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 necessary to conform medicare supplement policies and certificates with federal law. These regulations shall include, but not be limited to:
a. Establishment of minimum standards for benefits, claim payments, marketing and reporting practices and compensation arrangements;
b. Establishment of a uniform methodology for calculating and reporting loss ratios, and requiring refunds or credits if the policies or certificates do not meet loss ratio requirements;
c. Establishment of a process for filing of all requests for premium increases and rate changes, which may include public hearings as determined appropriate by the commissioner prior to approval of any premium increases;
d. Assurance of access by the public to policy, premium and loss ratio information; and
e. Establishment of standards for Medicare Select policies and certificates at such time as this State is authorized under federal law to authorize Medicare Select policies and certificates.
L.1982,c.94,s.5; amended 1992,c.163,s.4.
Structure New Jersey Revised Statutes
Section 17B:17-1 - Scope of act
Section 17B:17-2 - Insurer defined
Section 17B:17-3 - Life insurance defined
Section 17B:17-4 - Health insurance defined
Section 17B:17-5 - Annuity defined
Section 17B:17-5.1 - Definitions; funeral insurance policies
Section 17B:17-6 - Person defined
Section 17B:17-7 - Domestic insurer, foreign insurer, alien insurer defined
Section 17B:17-8 - State defined
Section 17B:17-9 - Domicile defined
Section 17B:17-10 - Principal office defined
Section 17B:17-11 - Authorized insurer, unauthorized insurer defined
Section 17B:17-12 - Certificate of authority; license defined
Section 17B:17-12.1 - Change of domicile for insurers
Section 17B:17-13 - Misdemeanor to do business unless authorized
Section 17B:17-13.1 - Charitable annuities.
Section 17B:17-14 - General penalty
Section 17B:17-15 - Conflict with other laws
Section 17B:17-16 - Separability of provisions
Section 17B:17-17 - Short title
Section 17B:17-19 - Definitions
Section 17B:17-20 - Application of act; exclusions
Section 17B:17-21 - Policy forms
Section 17B:17-22 - Issuance of policy forms after filing; construction with other laws
Section 17B:17-23 - Flesch reading ease score; authorization of lower score
Section 17B:17-24 - Content of policy forms; construction with other laws
Section 17B:17-25 - Date of application
Section 17B:17-26 - Definitions relative to life insurance.
Section 17B:17-27 - Applicability of act.
Section 17B:17-28 - Use of death index by insurer.
Section 17B:17-29 - Action of insurer upon receiving notice of death.
Section 17B:17-30 - Procedures to confirm death, location, notification of beneficiaries.
Section 17B:17-31 - Inapplicability of act.
Section 17B:18-1 - Scope of chapter
Section 17B:18-2 - Stock insurer defined
Section 17B:18-3 - Mutual insurer defined
Section 17B:18-4 - Organization of stock or mutual insurer
Section 17B:18-5 - Approval of certificate by commissioner; recording and filing
Section 17B:18-6 - Stipulations in stock subscriptions and applications
Section 17B:18-7 - Certificate of incorporation of mutual insurer; election of directors
Section 17B:18-8 - Loan to mutual insurer for organizational expenses
Section 17B:18-11 - Nomination of candidates for director
Section 17B:18-12 - Death, withdrawal or incapacity of candidates for director
Section 17B:18-13 - Qualified voters; "policyholder" defined
Section 17B:18-14 - Elections of directors of mutual insurers; procedure, ballots
Section 17B:18-15 - Nominations by others than board of directors; notice of election
Section 17B:18-16 - Canvass of votes; tie vote
Section 17B:18-17 - Report of result of election
Section 17B:18-19 - Number of directors; appointment of public directors; ex officio directors
Section 17B:18-20 - Public directors; carry-overs; appointments; terms; vacancies; powers
Section 17B:18-21 - Elected directors; carry-overs; terms; vacancies
Section 17B:18-22 - Elected directors; manner of electing
Section 17B:18-23 - Qualified voters; "policyholder" for purpose of election defined
Section 17B:18-24 - Nomination of candidates; demand by public directors
Section 17B:18-25 - Method of electing when no demand is made by public directors
Section 17B:18-27 - Mailing of ballot; effect
Section 17B:18-28 - Filing certificate on number of policies; copy delivered to Chief Justice
Section 17B:18-29 - Election of directors in mutual insurer issuing temporary stock
Section 17B:18-30 - Proxy voting permitted at elections
Section 17B:18-31 - Emergency by-laws
Section 17B:18-32 - Failure to adopt emergