - Time Limits, Suits
There shall be a provision that no action at law or in equity shall be brought to recover on the policy prior to the...
- Section 17b:27-46.1 - Treatment Of Alcoholism; Benefits
No group health insurance contract providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State, or approved for...
- Section 17b:27-46.1a - Reconstructive Breast Surgery; Benefits
1. Every group health insurance policy providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance...
- Section 17b:27-46.1b - Group Health Insurance Policies
Every group health insurance policy providing hospital or medical expense benefits delivered, issued, executed or renewed in this State, or approved for issuance or...
- Section 17b:27-46.1c - Benefits For Purchase Of Blood Products, Infusion Equipment
Every group health insurance policy providing hospital expense benefits to any policy holder or other person covered thereunder for expenses incurred in connection with...
- Section 17b:27-46.1d - Commercial Health Insurer Benefits For Preexisting Condition
a. Notwithstanding any other provision of law to the contrary, no group health insurance policy issued by an insurer pursuant to the provisions of...
- Section 17b:27-46.1e - Group Health Insurance Policy To Pay Benefits For Treatment Of Wilm's Tumor
Every group health insurance policy providing hospital or medical expense benefits shall provide benefits to any named insured or other person covered thereunder for...
- Section 17b:27-46.1f - Group Health Insurance Policy, Mammogram Examination Benefits.
5. a. No group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed, or renewed in this State or...
- Section 17b:27-46.1g - . Group Health Insurance Policy, Benefits For "Off-label" Drugs Required
6. a. Except as otherwise provided in P.L.1992, c.162 (C.17B:27A-17 et seq.), no group health insurance policy which provides benefits for expenses incurred in...
- Section 17b:27-46.1h - Group Health Insurer, Benefits For Health Promotion
7. a. Every group policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27-46.1i - Requirements For Group Health Insurer Providing Benefits For Pharmacy Services.
5. a. Notwithstanding any other provision of law to the contrary, no group health insurance policy which provides benefits for pharmacy services, prescription drugs,...
- Section 17b:27-46.1j - Benefits For Certain Cancer Treatments
5. In addition to benefits provided under regulations adopted pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), an insurer shall offer under every group policy...
- Section 17b:27-46.1k - Coverage For Birth And Natal Care; Group Insurance Policy
7. a. Every policy that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 et seq., or...
- Section 17b:27-46.1l - Group Health Insurance Policy, Child Screening, Blood Lead, Hearing Loss; Immunizations.
3.No group health insurance policy providing hospital or medical expense benefits for groups with more than 50 persons shall be delivered, issued, executed, or...
- Section 17b:27-46.1m - Coverage For Diabetes Treatment By Group Health Insurance Policy
5. a. Every group health insurance policy providing hospital or medical expense benefits that is delivered, issued, executed or renewed in this State pursuant...
- Section 17b:27-46.1n - Group Health Insurance Policy, Pap Smear Benefits
4.No group health insurance policy providing hospital or medical expense benefits for groups with greater than 50 persons shall be delivered, issued, executed or...
- Section 17b:27-46.1o - Group Health Insurance Policy, Prostate Cancer Testing
4. No group health insurance policy providing hospital or medical expense benefits for groups with greater than 49 persons shall be delivered, issued, executed...
- Section 17b:27-46.1p - Coverage For Minimum Inpatient Care Following Mastectomy By Group Policy
5. a. Every group policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27-46.1q - Applicability Of Health Care Quality Act
22. Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued,...
- Section 17b:27-46.1r - Coverage For Treatment Of Inherited Metabolic Diseases By Group Health Insurance Policy.
5.No group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, executed or renewed in this State, or approved for...
- Section 17b:27-46.1s - Group Health Insurer To Cover Certain Audiology, Speech-language Pathology Services.
5.Notwithstanding any other provision of chapter 27 of Title 17B of the New Jersey Statutes, benefits shall not be denied to any eligible individual...
- Section 17b:27-46.1t - Coverage For Treatment Of Domestic Violence Injuries By Group Health Insurance Policy.
5.Except as otherwise provided in P.L.1992, c.162 (C.17B:27A-17 et seq.), no group health insurance policy providing hospital or medical expense benefits shall contain any...
- Section 17b:27-46.1u - Coverage For Certain Dental Procedures For The Severely Disabled Or Child Age Five Or Under By Group Health Insurance Policy
5. a. No group health insurance policy providing hospital or medical benefits shall be delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27-46.1v - Group Health Insurers To Provide Coverage For Biologically-based Mental Illness.
5. a. Every group health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:27-46.1w - Coverage For Hemophilia Services By Group Health Insurers
4.Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed...
- Section 17b:27-46.1x - Group Health Insurance Policy To Provide Coverage For Treatment Of Infertility.
4. a. A group health insurance policy which provides hospital or medical expense benefits for groups with more than 50 persons, which includes pregnancy-related...
- Section 17b:27-46.1y - Group Policy To Provide Coverage For Colorectal Cancer Screening.
5.Every group policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 et...
- Section 17b:27-46.1z - Group Health Insurer Prescription Drug Plans To Cover Certain Infant Formulas.
4.A group health insurer which provides hospital or medical expense benefits for expenses incurred in the purchase of prescription drugs under a policy that...
- Section 17b:27-46.1aa - Policy Issued Under Chapter 27 Of Title 17b Required To Cover Certain Out-of-network Services.
4.Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed...
- Section 17b:27-46.1bb - Group Health Insurer To Offer Coverage For Domestic Partner.
51.A group health insurer that provides hospital or medical expense benefits under a policy that is delivered, issued, executed or renewed in this State...
- Section 17b:27-46.1cc - Group Health Insurance Policy, High Deductible, Coverage For Preventive Care.
8.No group health insurance policy providing hospital or medical expense benefits for groups with more than 50 persons, that qualifies as a high deductible...
- Section 17b:27-46.1dd - Group Health Insurance Policy, High Deductible, Deductible Inapplicable, Certain Circumstances.
9.Notwithstanding the provisions of section 3 of P.L.1995, c.316 (C.17B:27-46.1l) regarding deductibles for a high deductible health plan, a group health insurance policy providing...
- Section 17b:27-46.1ee - Group Health Insurer, Coverage For Prescription Female Contraceptives.
4.A group health insurer that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a policy...
- Section 17b:27-46.1ff - Group Health Insurance Policies To Provide Benefits For Orthotic And Prosthetic Appliances.
5. a. Every group health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:27-46.1gg - Group Health Insurance Policy To Provide Coverage For Hearing Aids For Certain Persons Aged 15 Or Younger.
6.A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27-46.1hh - Group Health Insurance Policy To Provide Installment Payments To Obstetrical Provider For Maternity Services.
5. a. Every group health insurance policy that provides benefits for maternity services, and that is delivered, issued, executed or renewed in this State,...
- Section 17b:27-46.1ii - Group Health Insurance Policy To Provide Benefits For Treatment Of Autism Or Other Developmental Disability.
5.Notwithstanding any other provision of law to the contrary, every group health insurance policy that provides hospital and medical expense benefits and is delivered,...
- Section 17b:27-46.1jj - Group Health Insurance Policy To Provide Coverage For Oral Anticancer Medications.
5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State...
- Section 17b:27-46.1kk - Group Health Insurance Policy To Provide Coverage For Sickle Cell Anemia.
4.Every group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to...
- Section 17b:27-46.1ll - Group Health Insurer To Provide Coverage For Prescription Eye Drops.
5. a. A group health insurer which provides hospital or medical expense benefits that include coverage for prescription eye drops, under a policy delivered,...
- Section 17b:27-46.1mm - Group Health Insurance Policy, Contract, Coverage For Synchronization Of Prescribed Medications.
5. a. Every group health insurance policy or contract delivered, issued, executed or renewed in this State, or approved for issuance or renewal in...
- Section 17b:27-46.2 - Second Surgical Opinions; Definitions
As used in this act: a. "Elective surgical procedure" means any nonemergency surgical procedure which may be scheduled at the convenience of the patient...
- Section 17b:27-46.3 - Group Insurance Policies; Provision Of Program On Request
Any insurer issuing a group insurance policy in accordance with chapter 27 of Title 17B of the New Jersey Statutes which provides coverage of...
- Section 17b:27-46.4 - Payment For Second Surgical Opinion Services
A second surgical opinion program shall provide for payment for the second surgical opinion services of an eligible physician and for essential laboratory and...
- Section 17b:27-46.5 - Third Surgical Opinion
If a second surgical opinion does not confirm that a proposed elective surgical procedure is medically advisable, the program must cover a third surgical...
- Section 17b:27-46.6 - Reduction Of Benefits Where No Second Opinion Obtained
Where a second surgical opinion program is operative in connection with surgical coverage under a group insurance policy, and provides second and third surgical...
- Section 17b:27-46.7 - Permissible Benefit Exclusions
A second surgical opinion program may exclude benefits while the patient is confined in a hospital as an inpatient, any surgical procedure not covered...
- Section 17b:27-46.8 - Payment For Opinion Services Of Physician
If a physician who furnishes a second or third surgical opinion also performs the surgical procedure, the second surgical opinion program need not provide...
- Section 17b:27-46.9 - Application Of Act
This act shall apply to all contracts in which the insurer has reserved the right to change the premium. L.1979, c. 329, s. 8.
- Section 17b:27-47 - Group Health Or Blanket Insurance--provisions As Favorable; Policies Issued Outside State
No policy of group health or blanket insurance, and no certificate thereunder shall be delivered or issued for delivery in this State if such...
- Section 17b:27-48 - Exceptions In Same Type As Benefits
Exceptions in the policy shall be printed in the policy and in the certificate with the same prominence as the benefits to which they...
- Section 17b:27-49 - Filing Of Forms
17B:27-49. a. No group health insurance policy, or blanket insurance policy, or application, if a written application is required and is to be made...
- Section 17b:27-50 - Reimbursement For Service Of Physician Or Practicing Psychologist
a. Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such...
- Section 17b:27-50.1 - Severability
If any section, subsection, paragraph, sentence, clause, phrase or word contained in this act shall be declared invalid for any reason whatsoever, such invalidity...
- Section 17b:27-51 - Reimbursement For Optometric Service
Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a...
- Section 17b:27-51.1 - Reimbursement For Service Of Chiropractor
Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a...
- Section 17b:27-51.1a - Group Health Insurance Benefits For Certain Nursing Services
2. a. Notwithstanding any provision of a policy of group health insurance, whenever such a policy provides for reimbursement for any service which is...
- Section 17b:27-51.2 - Legislative Findings And Declarations
The Legislature hereby finds and declares that the high cost of hospital care necessitates the establishment of alternative means of caring for patients who...
- Section 17b:27-51.3 - Definitions
As used in this act: a. "Home health care" means those nursing and other home health care services rendered to a person in his...
- Section 17b:27-51.4 - Home Health Care; Requirement For Coverage
Notwithstanding any provision of a policy of group health insurance, hereafter delivered or issued for delivery in this State, whenever such policy provides coverage...
- Section 17b:27-51.5 - Benefits
Every policy shall provide benefits required by section 3 without a separate deductible or coinsurance provision for the home health care benefit. For the...
- Section 17b:27-51.6 - Direct Reimbursement To Home Health Care Providers
The State Commissioner of Insurance, after consultation with the State Commissioner of Health, shall provide for a system of direct reimbursement to home health...
- Section 17b:27-51.7 - Regulations
The State Commissioner of Insurance, after consultation with the State Commissioner of Health, is hereby empowered and directed to promulgate regulations necessary to effectuate...
- Section 17b:27-51.8 - Policy Provision For Reimbursement Of Dental Services; Payment Regardless Of Discipline Of Provider
Notwithstanding any provision of a policy or contract of group health insurance hereafter delivered, issued for delivery, amended, renewed or ratified in this State...
- Section 17b:27-51.9 - Application To Policy Or Contract Not Limited To Reimbursement Of Specific Types Of Duly Licensed Health Care Professionals Other Than Dentists
The provisions of section 1 of this act shall also apply to any policy or contract of group health insurance already delivered or issued...
- Section 17b:27-51.10 - Renewal Date; Policy With Reservation Of Right To Change Premium
For the purposes of this act, a policy or contract in which the company has reserved the right to change the premium shall be...
- Section 17b:27-51.10a - Alternative Dental Coverage; Original Coverage Restricted To Limited Number Of Providers
Each employer or other organization which employs or has 25 or more employees or members during the full preceding calendar year which contributes to...
- Section 17b:27-51.10b - Employer Contribution
An employer or other organization shall be required to pay or contribute towards the provision of alternative coverage an amount equal to the premium...
- Section 17b:27-51.10c - Rules And Regulations
Within 120 days of the effective date of this act, the Commissioner of the Department of Insurance shall promulgate rules and regulations necessary to...
- Section 17b:27-51.11 - Definitions
As used in this act: a. "Group policy" means a group health insurance policy issued by an insurer pursuant to Title 17B of the...
- Section 17b:27-51.12 - Total Disability Of Employee Or Member; Continuation Under Group Policy; Conditions
A group policy delivered or issued for delivery in this State which insures employees or members and their dependents for hospital, surgical or major...
- Section 17b:27-51.13 - Inapplicability To Policy Without Right Of Insurer To Terminate Without Consent Of Insured
The provisions of this act shall not apply to any policy in which the insurer does not have the right to terminate the policy...
- Section 17b:27-52 - Group Life And Health--package Policies
Any insurer authorized to write in this State group life and group health insurance may provide such coverages in one policy or in separate...
- Section 17b:27-53 - Group Life And Health--rate Reductions And Application Of Dividends; Excess Over Employer's Cost
If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued under any group insurance policy heretofore or...
- Section 17b:27-54 - Application Of Provisions; Definitions.
14. The provisions of sections 14 through 27 of P.L.1997, c.146 (C.17B:27-54 through C.17B:27-67) shall apply to group health insurance coverage that is not...
- Section 17b:27-55 - Imposition Of Preexisting Condition Exclusion
15. A health insurer may impose a preexisting condition exclusion in its group health plan only if: a. the exclusion relates to a physical...
- Section 17b:27-56 - Incidents, Certain, No Imposition Of Preexisting Condition Exclusion
16. A health insurer which offers a group health plan shall not impose a preexisting condition exclusion for the following: a. on a newborn...
- Section 17b:27-57 - Genetic Information, Not Preexisting Condition
17. Genetic information shall not be treated as a preexisting condition in the absence of a diagnosis of the condition related to such information.
- Section 17b:27-58 - Counting Of Period Of Creditable Coverage
18. A period of creditable coverage shall not be counted, with respect to enrollment of an individual under a group health plan, if, after...
- Section 17b:27-59 - Application Of Creditable Coverage
19. Except as provided in this section, a health insurer which offers a group health plan shall count a period of creditable coverage without...
- Section 17b:27-60 - Written Certification Of Creditable Coverage Under Cobra
20. a. A health insurer which offers a group health plan shall provide a written certification of creditable coverage at the time an individual...
- Section 17b:27-61 - Affiliation Period Imposed By Hmo
21. A health maintenance organization which offers a group health plan and which does not impose a preexisting condition exclusion, may impose an affiliation...
- Section 17b:27-62 - Permission To Enroll For Group Coverage
22. A health insurer which offers a group health plan shall permit an employee or dependent who is eligible, but not enrolled, for coverage...
- Section 17b:27-63 - Dependent Special Enrollment Period
23. If a group health plan makes coverage available with respect to a dependent of an individual who is a participant under the plan...
- Section 17b:27-64 - Rules For Eligibility, Health Status-related Factors Prohibited
24. A health insurer which offers a group health plan may not establish rules for eligibility, including continued eligibility, of any individual to enroll...
- Section 17b:27-65 - Premiums, Contributions Regulated
25. A health insurer which offers a group health plan may not require an individual, as a condition of enrollment or continued enrollment under...
- Section 17b:27-66 - Renewal Of Coverage; Exceptions
26. A health insurer which offers health insurance coverage in connection with a group health plan shall renew the coverage under the plan at...
- Section 17b:27-67 - Modification Of Coverage
27. At the time of coverage renewal, a health insurer may modify the health insurance coverage for a product offered to a group health...
- Section 17b:27-68 - Conditions For Issuance, Delivery Of Group Life Insurance.
1.Except as provided in section 2 of this act, no policy of group life insurance shall be delivered or issued for delivery in this...
- Section 17b:27-69 - Conditions For Issuance, Delivery Of Group Life Insurance To Groups Not Included In C.17b:27-68.
2. a. Group life insurance offered to a resident of this State under a group life insurance policy issued to a group other than...
- Section 17b:27-70 - Written Notice To Prospective Insureds Of Noncompliance With C.17b:27-68; Definitions.
3. a. With respect to a program of insurance which, if issued on a group basis, does not meet the requirements of section 1...
- Section 17b:27-71 - Extension To Dependents Of Group Life Insurance Policy.
4.Except for a policy issued under subsection b. of section 1 of this act, a group life insurance policy may be extended to insure...
- Section 17b:27-72 - Required Provisions For Delivery, Issuance Of Group Life Insurance Policy.
5. a. No policy of group life insurance shall be delivered or issued for delivery in this State unless it contains in substance the...
- Section 17b:27-73 - Issuance, Delivery Of Individual Policy Of Life Insurance.
6.If an individual insured under a group insurance policy hereafter delivered or issued for delivery in this State becomes entitled under the terms of...
- Section 17b:27-74 - Filing Of Form Required For Delivery, Issuance Of Group Life Insurance.
7. a. No group life insurance policy, or application, if a written application is required and is to be made a part of the...
- Section 17b:27-75 - Payment Of Benefits.
8. a. Notwithstanding any policy provision to the contrary, benefits under a group life insurance policy subject to this act shall become payable by...
- Section 17b:27a-1 - Filing Of Paid Hospital Expense Claims; Definitions
18. a. Every carrier issuing health benefits plans in this State shall file its paid hospital expense claims paid by January 30, 1993 and...
- Section 17b:27a-2 - Definitions.
1.As used in sections 1 through 15, inclusive, of this act: "Board" means the board of directors of the program. "Carrier" means any entity...
- Section 17b:27a-2.1 - Regulations.
36.The Commissioner of Banking and Insurance shall, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt regulations necessary to implement sections...
- Section 17b:27a-2.2 - Effective Date.
37.Sections 1 through 8, 26 through 28, 36 and this section of this act shall take effect immediately and sections 9 through 25 and...
- Section 17b:27a-3 - Individual Health Benefits Plans, Applicability Of Act.
2. a. An individual health benefits plan issued on or after the effective date of this section of P.L.2008, c.38 shall be subject to...
- Section 17b:27a-4 - Offering Of Individual Health Benefits Required By Issuer Of Small Employer Health Benefits Plans.
3. a. No later than 180 days after the effective date of this section of P.L.2008, c.38, a carrier shall, as a condition of...
- Section 17b:27a-4.1 - Individual Policy, Contract For Hospital, Medical Expense Benefits, Coverage Of Subscriber's Child
7. a. A policy or contract which provides hospital or medical expense benefits under which dependent coverage is available shall not deny coverage for...
- Section 17b:27a-4.2 - Requirements Applicable To State Medicaid
8. A carrier shall not impose requirements on the Division of Medical Assistance and Health Services in the Department of Human Services which has...
- Section 17b:27a-4.3 - Eligibility For Enrollment In Individual Health Benefits Plan
4.Notwithstanding any other provision of law to the contrary, a carrier shall not consider a person's eligibility for medical assistance pursuant to P.L.1968, c.413...
- Section 17b:27a-4.4 - Findings, Declarations Relative To Exclusive Provider Organization Health Benefit Plans.
1.The Legislature hereby finds and declares that: a.While the Legislature enacted ground-breaking health insurance reform in 1992 for the individual market that provided guaranteed-issue,...
- Section 17b:27a-4.5 - Carrier Offering Plans Pursuant To C.17b:27a-2 et Seq. To Offer Epo; Coverages.
2. a. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et al.), every carrier that writes individual health benefits plans pursuant to P.L.1992, c.161 shall...
- Section 17b:27a-4.6 - Evaluation As To Effectiveness Of Act.
3.The New Jersey Individual Health Coverage Program Board, in consultation with the New Jersey Small Employer Health Benefits Program Board, shall evaluate the effectiveness...
- Section 17b:27a-4.7 - Carrier Offering Plans Pursuant To C.17b:27a-2 et Seq. May Offer Additional Plan With Certain Limited Benefits.
4.In addition to the health benefits plans offered by a carrier on the effective date of this act, a carrier that writes individual health...
- Section 17b:27a-5 - Laws Not Applicable To Plans
4. The following provisions shall not apply to basic health benefits plans and managed care health benefits plans issued pursuant to section 3 of...
- Section 17b:27a-6 - Individual Health Benefits Plans, Requirements.
5.An individual health benefits plan issued pursuant to section 3 of this act is subject to the following provisions: a.The health benefits plan shall...
- Section 17b:27a-7 - Establishment Of Policy; Contract Forms; High Deductible Health Plan; Benefit Levels.
6.The commissioner shall approve the policy and contract forms and benefit levels to be made available by all carriers for the health benefits plans...
- Section 17b:27a-7.1 - Coverage For Birth And Natal Care; Individual Health Policy
5. a. Every policy that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et...
- Section 17b:27a-7.2 - Coverage For Minimum Inpatient Care Following Mastectomy By Individual Health Benefits Plan
6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:27a-7.3 - Applicability Of Health Care Quality Act
24. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed...
- Section 17b:27a-7.4 - Coverage For Treatment Of Inherited Metabolic Diseases By Individual Health Benefits Plan.
6.No individual health benefits plan subject to the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) shall be delivered, issued, executed or renewed in this...
- Section 17b:27a-7.5 - Individual Health Benefits Plan To Provide Coverage For Biologically-based Mental Illness.
6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:27a-7.6 - Coverage For Hemophilia Services By Individual Health Policy
6.Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on...
- Section 17b:27a-7.7 - Individual Health Benefits Plan To Provide Coverage For Colorectal Cancer Screening.
6.Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27a-7.8 - Policy, Contract Issued Under C.17b:27a-2 et Seq. Required To Cover Certain Out-of-network Services.
6.Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on...
- Section 17b:27a-7.9 - Individual Health Benefits Plan To Offer Coverage For Domestic Partner.
53.Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27a-7.10 - Individual Health Benefits Plan, Mammogram Examination Benefits.
7. a. Every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.)...
- Section 17b:27a-7.11 - Individual Health Benefits Plan, High Deductible, Deductible Inapplicable, Certain Circumstances.
14.Notwithstanding the provisions of subsection e. of section 6 of P.L.1992, c.161 (C.17B:27A-7) regarding deductibles for a high deductible health plan, a health benefits...
- Section 17b:27a-7.12 - Individual Health Benefits Plan, Coverage For Prescription Female Contraceptives.
7.An individual health benefits plan required pursuant to section 3 of P.L.1992, c.161 (C.17B:27A-4) that provides benefits for expenses incurred in the purchase of...
- Section 17b:27a-7.13 - Individual Health Benefits Plans To Provide Benefits For Orthotic And Prosthetic Appliances.
6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State...
- Section 17b:27a-7.14 - Individual Health Benefits Plan To Provide Coverage For Hearing Aids For Certain Persons Aged 15 Or Younger.
7.An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to...
- Section 17b:27a-7.15 - Individual Health Benefits Plan To Provide Installment Payments To Obstetrical Provider For Maternity Services.
6. a. Every individual health benefits plan that provides benefits for maternity services, and that is delivered, issued, executed or renewed in this State,...
- Section 17b:27a-7.16 - Individual Health Benefits Plan To Provide Benefits For Treatment Of Autism Or Other Developmental Disability.
6.Notwithstanding any other provision of law to the contrary, an individual health benefits plan that provides hospital and medical expense benefits and is delivered,...
- Section 17b:27a-7.17 - Individual Health Benefits Plan To Provide Coverage For Oral Anticancer Medication.
6. a. An individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.),...
- Section 17b:27a-7.18 - Individual Health Benefits Plan To Provide Coverage For Sickle Cell Anemia.
7.Every individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to...
- Section 17b:27a-7.19 - Individual Health Benefits Plan To Provide Coverage For Prescription Eye Drops.
6. a. An individual health benefits plan which provides hospital or medical expense benefits that include coverage for prescription eye drops under a contract...
- Section 17b:27a-7.20 - Individual Health Benefits Plan, Coverage For Synchronization Of Prescribed Medications.
7. a. Every individual health benefits plan delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved...
- Section 17b:27a-8 - Offering Of Certain Coverage Not Required
7. a. A health maintenance organization shall not be required to offer coverage to or accept an applicant pursuant to this act if: (1)...
- Section 17b:27a-9 - Determination Of Rates.
8. a. (Deleted by amendment, P.L.2008, c.38). b.The board shall make application on behalf of all carriers for any other subsidies, discounts, or funds...
- Section 17b:27a-10 - New Jersey Individual Health Coverage Program; Board Of Directors.
9. a. There is created the New Jersey Individual Health Coverage Program. All carriers subject to the provisions of this act shall be members...
- Section 17b:27a-11 - Powers, Authority Of Program, Board.
10.The program shall have the general powers and authority granted under the laws of New Jersey to insurance companies, health service corporations and health...
- Section 17b:27a-12 - Procedures For Equitable Sharing Of Program Losses.
11.The board shall establish procedures for the equitable sharing of program losses among all members in accordance with their total market share as follows:...
- Section 17b:27a-12.1 - Exemption From Liability, Certain, For Hmo Formed By Umdnj.
2.Notwithstanding the provisions of any statute to the contrary, a health maintenance organization established by the University of Medicine and Dentistry of New Jersey...
- Section 17b:27a-13 - Statement Of Net Paid Losses
12. a. No later than March 1, 1993, any carrier issuing individual health benefits plans in the State shall file with the board a...
- Section 17b:27a-14 - Determination Of Disproportionate Share Of Substandard Risks
13. The board shall determine whether any carrier has a disproportionate share of substandard risks insured or enrolled under its individual health benefits plans...
- Section 17b:27a-15 - Sale Of Health Benefits Plan
14. A health benefits plan issued pursuant to section 3 of this act may be sold through an insurance producer licensed pursuant to P.L.1987,...
- Section 17b:27a-16 - Submission Of Rate Filings By Health Maintenance Organization Not Required
15. Notwithstanding the provisions of P.L.1973, c.337 (C.26:2J-1 et seq.) to the contrary, a health maintenance organization shall not be required to submit any...
- Section 17b:27a-16.1 - Board Actions Subject To Provisions Of Section; "Action" Defined; Procedure
8. Effective January 1, 1994, all actions adopted by the board shall be subject to the provisions of this section, notwithstanding the provisions of...
- Section 17b:27a-16.2 - Adoption Of Temporary Plan Of Operation
9. a. The commissioner shall, under the procedures provided pursuant to section 7 of P.L.1993, c.164, adopt a temporary plan of operation prepared pursuant...
- Section 17b:27a-16.3 - Purchase Of Other Insurance Coverage Not Required
10. A carrier shall not require an eligible person to purchase any other insurance coverage, including, but not limited to, life insurance, accident insurance...
- Section 17b:27a-16.4 - Adoption Of Standard Claim Form
11. The board, in conjunction with the board of the New Jersey Small Employer Health Benefits Program established pursuant to section 12 of P.L.1992,...
- Section 17b:27a-16.5 - Hospital, Medical Insurance Policy Renewals; Filing Of Rates.
5.A domestic mutual insurer which has converted from a health service corporation pursuant to the provisions of sections 2 through 4 of P.L.1995, c.196...
- Section 17b:27a-17 - Definitions Relative To Small Employer Health Benefits Plans.
1.As used in this act: "Actuarial certification" means a written statement by a member of the American Academy of Actuaries or other individual acceptable...
- Section 17b:27a-18 - Providers Of Health Benefits, Services Subject To Provisions Of Act
2. Every health insurer, health service corporation, medical service corporation, hospital service corporation, and health maintenance organization licensed or authorized to provide health benefits...
- Section 17b:27a-18.1 - Provision Of Benefits To Subscriber's Child Under Small Employer Policy, Contract
9. a. A policy or contract which provides hospital or medical expense benefits under which dependent coverage is available shall not deny coverage for...
- Section 17b:27a-18.2 - Requirements Applicable To State Medicaid
10. A carrier shall not impose requirements on the Division of Medical Assistance and Health Services in the Department of Human Services which has...
- Section 17b:27a-19 - Health Benefits Plans Offered To Small Employers; Exceptions.
3. a. Except as provided in subsection f. of this section, every small employer carrier shall, as a condition of transacting business in this...
- Section 17b:27a-19a - Small Employer Carrier, Offering Of High Deductible Plan.
17. A small employer carrier, as a condition of transacting business in this State, may offer, on or after the effective date of P.L.2005,...
- Section 17b:27a-19.1 - Hospital Confinement, Other Supplemental Limited Benefit Insurance Plans; Requirements
10. a. A carrier shall not deliver or issue for delivery a hospital confinement or other supplemental limited benefit insurance plan unless the applicant...
- Section 17b:27a-19.2 - Coverage For Birth And Natal Care; Small Employer Health Policy.
6. a. Every policy that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et...
- Section 17b:27a-19.3 - Regulations Governing Rating Methodology, Calculation Of Loss Ratios
7.The commissioner, in consultation with the board, shall establish regulations governing the applicable rating methodology and manner in which loss ratios shall be calculated...
- Section 17b:27a-19.4 - Coverage For Minimum Inpatient Care Following Mastectomy By Small Employer Health Benefits Plan
7. a. Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this...
- Section 17b:27a-19.5 - Applicability Of Health Care Quality Act
23. Notwithstanding the provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed...
- Section 17b:27a-19.6 - Coverage For Treatment Of Inherited Metabolic Diseases By Small Employer Health Benefits Plan.
7.No small employer health benefits plan subject to the provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) shall be delivered, issued, executed or renewed in...
- Section 17b:27a-19.7 - Small Employer Health Benefits Plan To Provide Coverage For Biologically-based Mental Illness.
7. a. Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this...
- Section 17b:27a-19.8 - Coverage For Hemophilia Services By Small Employer Plan
5.Notwithstanding the provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on...
- Section 17b:27a-19.9 - Small Employer Health Benefits Plan To Provide Coverage For Colorectal Cancer Screening.
7.Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant...
- Section 17b:27a-19.10 - Policy, Contract Issued Under C.17b:27a-17 et Seq. Required To Cover Certain Out-of-network Services.
5.Notwithstanding the provisions of P.L.1992, c.162 (C.17B:27A-17 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on...
- Section 17b:27a-19.11 - Carrier Offering Plans Pursuant To C.17b:27a-17 et Seq. May Offer Additional Plan With Certain Limited Benefits.
5.In addition to the standard health benefits plans offered by a carrier on the effective date of this act, a carrier that writes small...
- Section 17b:27a-19.12 - Small Employer Health Benefits Plan To Offer Coverage For Domestic Partner.
54.Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant...
- Section 17b:27a-19.13 - Small Employer Health Benefits Plan, Mammogram Examination Benefits.
8. a. Every small employer health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et...
- Section 17b:27a-19.14 - High Deductible Health Plan, Small Employer, Deductible Inapplicable, Certain Circumstances.
16. Notwithstanding the provisions of subsection k. of section 3 of P.L.1992, c.162 (C.17B:27A-19) regarding deductibles for a high deductible health plan, a health...
- Section 17b:27a-19.15 - Small Employer Health Benefits Plan, Coverage For Prescription Female Contraceptives.
8.A small employer health benefits plan required pursuant to section 3 of P.L.1992, c.162 (C.17B:27A-19) that provides benefits for expenses incurred in the purchase...
- Section 17b:27a-19.16 - Coverage For Certain Dependents Until Age 31 By Small Employer Health Benefits Plan.
5. a. As used in this section, "dependent" means a covered person's child by blood or by law who: (1)is 30 years of age...
- Section 17b:27a-19.17 - Small Employer Health Benefits Plans To Provide Benefits For Orthotic And Prosthetic Appliances.
7. a. Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this...
- Section 17b:27a-19.18 - Small Employer Health Benefits Plan To Provide Coverage For Hearing Aids For Certain Persons Aged 15 Or Younger.
8.A small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant...
- Section 17b:27a-19.19 - Small Employer Health Benefits Plan To Provide Installment Payments To Obstetrical Provider For Maternity Services.
7. a. Every small employer health benefits plan that provides benefits for maternity services, and that is delivered, issued, executed or renewed in this...
- Section 17b:27a-19.20 - Small Employer Health Benefits Plan To Provide Benefits For Treatment Of Autism Or Other Developmental Disability.
7.Notwithstanding any other provision of law to the contrary, a small employer health benefits plan that provides hospital and medical expense benefits and is...
- Section 17b:27a-19.21 - Small Employer Health Benefits Plan To Provide Coverage For Oral Anticancer Medications.
7. a. A small employer health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et...
- Section 17b:27a-19.22 - Small Employer Health Benefits Plan To Provide Coverage For Sickle Cell Anemia.
8.Every small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant...
- Section 17b:27a-19.23 - Small Employer Health Benefits Plan To Provide Coverage For Prescription Eye Drops.
7. a. A small employer health benefits plan which provides hospital or medical expense benefits that include coverage for prescription eye drops under a...
- Section 17b:27a-19.24 - Small Employer Health Benefits Plan, Coverage For Synchronization Of Prescribed Medications.
8. a. Every small employer health benefits plan delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), or...
- Section 17b:27a-20 - Coinsurance, Deductibles Applicable
4. Plans required to be offered under this act may be subject to coinsurance and deductibles, which may vary by selected portions of the...
- Section 17b:27a-21 - Standard Coordination Of Benefits Provisions Applicable
5. Coverage provided pursuant to this act shall be subject to standard coordination of benefits provisions for all persons covered under the policy or...
- Section 17b:27a-21.1 - Eligibility For Enrollment In Small Employer Health Benefits Plan
5.Notwithstanding any other provision of law to the contrary, a carrier shall not consider a person's eligibility for medical assistance pursuant to P.L.1968, c.413...
- Section 17b:27a-22 - Preexisting Condition Provisions
6. a. No health benefits plan subject to this act shall include any provision excluding coverage for a preexisting condition regardless of the cause...
- Section 17b:27a-23 - Policies, Contracts Renewable; Exceptions.
7.Every policy or contract issued to small employers in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.) shall be renewable with respect to...
- Section 17b:27a-24 - Reasonable Specified Minimum Participation.
8.Any small employer carrier may require a reasonable specified minimum participation of eligible employees, which shall not exceed 75%, or reasonable minimum employer contributions...
- Section 17b:27a-25 - Premium Rates; Other Plan Requirements.
9. a. (1) (Deleted by amendment, P.L.1997, c.146). (2)(Deleted by amendment, P.L.1997, c.146). (3) (a)For all policies or contracts providing health benefits plans for...
- Section 17b:27a-25.1 - Findings, Declarations Relative To Small Employer Health Benefits Purchasing Alliances
1.The Legislature finds and declares that: a.Small employers, that is, employers that employ between two and 50 employees, have traditionally been at an economic...
- Section 17b:27a-25.2 - Definitions Relative To Small Employer Benefits Purchasing Alliances
2.As used in this act: "Board" means a small employer purchasing alliance board of directors provided for in section 4 of this act. "Carrier"...
- Section 17b:27a-25.3 - Small Employer Purchasing Alliance, Formation
3.Any eligible group of small employers may join together, by means of a joint contract under the procedures established by this act, to form...
- Section 17b:27a-25.4 - Board Of Directors
4.The purchasing alliance, which may be a corporation, shall be governed by a board of directors, elected by the members of the purchasing alliance....
- Section 17b:27a-25.5 - Bylaws, Contents
5.The board shall adopt by-laws for the operation of the purchasing alliance, which shall be effective upon ratification by a two-thirds majority of the...
- Section 17b:27a-25.6 - Further Authority Of Alliance
6.In addition to the powers authorized under this act, a purchasing alliance shall have the authority to: a.Set reasonable fees for membership in the...
- Section 17b:27a-25.7 - Restrictions On Alliances
7.A purchasing alliance established pursuant to the provisions of this act shall not: a.Purchase health care services, assume risk for the cost or provision...
- Section 17b:27a-25.8 - Certificate From Alliance To Commissioner
8. a. Within 30 days after its organization, the purchasing alliance board shall file with the commissioner a certificate which shall list the members...
- Section 17b:27a-25.9 - Rules, Regulations
10. The commissioner shall promulgate rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the provisions...
- Section 17b:27a-26 - Health Maintenance Organization Coverage; Exceptions
10. a. No health maintenance organization shall be required to offer coverage or accept applications pursuant to section 3 of this act to a...
- Section 17b:27a-27 - Continued Coverage For Certain Terminated Employees, Dependents.
11. a. (1) Every policy or contract issued to a small employer in this State, including, but not limited to, policies or contracts which...
- Section 17b:27a-28 - New Jersey Small Employer Health Benefits Program Created
12. There is created a nonprofit entity to be known as the New Jersey Small Employer Health Benefits Program. All carriers issuing health benefits...
- Section 17b:27a-29 - Meetings, Organization Of Board; Terms.
13. a. Within 60 days of the effective date of this act, the commissioner shall give notice to all members of the time and...
- Section 17b:27a-29.1 - Immunity From Liability For Board
11.A member of the board and an employee of the board shall not be liable in an action for damages to any person for...
- Section 17b:27a-29.2 - Rules, Regulations For Voluntary Risk Pooling Arrangement
12.The board may, if necessary, adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to establish a voluntary...
- Section 17b:27a-30 - Submission Of Plan Of Operation
14. Within 90 days after the election of the initial board, the board shall submit to the commissioner a plan of operation which shall...
- Section 17b:27a-31 - Contents Of Plan Of Operation
15. The plan of operation shall constitute a public record and shall include, but not be limited to, the following: a. A method of...
- Section 17b:27a-32 - Authority Of Board
16. The board shall have the authority to: a. Enter into contracts as are necessary or proper to carry out the provisions and purposes...
- Section 17b:27a-33 - Formulation Of Five Health Benefits Plans
17. Subject to the approval of the commissioner, the board shall formulate the five health benefits plans to be made available by small employer...
- Section 17b:27a-41 - Violations, Penalty
25. Any carrier which violates this act shall be subject to a penalty assessment, as determined by the commissioner. L.1992,c.162,s.25; amended 1995,c.298,s.9.
- Section 17b:27a-43 - Violations, Penalties
27. A carrier which violates any provision of this act shall be liable to a penalty of not less than $2,000 and not greater...
- Section 17b:27a-44 - Assessments Not Charged To Policyholders, Public
28. No assessment provided for under this act shall be charged, directly or indirectly, to policyholders or the public, provided that a carrier may...
- Section 17b:27a-45 - Standard Claim Form
29. The board, in conjunction with the board of the New Jersey Individual Health Coverage Program established pursuant to section 9 of P.L.1992, c.161...
- Section 17b:27a-47 - Coverage Obtained Through Out-of-state Trust, Compliance Required
12. Group hospital or medical coverage obtained through an out-of-State trust covering a group of 49 or fewer employees or participating persons who are...
- Section 17b:27a-48 - Multiple Employer Arrangement; Requirements
13. A multiple employer arrangement covering a group of 49 or fewer employees or participating persons of an individual employer who are residents of...
- Section 17b:27a-49 - Notification To Commissioner By Carrier Of Multiple Employer Arrangement
14. A carrier shall notify the commissioner by December 31 of each year of any health care coverage or benefits, stop-loss coverage or administrative...
- Section 17b:27a-50 - Change Of Coverage By Small Employer; Restrictions
15. a. A small employer who purchases a health benefits plan or rider pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.) shall not be permitted...
- Section 17b:27a-51 - Board Actions Subject To Provisions Of Section; "Action" Defined; Procedure
17. Effective January 1, 1994, all actions adopted by the board shall be subject to the provisions of this section, notwithstanding the provisions of...
- Section 17b:27a-53 - Other Insurance Purchases Not Required
21. A carrier shall not require a small employer to purchase any other insurance coverage, including, but not limited to, life insurance, accident insurance...
- Section 17b:27a-54 - Commissioner Authorized To Approve Establishment Of Arrangement; Rules, Regulations
22. Notwithstanding any other law to the contrary, the commissioner is authorized to approve the establishment of an arrangement by an insurance company operating...
- Section 17b:27a-55 - Written Notice Required For Issuance, Renewal Of High Deductible Health Plan; Declaration Of Understanding.
18. a. An insurance company, health service corporation, hospital service corporation, medical service corporation or health maintenance organization authorized to issue health benefits plans...
- Section 17b:27a-56 - Provision Of Biannual Surveys To Dobi By Health Insurers.
19. a. Any health insurer, as a condition of transacting business in this State, offering a contract, policy, or plan that qualifies as a...
- Section 17b:27b-1 - Definitions Relative To Third Party Administrators, Billing Services.
1.As used in this act: "Benefits payer" means an insurer authorized to issue health or dental benefits plans in this State, or any other...
- Section 17b:27b-2 - Licensure, Registration Required For Third Party Administrators.
2. a. On or after January 1, 2002, no person shall act as, offer to act as, or hold himself out to be, a...
- Section 17b:27b-3 - Additional Information Required For Licensure, Registration.
3.In addition to the information required by section 2 of this act, the applicant for licensure or registration shall file with the commissioner: a.a...
- Section 17b:27b-4 - Issuance Of License, Approval Of Application For Registration.
4.The commissioner may issue a license to an applicant or approve an application for registration as a third party administrator if he finds that...
- Section 17b:27b-5 - Denial Of License, Registration.
5.The commissioner may deny an application for licensure or registration as a third party administrator if he finds that any of the standards established...
- Section 17b:27b-6 - Provisions Of Written Agreement; Requirements.
6.A third party administrator shall not conduct any business with a benefits payer in the absence of a written agreement between the administrator and...
- Section 17b:27b-7 - Access To Books, Records.
7. a. The commissioner shall have access to all books and records of a third party administrator for the purposes of examination, audit and...
- Section 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,...
- Section 17b:27b-9 - Fiduciary Responsibility Of Third Party Administrators.
9. a. A third party administrator shall be deemed to act in a fiduciary capacity on behalf of the benefits payer in the receipt...
- Section 17b:27b-10 - Separate Accounts For Funds Remitted.
10. All funds remitted to an administrator by a benefits payer licensed or authorized to do business in this State shall be held by...
- Section 17b:27b-11 - Prompt Delivery Of Communications To Enrollees.
11. Any policies, certificates, booklets, termination notices or other written communications delivered by the benefits payer to the third party administrator for delivery to...
- Section 17b:27b-12 - Notification Of Material Changes To Commissioner.
12. A third party administrator shall immediately notify the commissioner of any material change in its ownership, control or other fact or circumstance affecting...
- Section 17b:27b-13 - Annual Reports.
13. A third party administrator shall file an annual report for the preceding calendar year with the commissioner on or before March 1 of...
- Section 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:...
- Section 17b:27b-15 - Immediate Suspension Of License, Registration, Grounds.
15. The commissioner may, without advance notice or hearing, immediately suspend the license or registration of a third party administrator if he finds that...
- Section 17b:27b-16 - Certification Required For Third Party Billing Services.
16. On or after January 1, 2002, no person shall act as, offer to act as or hold himself out to be a third...
- Section 17b:27b-17 - Additional Information To Be Filed By Third Party Billing Services.
17. In addition to the information otherwise required by this act or by the commissioner, a third party billing service shall file with the...
- Section 17b:27b-18 - Approval Of Applications For Certification.
18. The commissioner may approve an application for certification as a third party billing service if he finds that the applicant meets the standards...
- Section 17b:27b-19 - Denial Of Applications For Certification.
19. The commissioner may deny an application for certification as a third party billing service if he finds that any of the standards established...
- Section 17b:27b-20 - Written Agreements Required For Conducting Business As Third Party Billing Service.
20. A third party billing service shall not conduct any business with a client in the absence of a written agreement between the billing...
- Section 17b:27b-21 - Fiduciary Responsibility Of Third Party Billing Services.
21. A third party billing service that accepts monies from health benefits payers on behalf of a client shall be deemed to act in...
- Section 17b:27b-22 - Notification Of Material Changes To Commissioner.
22. a. A third party billing service shall immediately notify the commissioner of any material change in its ownership, control, or other fact or...
- Section 17b:27b-23 - Suspension, Revocation Of Certification.
23. The commissioner may suspend or revoke a certification issued pursuant to this act if he finds that the third party billing service: a.is...
- Section 17b:27b-24 - Violations, Penalties.
24. The commissioner may, upon notice and hearing, assess a civil administrative penalty in an amount not less than $250 nor more than $5,000...
- Section 17b:27b-25 - Rules, Regulations.
25. The commissioner shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to carry out the purposes...
- Section 17b:27c-1 - Short Title.
1.This act shall be known and may be cited as the "Self-Funded Multiple Employer Welfare Arrangement Regulation Act." L.2001,c.352,s.1.
- Section 17b:27c-2 - Purposes Of Act.
2.The purposes of this act are to: a.provide for the registration of self-funded or partially self-funded multiple employer welfare arrangements; b.regulate self-funded or partially...
- Section 17b:27c-3 - Definitions Relative To Self-funded Multiple Employer Welfare Arrangements.
3.For purposes of this act: "Association" means a group of 100 or more persons organized and maintained in good faith for purposes other than...
- Section 17b:27c-4 - Annual Registration, Fee.
4.A self-funded multiple employer welfare arrangement shall register annually with the commissioner and pay a registration fee established by the commissioner which shall not...
- Section 17b:27c-5 - Deposit, Maintenance Of Cash, Securities.
5. a. A self-funded multiple employer welfare arrangement shall deposit and continuously maintain with a financial institution licensed in this State, cash or securities...
- Section 17b:27c-6 - Required Filings.
6.Each self-funded multiple employer welfare arrangement shall file all of the following with the commissioner: a.No later than May 15th of each calendar year...
- Section 17b:27c-7 - Liability Of Members.
7. a. The liability of each member for the obligations of the self-funded multiple employer welfare arrangement shall be individual, several and proportionate, but...
- Section 17b:27c-8 - Inapplicability Of Insurance Laws In Certain Circumstances.
8. a. Except as provided by this act, the insurance laws of this State do not apply to the operation of self-funded multiple employer...
- Section 17b:27c-9 - Examination Of Loss Reserves.
9. a. The commissioner may, upon reasonable notice, conduct an examination of the loss reserves of a self-funded multiple employer welfare arrangement as often...
- Section 17b:27c-10 - Revocation, Suspension Of Certificate Of Registration; Violations, Penalties.
10. a. The commissioner may revoke or suspend the certificate of registration of any self-funded multiple employer welfare arrangement that fails to correct any...
- Section 17b:27c-11 - Rehabilitation, Liquidation, Conservation, Dissolution.
11.Any rehabilitation, liquidation, conservation or dissolution of a self-funded multiple employer welfare arrangement shall be conducted under the supervision of the State Superior Court...
- Section 17b:27c-12 - Rules, Regulations.
12.The commissioner, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), may adopt rules and regulations necessary to effectuate the purposes...
- Section 17b:27d-1 - Findings, Declarations Relative To Mandated Health Benefits
1.The Legislature finds and declares that: a.Health benefits coverage, while providing important protection for individuals, is costly for individuals and businesses that insure their...
- Section 17b:27d-2 - Definitions Relative To Mandated Health Benefits
2.As used in this act: "Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation or health maintenance organization authorized...
- Section 17b:27d-3 - Mandated Health Benefits Advisory Commission
3.There is established the Mandated Health Benefits Advisory Commission to study the social, financial and medical impact of proposed mandated health benefits. L.2003,c.193,s.3.
- Section 17b:27d-4 - Membership; Terms; Vacancies.
4.The commission shall consist of 17 voting members as follows: the Commissioners of Health, Human Services and Banking and Insurance or their designees, who...
- Section 17b:27d-5 - Election Of Chairman, Vice Chairman, Appointment Of Secretary; Meetings.
5. a. The commission shall organize and hold its first meeting within 90 days after the appointment of its members and shall elect a...
- Section 17b:27d-6 - Duties Of Commission Relative To Review Of Bills.
6.It shall be the duty of the commission to review any bill introduced in either House of the Legislature that would require a carrier...
- Section 17b:27d-7 - Contents Of Review Of Bill.
7.The review of a bill containing a proposed mandated health benefit by the commission shall include the following: a.The social impact of mandating the...
- Section 17b:27d-8 - Development Of System Of Data Collection; Review, Comment.
8.In the course of studying and evaluating proposed mandated health benefits, the commission shall: a.develop criteria for a system and program of data collection,...
- Section 17b:27d-9 - Report To Governor, Legislature
9.The commission shall report to the Governor and Legislature three years from the effective date of this act on its activities. The report shall...
- Section 17b:27d-10 - Report By Mandated Health Benefits Advisory Commission.
13. a. Notwithstanding the provisions of any other law to the contrary, the Mandated Health Benefits Advisory Commission established pursuant to section 3 of...
- Section 17b:27d-11 - Work Group Regarding Risk Factors For Breast Cancer, Breast Imaging Options.
14. a. The Department of Health, in conjunction with the Medical Society of New Jersey, shall convene a work group to review and report...
- Section 17b:27e-1 - Purpose Of Act On Long-term Care Insurance
1.The purpose of this act is to promote the public interest, to promote the availability of long-term care insurance policies, to protect applicants for...
- Section 17b:27e-2 - Application Of Act
2.The requirements of this act shall apply to policies delivered or issued for delivery in this State on or after the effective date of...
- Section 17b:27e-3 - Short Title
3.This act shall be known and may be cited as the "New Jersey Long-Term Care Insurance Act." L.2003,c.207,s.3.
- Section 17b:27e-4 - Definitions Relative To Regulation Of Long-term Care Insurance
4.As used in this act, unless the context requires otherwise: "Applicant" means: (1)In the case of an individual long-term care insurance policy, the person...
- Section 17b:27e-5 - Compliance Required
5. a. Any policy, certificate or rider advertised, marketed or offered as long-term care insurance shall comply with the provisions of this act. b.No...
- Section 17b:27e-6 - Prohibitions Relative To Long-term Care Insurance
6. a. No long-term care insurance policy or certificate shall: (1)Be cancelled, nonrenewed or otherwise terminated on the grounds of the age or the...
- Section 17b:27e-7 - Grounds For Rescinding Policy, Denying A Claim
7. a. For a policy or certificate that has been in force for less than six months, an insurer may rescind a long-term care...
- Section 17b:27e-8 - Conditions For Delivery, Issuance Of Policy
8. a. Except as provided in subsection b. of this section, a long-term care insurance policy shall not be delivered or issued for delivery...
- Section 17b:27e-9 - Regulations
9.The commissioner shall promulgate regulations, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), necessary to effectuate the purposes of this act...
- Section 17b:27e-10 - Prior Approval Of Commissioner Required
10. a. Every long-term care insurance policy or contract, including any application, certificate, rider or endorsement to be issued or delivered in this State...
- Section 17b:27e-11 - Insurer To File Rates, Rating Schedule, Supporting Documentation
11. An insurer providing long-term care insurance issued on an individual basis in this State shall file, for the commissioner's approval, its rates, rating...
- Section 17b:27e-12 - Additional Penalties
12. In addition to any other penalties provided by the laws of this State, any insurer and any insurance producer found to have violated...
- Section 17b:27f-1 - Definitions Relative To Pharmacy Benefits Managers.
1.As used in this act: "Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized...
- Section 17b:27f-2 - Duties Of Pharmacy Benefits Manager Relative To Contracts.
2.Upon execution or renewal of each contract, a pharmacy benefits manager shall, with respect to contracts between a pharmacy benefits manager and a contracted...
- Section 17b:27f-3 - Requirements For Placing Prescription Drug On Multiple Source Generic List.
3. a. In order to place a particular prescription drug on a multiple source generic list, the pharmacy benefits manager shall, at a minimum,...
- Section 17b:27f-4 - Process For Appeals, Investigation And Dispute Resolution.
4.All contracts between a pharmacy benefits manager and a contracted pharmacy shall include a process to appeal, investigate, and resolve disputes regarding multiple source...
- Section 17b:27f-5 - Rules, Regulations.
5.The Commissioner of Banking and Insurance shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations, including any...
- Section 17b:28-1 - Definition
When used in this chapter, the following terms shall have the following respective meanings: a. "Separate account contract" means any contract issued by an...
- Section 17b:28-2 - Qualification Of Insurer
No present or future domestic insurer shall undertake the issuance of any contract on a variable basis, and no foreign or alien insurer heretofore...
- Section 17b:28-3 - Certificate To Sell
17B:28-3. a. No agent or solicitor employed by an agent heretofore or hereafter licensed shall be authorized to sell or act or aid in...
- Section 17b:28-4 - Required Statements; Procedure
Any contract on a variable basis delivered or issued for delivery in this State, and any certificate evidencing variable benefits issued pursuant to any...
- Section 17b:28-5 - Form Of Contract
17B:28-5. (a) No contract on a variable basis shall be delivered or issued for delivery in this State by any insurer until a copy...
- Section 17b:28-6 - Administration
Any insurer maintaining one or more separate accounts shall submit annually to the commissioner a report of the business of its separate accounts. Such...
- Section 17b:28-7 - Separate Accounts; Approval By Commissioner
17B:28-7. Separate accounts; approval by commissioner. Any present or future domestic insurer shall have authority to establish and operate one or more separate accounts...
- Section 17b:28-8 - Amounts Placed In Account; Liabilities
Except as may be otherwise specifically provided by the contract, all amounts with respect to any contract on a variable basis shall be placed...
- Section 17b:28-9 - Investment Of Assets; Eligibility; Definition
17B:28-9. Investment of assets; eligibility; definition. a. The assets held in a separate account, or any part thereof, may be invested in: (i) Common...
- Section 17b:28-10 - Valuation Of Assets
Except as the commissioner may require or permit a different basis of valuation, the valuation of separate account assets for all purposes, including annual...
- Section 17b:28-11 - Reserve Liability
The reserve liability for contracts on a variable basis shall be established by the commissioner pursuant to the requirements of section 17B:19-8 (the Standard...
- Section 17b:28-12 - Annuities
Any insurer which establishes one or more variable contract accounts and issues variable annuity contracts may in its discretion, but need not, require in...
- Section 17b:28-14 - Regulation Of Separate Account Contracts, Insurers Issuing The Same And Sales Agents
The commissioner shall have the sole and exclusive authority to regulate the issuance and sale of separate account contracts; and such contracts, the insurers...
- Section 17b:28-15 - Application To Separate Accounts And Separate Account Contracts Of Title 17b; Required Provisions For Variable Life Insurance Contracts
Except for N.J.S. 17B:25-3, 17B:25-8, 17B:25-9, 17B:25-13, 17B:25-19 and 17B:27-11, in the case of a variable life insurance policy and except as otherwise provided...
- Section 17b:28a-1 - Insurance Against Risk Of Loss In Value Of Redeemable Securities Issued By Investment Company
A domestic insurer authorized to do the business specified in N.J.S. 17B:17-3 may issue and deliver individual and group policies insuring against the risk...
- Section 17b:28a-2 - Limitation On Benefit And Protection
Except with the approval of the commissioner and under such conditions as he may prescribe, the benefit provided by such insurance may not exceed...
- Section 17b:28a-3 - Undertaking Or Continuance; Approval Of Commissioner; Rules And Regulations
No domestic insurer shall undertake or continue the issuance of any such insurance unless the commissioner is satisfied that the condition or methods of...
- Section 17b:28a-4 - Form Of Policy; Submission To Commissioner
No policy providing investment return assurance shall be issued or delivered in this State until a copy of the form thereof is submitted to...
- Section 17b:28a-5 - Foreign Or Alien Insurers; Conditions For Qualification To Issue
No foreign or alien company shall deliver or issue for delivery within this State any policy of investment return assurance unless it is licensed...
- Section 17b:28a-6 - Rules And Regulations
The commissioner shall make appropriate further rules and regulations for the protection of policyholders and the public, including requirements for nonforfeiture benefits where appropriate,...
- Section 17b:29-1 - Scope; Differences In Long-term And Short-term Indebtedness; Rules And Regulations
All life insurance and all health insurance in connection with loans or other credit transactions shall be subject to the provisions of this chapter,...
- Section 17b:29-2 - Definitions
a. "Credit life insurance" means insurance on the life of a debtor pursuant to or in connection with a specific loan or other credit...
- Section 17b:29-3 - Forms Of Credit Life Insurance And Credit Health Insurance
Credit life insurance and credit health insurance shall be issued only in the following forms: a. Individual policies of life insurance issued to debtors...
- Section 17b:29-3.1 - Insurance Offered With Credit Involuntary Unemployment Insurance
1. a. The individual and group coverages permitted by N.J.S.17B:29-3 may be offered in combination with credit involuntary unemployment insurance, credit personal property insurance,...
- Section 17b:29-4 - Amount Of Credit Life Insurance And Credit Health Insurance
a. Credit Life Insurance (1) The initial amount of credit life insurance shall not exceed the total amount repayable under the contract of indebtedness...
- Section 17b:29-5 - Term Of Credit Life Insurance And Credit Health Insurance
The term of any credit life insurance or credit health insurance shall, subject to acceptance by the insurer, commence on the date when the...
- Section 17b:29-6 - Provisions Of Policies And Certificates Of Insurance: Disclosure To Debtors
a. All credit life insurance and credit health insurance sold shall be evidenced by an individual policy, or in the case of group insurance...
- Section 17b:29-7 - Filing Of Forms; Premium Rate Schedules
17B:29-7. a. All forms of policies, certificates of insurance, notice of proposed insurance, applications for insurance, endorsements and riders delivered or issued for delivery...
- Section 17b:29-8 - Premiums And Refunds
a. Any insurer may revise its schedules of premium rates from time to time, and shall file such revised schedules with the commissioner. No...
- Section 17b:29-9 - Issuance Of Policies
All policies of credit life insurance and credit health insurance shall be delivered or issued for delivery in this State only by an insurer...
- Section 17b:29-10 - Claims
a. All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All...
- Section 17b:29-11 - Existing Insurance--choice Of Insurer
When credit life insurance or credit health insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor,...
- Section 17b:29-12 - Enforcement
Whenever the commissioner finds that there has been a violation of this chapter or any rules or regulations issued pursuant thereto, and after written...
- Section 17b:29-13 - Judicial Review
Any party to the proceeding affected by an order of the commissioner shall be entitled to judicial review by following the procedure set forth...
- Section 17b:30-1 - Declaration Of Purpose
The principal purpose of chapter 30 is to regulate trade practices in the business of life insurance, health insurance and annuities in accordance with...
- Section 17b:30-2 - Practices Prohibited
No person shall engage in this State in any trade practice which is defined in this chapter as or determined pursuant to this chapter...
- Section 17b:30-3 - Misrepresentations And False Advertising Of Policies Or Annuity Contracts
No person shall make, issue, circulate or cause to be made, issued or circulated, any estimate, illustration, circular or statement misrepresenting the terms of...
- Section 17b:30-4 - False Information And Advertising
No person shall make, publish, disseminate, circulate, or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated, or...
- Section 17b:30-5 - False Financial Statements
a. No person shall file with any supervisory or other public official, or make, publish, disseminate, circulate or deliver to any person, or place...
- Section 17b:30-6 - "Twisting" Prohibited
No person shall make any misleading representations or incomplete or fraudulent comparison of any insurance policies or annuity contracts or insurers for the purpose...
- Section 17b:30-7 - Defamation
No person shall make, publish, disseminate, or circulate, directly or indirectly, or aid, abet or encourage the making, publishing, disseminating or circulating of any...
- Section 17b:30-8 - Boycott, Coercion And Intimidation
No person or persons shall enter into any agreement to commit, or by any concerted action commit, any act of boycott, coercion or intimidation...
- Section 17b:30-9 - Stock Operations And Advisory Board Contracts
No person shall issue or deliver or permit agents, officers, or employees to issue or deliver, agency company stock or other capital stock, or...
- Section 17b:30-10 - Stock Acquisition, Common Management
No insurer shall retain, invest in or acquire the whole or any part of the capital stock of any other insurer or insurers, or...
- Section 17b:30-11 - Interlocking Directorate
No person shall be a director of 2 or more competing insurers so as to substantially lessen competition generally in the business of insurance...
- Section 17b:30-12 - Discrimination Prohibited; Terms Defined.
17B:30-12. a. No person shall discriminate against any person or group of persons because of race, creed, color, national origin or ancestry of such...
- Section 17b:30-13 - Rebates And Special Inducements
Except as otherwise expressly provided by law, no person shall knowingly make, permit to be made or offer to make any contract of life...
- Section 17b:30-13.1 - Unfair Claim Settlement Practices
No person shall engage in unfair claim settlement practices in this State. Unfair claim settlement practices which shall be unfair practices as defined in...
- Section 17b:30-13.2 - Record Of Complaints
Failure of any person to maintain a complete record of all the complaints which it has received since the date of its last examination...
- Section 17b:30-14 - Exceptions To Discrimination And Rebates
Nothing in sections 17B:30-12 or 17B:30-13 shall be construed as including within the definition of discrimination or rebates any of the following practices: a....
- Section 17b:30-15 - Enumeration Of Acts Not Exclusive
The enumeration in this chapter of specific unfair methods of competition and unfair or deceptive acts and practices in the business of insurance or...
- Section 17b:30-16 - Commissioner's Powers Of Investigation
The commissioner shall have power to examine and investigate into the affairs of every person acting as an insurer or engaged in the business...
- Section 17b:30-17 - Desist Orders For Prohibited Practices; Penalty
a. If the commissioner has reason to believe that any person has been engaged or is engaging in this State in any unfair method...
- Section 17b:30-18 - Procedures As To Undefined Practices
Whenever the commissioner shall have reason to believe that any person engaged in the business of insurance or annuities is engaging in this State...
- Section 17b:30-19 - Appeal By Intervenor
If the determination of the commissioner does not charge a violation of this chapter, then any intervenor in the proceedings before him may, within...
- Section 17b:30-20 - Violation Of Cease And Desist Order; Penalty
Any person who violates a cease and desist order of the commissioner issued under this chapter shall be liable to a penalty not exceeding...
- Section 17b:30-21 - Provisions Of Chapter Additional To Existing Laws
The powers vested in the commissioner by this chapter shall be additional to any other powers to enforce any penalties, fines or forfeitures authorized...
- Section 17b:30-22 - Immunity From Prosecution
If any person shall ask to be excused from testifying or from producing any books, papers, records, correspondence or other documents at any hearing...
- Section 17b:30-23 - Timetable For Implementation Of Electronic Receipt, Transmission Of Health Care Claim Information; Standard Forms.
1. a. (1) The Commissioner of Banking and Insurance, in consultation with the Commissioner of Health, shall establish, by regulation, a timetable for implementation...
- Section 17b:30-24 - Regulations.
15.The Commissioner of Banking and Insurance, in consultation with the Commissioner of Health, shall adopt regulations to effectuate the purposes of sections 1 through...
- Section 17b:30-25 - Thomas A. Edison State College To Study, Monitor Effectiveness Of Electronic Data Interchange Technology, Electronic Health Records.
16.Thomas A. Edison State College shall study and monitor the effectiveness of electronic data interchange technology and electronic health records in reducing administrative costs,...
- Section 17b:30-26 - Definitions Relative To Payment Of Health And Dental Insurance Plans.
1.As used in this act: "Capitation payment" means a periodic payment to a health care provider for his services under the terms of a...
- Section 17b:30-27 - Applicability.
2.The provisions of this act shall apply only to insured health benefits or dental plans and insured claims submitted to payers. L.1999,c.155,s.2.
- Section 17b:30-28 - Provision Of Information.
3. A payer shall, at the request of a covered person, that person's agent, or an eligible health care provider, provide information as to...
- Section 17b:30-29 - Provision Of Toll-free Telephone Number.
4.A payer shall provide covered persons and eligible health care providers with a toll-free telephone number for making inquiries regarding paid claims or pending...
- Section 17b:30-30 - Maintenance Of Claims Records; Audit Required.
5. a. A payer shall maintain a record which shall be audited by a private auditing firm at the expense of the payer, to...
- Section 17b:30-31 - Additional Record Of Claims.
6. a. In addition to the annual audit required by section 5 of this act, the payer shall maintain and report to the commissioner...
- Section 17b:30-32 - Overdue Capitation Payment.
7. a. Payment of a capitation payment to a health care provider shall be deemed to be overdue if not remitted to the provider...
- Section 17b:30-33 - Regulations.
8.No later than 180 days following the date of enactment of this act, the commissioner shall adopt regulations pursuant to the "Administrative Procedure Act,"...
- Section 17b:30-34 - Inapplicability Of Act.
9.The provisions of this act shall not apply to any payer determined by the commissioner to be impaired, to be subject to the provisions...
- Section 17b:30-35 - Definitions Relative To Standardized Pharmacy Identification Cards
1.As used in this act: "Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation or health maintenance organization authorized...
- Section 17b:30-36 - Issuance Of Standardized Pharmacy Identification Information, Card To Primary Insured
2. a. A carrier, multiple employer welfare arrangement or other health benefits plan provider, or its agents, contractors or administrators, including but not limited...
- Section 17b:30-37 - Exceptions For Issuance Of Card
3. a. A carrier, multiple employer welfare arrangement or other health benefits plan provider shall not be required to issue a pharmacy identification card...
- Section 17b:30-38 - Provision Of New Pharmacy Identification Card
4.A carrier, multiple employer welfare arrangement or other health benefits plan provider shall provide each primary insured with a new pharmacy identification card within...
- Section 17b:30-39 - Rules, Regulations
5.The Commissioner of Banking and Insurance shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to carry...
- Section 17b:30-40 - Definitions, Construction, Regulations On Notice Of Premium Increase To Employers.
5. a. As used in this section: "Carrier"means any entity subject to the insurance laws and regulations of this State, or subject to the...
- Section 17b:30-41 - Findings, Declarations Relative To Collection Of Unpaid Hospital Accounts.
1.The Legislature finds and declares that: a.The rising cost of hospital-based health care in this State impedes the ability of the State and insurers...
- Section 17b:30-42 - Definitions Relative To Collection Of Unpaid Hospital Accounts.
2.As used in this act: "Coinsurance" means the percentage of a charge covered by a health plan that must be paid by a person...
- Section 17b:30-44 - "New Jersey Hospital Care Payment Fund."
4. a. There is established the "New Jersey Hospital Care Payment Fund" in the Department of the Treasury. b.The fund shall be comprised of...
- Section 17b:30-45 - Authority Of Department.
5.The department is authorized to: a.Accept assignment of debts from hospitals which have followed the procedures outlined in section 7 of this act, or...
- Section 17b:30-46 - Decisions Of Department Constitute Final Agency Action.
6.Decisions of the department, regarding the fairness formula, the validity of debts, the adequacy of data provided to the department by hospitals for use...
- Section 17b:30-47 - Procedures For Participating Hospitals.
7. a. The following procedures shall apply for those hospitals that wish to participate in the voluntary assignment program created by this act. b.The...
- Section 17b:30-48 - Short Title.
1.This act shall be known and may be cited as the "Health Claims Authorization, Processing and Payment Act." L.2005,c.352,s.1.
- Section 17b:30-49 - Findings, Declarations Relative To Processing Health Claims.
2.The Legislature finds and declares that: a.Health care services available under health benefits plans must be promptly provided to covered persons under all circumstances,...
- Section 17b:30-50 - Definitions Relative To Processing Health Claims.
3.As used in sections 3 through 7 of P.L.2005, c.352 (C.17B:30-50 through C.17B:30-54): "Authorization" means a determination required under a health benefits plan, that...
- Section 17b:30-51 - Information Required From Payer.
4. a. A payer shall provide the following information concerning utilization management and the processing and payment of claims in a clear and conspicuous...
- Section 17b:30-52 - Response By Payer To Request For Authorization Of Health Care Services.
5. a. A payer shall respond to a hospital or physician request for authorization of health care services by either approving or denying the...
- Section 17b:30-53 - Reimbursement For Covered Services, Conditions.
6. a. When a hospital or physician complies with the provisions set forth in section 5 of P.L.2005, c.352 (C.17B:30-52), no payer, or payer's...
- Section 17b:30-54 - Reimbursement According To Provider Contract.
7.A payer, or payer's agent, shall reimburse a hospital or physician according to the provider contract for all medically necessary emergency and urgent care...
- Section 17b:30-55 - Violations, Penalties; Rules, Regulations.
17. a. The Commissioner of Banking and Insurance shall enforce the provisions of sections 2 through 7 of P.L.2005, c.352 (C17B:30-49 through C.17B:30-54) and...
- Section 17b:30-56 - Rules, Regulations.
20.The Commissioner of Banking and Insurance shall promulgate rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to...
- Section 17b:30-57 - Liberal Construction.
21.This act shall be liberally construed to effectuate the legislative purposes of the act. L.2005,c.352,s.21.
- Section 17b:30-58 - Definitions Relative To Reimbursement For Certain Ambulance Services.
1.As used in this act: "Ambulance service" means the provision of emergency health care services, basic life support services, advanced life support services, critical...
- Section 17b:30-59 - Assignment Of Benefits To Service Provider Of Right To Receive Reimbursement For Ambulance Service.
2. a. Notwithstanding any provision of law to the contrary, a covered person may, through an assignment of benefits, assign to a service provider...
- Section 17b:30b-1 - Short Title.
1.This act shall be known and may be cited as the "Viatical Settlements Act." L.2005,c.229,s.1.
- Section 17b:30b-2 - Definitions Relative To Viatical Settlements.
2.As used in this act: "Advertising" means any written, electronic or printed communication or any communication by means of recorded telephone messages or transmitted...
- Section 17b:30b-3 - License To Operate As Viatical Settlement Provider.
3. a. A person shall not operate as a viatical settlement provider without first obtaining a license from the commissioner of the state of...
- Section 17b:30b-4 - Refusal To Issue, Suspension, Revocation, Refusal To Renew License.
4. a. The commissioner may refuse to issue, suspend, revoke or refuse to renew the license of a viatical settlement provider, if the commissioner...
- Section 17b:30b-5 - Approval Of Viatical Settlement Forms By Commissioner.
5.A person shall not use a viatical settlement contract form or provide a disclosure statement or application form to a viator in this State...
- Section 17b:30b-6 - Filing Of Annual Statement.
6. a. Each viatical settlement provider licensee shall file with the commissioner on or before March 1 of each year an annual statement containing...
- Section 17b:30b-7 - Examinations Of Licensees By Commissioner.
7. a. (1) The commissioner may conduct an examination of a licensee under this act as often as the commissioner, in his sole discretion,...
- Section 17b:30b-8 - Disclosures To Viator, Procedure.
8. a. With each application for a viatical settlement, a viatical settlement provider or life insurance producer shall provide the viator with at least...
- Section 17b:30b-9 - Material Required Prior To Entering Into Viatical Settlement Contract.
9. a. (1) A viatical settlement provider entering into a viatical settlement contract shall first obtain: (a)If the viator is the insured, a written...
- Section 17b:30b-10 - Two-year Period Required Between Issuance Of Policy And Viatical Settlement; Exceptions.
10. a. It is a violation of this act for any person to enter into a viatical settlement contract within a two-year period commencing...
- Section 17b:30b-11 - Advertisement Of Viatical Settlement Contracts; Guidelines, Standards.
11.The purpose of this section is to provide prospective viators with clear and unambiguous statements in the advertisement of viatical settlement contracts and to...
- Section 17b:30b-12 - Fraudulent Viatical Settlement Acts, Prohibited, Reporting, Investigation, Prosecution.
12. a. A person shall not commit a fraudulent viatical settlement act as defined in section 2 of this act. b.A person shall not...
- Section 17b:30b-13 - Injunction In Addition To Penalties, Enforcement Provisions.
13. a. In addition to the penalties and other enforcement provisions of this act, if any person violates this act or any regulation implementing...
- Section 17b:30b-14 - Violation Considered Unfair Trade Practice; Penalties.
14.A violation of this act shall be considered an unfair trade practice pursuant to N.J.S.17B:30-1 et seq. and shall be subject to the penalties...
- Section 17b:30b-15 - Regulations, Authority Of Commissioner.
15.The commissioner shall have the authority to promulgate regulations implementing the provisions of this act pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1...
- Section 17b:30b-16 - Construction Of Act With Uniform Securities Law.
16.Nothing in this act shall be construed to preempt or otherwise limit the provisions of the "Uniform Securities Law (1967)," P.L.1967, c.93 (C.49:3-47 et...
- Section 17b:30b-17 - Continuation Of Negotiating Viatical Settlements, Certain Circumstances Prior To Act.
17. a. Notwithstanding the provisions of sections 1 through 16 of this act, a person who has lawfully negotiated viatical settlement contracts between a...
- Section 17b:32-31 - Short Title, Purpose Of Act
1. a. This act shall be known and may be cited as the "Life and Health Insurers Rehabilitation and Liquidation Act." b. The purpose...
- Section 17b:32-32 - Application Of Authorized Proceedings
2. The proceedings authorized by this act shall be applied to: a. All insurers who are doing, or have done, insurance business in this...
- Section 17b:32-33 - Definitions
3. For the purposes of this act: "Ancillary state" means any state other than a domiciliary state. "Commissioner" means the Commissioner of Insurance of...
- Section 17b:32-34 - Jurisdiction Over Delinquency Proceedings
4. a. No delinquency proceeding shall be commenced under this act by anyone other than the commissioner and no court shall have jurisdiction to...
- Section 17b:32-35 - Restraining Orders, Injunctions
5. a. Any receiver appointed in a proceeding under this act may at any time apply for, and the Superior Court may grant, such...
- Section 17b:32-36 - Cooperation With Commissioner In Proceedings
6. a. Any officer, manager, director, trustee, owner, employee or agent of any insurer, or any other person with authority over or in charge...
- Section 17b:32-37 - Proceedings Previously Commenced Deemed Commenced Under This Act; Exceptions, Distribution Of Claims
7. a. Every proceeding heretofore commenced under the laws in effect before the enactment of this act shall be deemed to have been commenced...
- Section 17b:32-38 - Prohibitions Relative To Insurer Subject To Delinquency Proceeding
8. No insurer that is subject to any delinquency proceedings, whether administrative or judicial, shall: a. Be released from that proceeding, unless that proceeding...
- Section 17b:32-39 - Filing Of Petition; Court Orders
9. a. The commissioner may file in the Superior Court of this State a petition alleging that, with respect to a domestic insurer: (1)...
- Section 17b:32-40 - Confidentiality Of Documents, Files, Records, Papers
10. In all proceedings and judicial reviews thereof under section 9 of this act, all records of the insurer, other documents, and all department...
- Section 17b:32-41 - Petition For Authority To Rehabilitate Insurer
11. The commissioner may petition the Superior Court for an order authorizing him to rehabilitate a domestic insurer or an alien insurer domiciled in...
- Section 17b:32-42 - Appointment Of Rehabilitator
12. a. An order to rehabilitate the business of a domestic insurer, or an alien insurer domiciled in this State, shall appoint the commissioner...
- Section 17b:32-43 - Powers Of Rehabilitator
13. a. The commissioner as rehabilitator may appoint one or more special deputies, who shall have all the powers and responsibilities of the rehabilitator...
- Section 17b:32-44 - Staying Of Pending Actions
14. a. Any court in this State before which any action or proceeding in which the insurer is a party, or is obligated to...
- Section 17b:32-45 - Petition For Order Of Liquidation
15. a. Whenever the commissioner believes further attempts to rehabilitate an insurer would substantially increase the risk of loss to creditors, policyholders or the...
- Section 17b:32-46 - Basis For Order Of Liquidation
16. The commissioner may petition the Superior Court for an order directing him to liquidate a domestic insurer or an alien insurer domiciled in...
- Section 17b:32-47 - Appointment Of Liquidator
17. a. An order to liquidate the business of a domestic insurer shall appoint the commissioner and his successors in office liquidator and shall...
- Section 17b:32-48 - Policies To Continue In Force
18. a. Policies of life or health insurance or annuities shall continue in force for such period and under such terms as is provided...
- Section 17b:32-49 - Petition For Dissolution
19. The commissioner may petition for an order dissolving the corporate existence of a domestic insurer, or the United States branch of an alien...
- Section 17b:32-50 - Powers Of Liquidator
20. a. The liquidator shall have the power: (1) To appoint a special deputy or deputies to act for him under this act, and...
- Section 17b:32-51 - Notice Of Liquidation Order
21. a. Unless the court otherwise directs, the liquidator shall give or cause to be given notice of the liquidation order as soon as...
- Section 17b:32-52 - Provision Of Information To Liquidator By Agents, Licensing Affected
22. a. Every person who receives notice, in the form prescribed in section 21 of this act, that an insurer which he represents as...
- Section 17b:32-53 - Actions Against Or By Insurer, Liquidator
23. a. Upon issuance of an order appointing a liquidator of a domestic insurer or of an alien insurer domiciled in this State, no...
- Section 17b:32-54 - Preparation Of List Of Insurer's Assets
24. a. As soon as practicable after the liquidation order but not later than 120 days thereafter, the liquidator shall prepare in duplicate a...
- Section 17b:32-55 - Transfers, Obligations Deemed Fraudulent
25. a. Every transfer made or suffered and every obligation incurred by an insurer within one year prior to the filing of a successful...
- Section 17b:32-56 - Transfer Of Real Property Deemed Valid
26. a. After a petition for rehabilitation or liquidation has been filed, but before an order of rehabilitation or liquidation is granted, a transfer...
- Section 17b:32-57 - Preferences
27. a. (1) A preference is a transfer of any of the property of an insurer to or for the benefit of a creditor,...
- Section 17b:32-58 - Claims Of Creditor
28. a. No claims of a creditor who has received or acquired a preference, lien, conveyance, transfer, assignment or encumbrance voidable under this act,...
- Section 17b:32-59 - Mutual Debts, Credits
29. a. Mutual debts or mutual credits, whether arising out of one or more contracts between the insurer and another person in connection with...
- Section 17b:32-60 - Report By Liquidator
30. a. As soon as practicable, but not more than two years from the date of an order of liquidation under section 17 of...
- Section 17b:32-61 - Amount Recoverable Not Affected By Delinquency Proceedings
31. The amount recoverable by the liquidator from reinsurers shall not be reduced as a result of the delinquency proceedings, regardless of any provision...
- Section 17b:32-62 - Payment Of Unpaid Premium, Violations; Penalties; Appeals
32. a. (1) An agent, broker, premium finance company, or any other person, other than the insured, responsible for the payment of a premium...
- Section 17b:32-63 - Proposal To Disburse Assets
33. a. Within 120 days of a final determination of insolvency of an insurer by a court of competent jurisdiction of this State, the...
- Section 17b:32-64 - Filing Of Proof Of Claims
34. a. Proof of all claims shall be filed with the liquidator in the form required by section 35 of this act on or...
- Section 17b:32-65 - Statement To Proof Of Claim
35. a. Proof of claim shall consist of a statement signed by the claimant that includes all of the following that are applicable: (1)...
- Section 17b:32-66 - Contingent, Absolute, Limited Claims
36. a. A claim may be allowed even if contingent, if it is filed in accordance with section 34 of this act. It may...
- Section 17b:32-67 - Third Party, Insured Claims
37. a. Whenever any third party asserts a cause of action against an insured of an insurer in liquidation, the third party may file...
- Section 17b:32-68 - Denial Of Claims
38. a. When a claim is denied in whole or in part by the liquidator, written notice of the determination shall be given to...
- Section 17b:32-69 - Proving, Filing Of Claim Of Subrogee
39. Whenever a creditor, whose claim against an insurer is secured, in whole or in part, by the undertaking of another person, fails to...
- Section 17b:32-70 - Determination Of Value Of Security
40. a. The value of any security held by a secured creditor shall be determined in one of the following ways, as the court...
- Section 17b:32-71 - Priority Of Distribution Of Claims
41. a. The priority of distribution of claims from the insurer's estate shall be in accordance with the order in which each class of...
- Section 17b:32-72 - Review Of Claims
42. a. The liquidator shall review all claims duly filed in the liquidation and shall make such further investigation as he shall deem necessary....
- Section 17b:32-73 - Payment Of Distributions
43. Under the direction of the court, the liquidator shall pay distributions in a manner that will assure the proper recognition of priorities and...
- Section 17b:32-74 - Distribution Of Unclaimed Funds
44. Distribution of all unclaimed funds subject to distribution remaining in the liquidator's hands when he is ready to apply to the court for...
- Section 17b:32-75 - Application For Discharge
45. a. When all assets justifying the expense of collection and distribution have been collected and distributed under this act, the liquidator shall apply...
- Section 17b:32-76 - Petition For Reopening Of Proceedings
46. After the liquidation proceeding has been terminated and the liquidator discharged, the commissioner or other interested party may at any time petition the...
- Section 17b:32-77 - Retaining, Destruction Of Records
47. Whenever it shall appear to the commissioner that the records of any insurer in the process of liquidation or completely liquidated are no...
- Section 17b:32-78 - Audits Of Receiverships
48. The Superior Court may, as it deems appropriate, cause audits to be made of the books of the commissioner relating to any receivership...
- Section 17b:32-79 - Grounds For Appointment Of Conservator
49. a. If a domiciliary liquidator has not been appointed, the commissioner may apply to the Superior Court by verified petition for an order...
- Section 17b:32-80 - Grounds For Liquidation Of Assets Of Insurer
50. a. If no domiciliary receiver has been appointed, the commissioner may apply to the Superior Court by verified petition for an order directing...
- Section 17b:32-81 - Vesting Of Title With Domiciliary Liquidator
51. a. The domiciliary liquidator of an insurer domiciled in a reciprocal state shall, except as to special deposits and security on secured claims...
- Section 17b:32-82 - Petition For Appointment As Ancillary Receiver
52. a. If a domiciliary liquidator has been appointed for an insurer not domiciled in this State, the commissioner may file a petition with...
- Section 17b:32-83 - Institution Of Proceedings
53. The commissioner in his sole discretion may institute proceedings under sections 9 and 10 of this act at the request of the commissioner...
- Section 17b:32-84 - Claims Filed In Liquidation Proceedings Begun In State
54. a. In a liquidation proceeding begun in this State against an insurer domiciled in this State, claimants residing in foreign countries or in...
- Section 17b:32-85 - Claims Filed In Liquidation Proceedings In Reciprocal State
55. a. In a liquidation proceeding in a reciprocal state against an insurer domiciled in that state, claimants against the insurer who reside within...
- Section 17b:32-86 - Actions, Proceedings Prohibited During Pendency Of Liquidation Proceeding
56. During the pendency in this or any other state of a liquidation proceeding, whether called by that name or not, no action or...
- Section 17b:32-87 - Order Of Distribution Of Claims
57. a. In a liquidation proceeding in this State involving one or more reciprocal states, the order of distribution of the domiciliary state shall...
- Section 17b:32-88 - Failure Of Ancillary Receiver To Transfer Assets
58. If an ancillary receiver in another state or foreign country, whether called by that name or not, fails to transfer to the domiciliary...
- Section 17b:32-89 - Persons Entitled To Protection
59. a. For the purpose of this section, the following persons are entitled to protection under subsection b. of this section: (1) All receivers...
- Section 17b:32-90 - Commissioner's Powers Unaffected
60. This act shall not be interpreted to limit the powers granted to the commissioner by other provisions of law. L.1992,c.65,s.60.
- Section 17b:32-91 - Rules, Regulations
61. The commissioner may, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), promulgate necessary rules and regulations to implement the provisions...
- Section 17b:32-92 - Rights Relative To Certain Financial Agreements; Terms Defined.
1. a. (1) Notwithstanding any other provision of the "Life and Health Insurers Rehabilitation and Liquidation Act," P.L.1992, c.65 (C.17B:32-31 et seq.) to the...
- Section 17b:32a-1 - Short Title
1. Sections 2 through 19 of this act shall be known and may be cited as the "New Jersey Life and Health Insurance Guaranty...
- Section 17b:32a-2 - Purpose Of Act
2. a. The purpose of this act is to protect, subject to certain limitations, those persons specified in subsection a. of section 3 of...
- Section 17b:32a-3 - Provision Of Coverage
3. a. This act shall provide coverage, for the policies and contracts specified in subsection b. of this section, to: (1) persons who, regardless...
- Section 17b:32a-4 - Definitions
4. As used in this act: "Account" means either of the two accounts created under subsection b. of section 5 of this act. "Association"...
- Section 17b:32a-5 - New Jersey Life And Health Insurance Guaranty Association Created
5. a. There is created a nonprofit legal entity to be known as the New Jersey Life and Health Insurance Guaranty Association. All member...
- Section 17b:32a-6 - Board Of Directors Of Association
6. a. There shall be a board of directors of the association which shall consist of not less than five nor more than nine...
- Section 17b:32a-7 - Powers Of The Association
7. a. If a member insurer is an impaired domestic insurer, the association may, in its discretion, and subject to any conditions imposed by...
- Section 17b:32a-8 - Member Insurers Assessed To Provide Funding For Association
8. a. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors...
- Section 17b:32a-9 - Plan Of Operation
9. a. (1) The association shall submit to the commissioner a plan of operation and any amendments thereto necessary or suitable to assure the...
- Section 17b:32a-10 - Additional Duties, Powers Of Commissioner
10. a. In addition to the duties and powers enumerated elsewhere in this act, the commissioner shall: (1) upon request of the board of...
- Section 17b:32a-11 - Detection, Prevention Of Insurer Insolvencies, Impairments
11. a. To aid in the detection and prevention of insurer insolvencies or impairments, the commissioner may: (1) notify the commissioners of insurance or...
- Section 17b:32a-12 - Liabilities Of Impaired, Insolvent Insurers
12. a. Nothing in this act shall be construed to reduce the liability for unpaid assessments of the insureds of an impaired or insolvent...
- Section 17b:32a-13 - Association Subject To Examination, Regulation
13. The association shall be subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner each year,...
- Section 17b:32a-14 - Association Exempt From Fees, Taxes
14. The association shall be exempt from payment of all fees and all taxes levied by this State or any of its subdivisions, except...
- Section 17b:32a-15 - Immunity From Liability
15. a. There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member...
- Section 17b:32a-16 - Stay Of Proceedings Involving Insolvent Insurer
16. Upon application and notice, all proceedings in which an insolvent insurer is a party or is obligated to defend a party in any...
- Section 17b:32a-17 - Association Shall Not Be Used To Promote Insurance Sales
17. a. No person, including an insurer, agent or affiliate of an insurer or insurance producer shall make, publish, disseminate, circulate or place before...
- Section 17b:32a-18 - Member Insurer May Offset Assessments Against Premium Tax Liability
18. a. A member insurer may offset against its premium tax liability, attributable to premiums written in that year, and determined pursuant to section...
- Section 17b:32a-19 - Provisions Not Applicable To Certain Insurers
19. The provisions of sections 2 through 18 of this act shall not apply to any insurer which is insolvent or impaired on December...
- Section 17b:32b-1 - Short Title.
1.This act shall be known and may be cited as the "New Jersey Insolvent Health Maintenance Organization Assistance Fund Act of 2000." L.2000,c.12,s.1.
- Section 17b:32b-2 - Purpose Of Act.
2.The purpose of this act is to protect, subject to certain limitations, covered individuals and providers against the failure or inability of HIP Health...
- Section 17b:32b-3 - Definitions Relative To Certain Insolvent Health Maintenance Organizations.
3.As used in this act: "Association" means the New Jersey Insolvent Health Maintenance Organization Assistance Association created by section 5 of this act. "Commissioner"...
- Section 17b:32b-4 - Payment For Eligible Services, Benefits.
4.This act shall provide payment for eligible services or benefits under a covered health maintenance organization contract on an equitable basis to any covered...
- Section 17b:32b-5 - New Jersey Insolvent Health Maintenance Organization Assistance Association.
5.There is created a nonprofit legal entity to be known as the New Jersey Insolvent Health Maintenance Organization Assistance Association. All health maintenance organizations...
- Section 17b:32b-6 - New Jersey Insolvent Health Maintenance Organization Assistance Fund.
6. a. For purposes of administration and assessment, the New Jersey Insolvent Health Maintenance Organization Assistance Fund is created, and shall be held in...
- Section 17b:32b-7 - Board Of Directors.
7. a. The board of directors of the association shall consist of not less than five nor more than nine members, who shall be...
- Section 17b:32b-8 - Maximum Liability Of Association.
8. a. The maximum liability of the association for all coverage provided under this act shall be limited to the amount available from the...
- Section 17b:32b-9 - Assessment Of Member Organizations.
9. a. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors...
- Section 17b:32b-10 - Submission Of Plan Of Operation.
10. a. (1) The association shall submit to the commissioner a plan of operation, and any amendments thereto, necessary or suitable to assure the...
- Section 17b:32b-11 - Additional Powers, Duties Of The Commissioner.
11. a. In addition to the duties and powers enumerated elsewhere in this act, the commissioner shall, upon request of the board of directors,...
- Section 17b:32b-12 - Tax Credit Permitted For Member Organizations.
12. a. A member organization shall be allowed a credit against the tax imposed pursuant to section 5 of P.L.1945, c.162 (C.54:10A-5), in an...
- Section 17b:32b-13 - Examination, Regulation.
13. a. The association shall be subject to examination and regulation by the commissioner. The board of directors shall submit to the commissioner each...
- Section 17b:32b-14 - Exemption Of Association From Certain Fees, Taxes.
14. The association shall be exempt from the payment of all fees and all taxes levied by this State or any of its subdivisions,...
- Section 17b:32b-15 - Condition For Receipt By Providers Of Payments.
15. As a condition of receiving payment directly from the association for an eligible claim against an insolvent organization, a provider shall agree to...
- Section 17b:32b-16 - Immunity From Liability For Member Organizations, Etc.
16. There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member organization...
- Section 17b:32b-17 - Rules, Regulations.
18. The commissioner shall promulgate such rules and regulations as may be necessary to effectuate the purposes of this act. L.2000,c.12,s.18.
- Section 17b:33-1 - Short Title
This chapter shall be known as the Unauthorized Insurers' Process Act. a. The purpose of this chapter is to subject unauthorized insurers to the...
- Section 17b:33-2 - Acts Constituting Commissioner As Process Agent
Any of the following acts in this State by an unauthorized insurer, whether effected by mail or other means, shall be equivalent to and...
- Section 17b:33-3 - Service Of Process On Commissioner As Process Agent
Service of process and other papers upon the commissioner as the true and lawful attorney of an unauthorized insurer pursuant to this chapter may...
- Section 17b:33-4 - Service Of Process On Persons Acting On Behalf Of Unauthorized Insurer
In addition to other methods authorized for the service of process and other papers upon an unauthorized insurer, such service may be made upon...
- Section 17b:33-5 - Service Of Process By Other Means
Nothing in this chapter shall be taken or construed to limit or abridge the means or methods by which any process or other papers...
- Section 17b:33-6 - Judgment By Default
Whenever the service of process is effected by a method authorized by this chapter, the time within which the defendant shall be allowed to...
- Section 17b:33-7 - Deposit Of Bond By Unauthorized Insurer
Before any unauthorized insurer shall file or cause to be filed any pleading or other paper in any action or proceeding instituted against it...
- Section 17b:33-8 - Damages For Unjustified Refusal To Pay
In any action against an unauthorized foreign or alien insurer upon a contract of insurance issued or delivered in this State to a resident...
- Section 17b:33-9 - Misrepresentation By Unauthorized Insurer; Notice To Domiciliary Supervisory Official; Action
No unauthorized insurer shall make, issue, circulate or cause to be made, issued or circulated, to residents of this State any estimate, illustration, circular,...
- Section 17b:34-1 - Applicability Of Chapter
The provisions of this chapter shall apply to all matters in respect to which a particular section directs that proceedings shall be governed by...
- Section 17b:34-2 - General Policy
Provisions for procedure, administration and the like, set out in this Code shall be construed and applied so as to aid in the operation...
- Section 17b:34-3 - Subsequently Enacted Laws
Laws hereafter enacted by way of amendment or supplement to this Code shall be dealt with in respect to matters of procedure, administration and...
- Section 17b:34-4 - Filing
Whenever any matter is required to be filed with the commissioner, the same shall be deemed to have been filed on the date it...
- Section 17b:34-5 - Submission For Approval Or Determination
Whenever any matter is required to be submitted, filed or otherwise presented so that it may be brought to the attention of the commissioner,...
- Section 17b:34-6 - Effect Of Withdrawals, Approvals And The Like
The withdrawal of any matter shall be without prejudice unless expressly stated to be with prejudice. Approvals resulting from the lapse of time shall...
- Section 17b:34-7 - Number Of Copies
One copy of any paper or other matter to be filed, submitted or otherwise presented shall be sufficient. Additional copies if thereafter requested by...
- Section 17b:34-8 - Subpoenas
17B:34-8. Subpoenas to witnesses shall be issued in the name of the commissioner by him or by any deputy commissioner or other employee designated...
- Section 17b:34-9 - Orders Pending Hearing
In any formal proceeding, where the commissioner finds that the interests of the public require that immediate action be taken pending the completion of...
- Section 17b:34-10 - Judicial Review; Stay
Orders of the commissioner, whether temporary or final, shall be subject to judicial review. Any party intending to seek judicial review may request the...
- Section 17b:34-11 - Matters Not Otherwise Provided For
In the administration of any matter, the procedure for which is not specified by any applicable provision of law or of any rule or...
- Section 17b:34-12 - Effect Of Chapter
The enactment of the provisions of this Chapter shall provide an alternative method of action and shall in no way be deemed to repeal...
- Section 17b:35-1 - Certificate Of Authority Existing Prior To Effective Date Of Act; Expiration; Renewal
Every certificate of authority of an insurer in force immediately prior to the effective date of this act and existing under any law herein...
- Section 17b:35-2 - Licenses In Force Prior To Effective Date Of Act; Continuance; Expiration; Renewal
Every license in force immediately prior to the effective date of this act and existing under any law herein repealed shall be valid until...
- Section 17b:35-3 - Form Of Insurance Document, Rate Or Filing Lawfully Used Prior To Effective Date Of Act; Continuance Of Use And Effectiveness
Every form of insurance document and every rate or other filing lawfully in use immediately prior to the effective date of this act may...
- Section 17b:35-4 - Deposits In Compliance With Condition Precedent To Or In Connection With Certificate Of Authority Prior To Effective Date Of Act; Use For Similar Purposes
Any deposit made in this State under any law repealed herein, with or through the Department of Insurance or the commissioner, or by any...
- Section 17b:35-5 - References To Repealed Provisions As References To Provisions Of This Act
Any laws of New Jersey, other than this act, remaining in force after the effective date of this act which refer to certain provisions...
- Section 17b:35-6 - Impairment Or Effect On Acts, Offenses, Rights, Penalties, Etc., Prior To Effective Date Of Act
This act shall not impair or affect any act done, offense committed, or right accruing, accrued, or acquired, or liability, penalty, forfeiture or punishment...
- Section 17b:35-7 - Insurer Organized Under Any Repealed Act; Continuance Of Existence And Rights
The repeal by this code of the whole or any part of any act under which there was organized any insurer in existence on...
- Section 17b:36-1 - Sections And Acts Saved From Repeal
The following sections, acts, and parts of acts, together with all amendments and supplements thereto, are saved from repeal. a. The following sections of...
- Section 17b:36-2 - Sections And Acts Repealed
The following sections, acts, and parts of acts, together with all amendments and supplements thereto, are hereby repealed. a. The following sections of the...
- Section 17b:36-3 - Partial Repealers
a. The following sections of the Revised Statutes are hereby repealed insofar as they apply to the formation of and subsequent authorization of companies...
- Section 17b:36-4 - Effective Date
Except as otherwise expressly provided this act shall take effect January 1, 1972. L.1971, c. 144, s. 17B:36-4.
- Section 17b:37-1 - Short Title, Findings, Declarations.
1. a. This act shall be known and may be cited as the "Interstate Insurance Product Regulation Compact." b.The Legislature finds and declares that...
- Section 17b:37-2 - Definitions Relative To The "Interstate Insurance Product Regulation Compact."
2.For the purposes of this act: "Advertisement" means any material designed to create public interest in an insurance product, or induce the public to...
- Section 17b:37-3 - "Interstate Insurance Product Regulation Commission."
3. a. The compacting states hereby create and establish a joint public agency known as the "Interstate Insurance Product Regulation Commission." Pursuant to section...
- Section 17b:37-4 - Powers Of Commission.
4.The commission shall have the following powers: a.To promulgate rules, pursuant to section 7 of this act, which shall have the force and effect...
- Section 17b:37-5 - Membership Of Commission; Organization; Bylaws.
5. a. (1) Each compacting state shall have and be limited to one member of the commission. Each member shall be qualified to serve...
- Section 17b:37-6 - Meetings, Actions.
6. a. The commission shall meet and take those actions consistent with the provisions of this act and the bylaws. b.Each member of the...
- Section 17b:37-7 - Rules, Uniform Standards, Operating Procedures.
7. a. The commission shall promulgate reasonable rules, including uniform standards and operating procedures, in order to effectively and efficiently achieve the purposes of...
- Section 17b:37-8 - Rules Establishing Conditions, Procedures For Public Inspection, Copying Of Information And Official Records.
8. a. The commission shall promulgate rules establishing conditions and procedures for public inspection and copying of its information and official records, except for...
- Section 17b:37-9 - Resolution Of Disputes, Issues Subject To Compact.
9.The commission shall attempt, upon the request of a member, to resolve any disputes or other issues that are subject to the compact and...
- Section 17b:37-10 - Approval Process For Product.
10. a. Insurers and third party filers seeking to have a product approved by the commission shall file the product with, and pay applicable...
- Section 17b:37-11 - Disapproved Product Or Advertisement; Appeal.
11. a. Not later than 30 days after the commission has given notice of a disapproved product or advertisement filed with the commission, the...
- Section 17b:37-12 - Payment Of Reasonable Expenses Of Establishment, Organization.
12. a. The commission shall pay or provide for the payment of the reasonable expenses of its establishment and organization. To fund the cost...
- Section 17b:37-13 - Eligibility Of States To Join Compact.
13. a. Any state is eligible to become a compacting state. b.The compact shall become effective and binding upon legislative enactment of the compact...
- Section 17b:37-14 - Withdrawal, Termination, Reinstatement.
14. a. (1) Once effective, the compact shall continue in force and remain binding upon each compacting state; however, a compacting state may withdraw...
- Section 17b:37-15 - Severability; Liberal Construction.
15. a. The provisions of this act shall be severable; and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions...
- Section 17b:37-16 - Enforcement Of Laws Of Compacting State Unaffected.
16. a. (1) Nothing herein shall prevent the enforcement of any other law of a compacting state, except as provided in subsection b. of...
- Section 17b:37-17 - Report To Legislature.
17. The Commissioner of Banking and Insurance shall report to the Legislature, as provided pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), within one...
Last modified: October 11, 2016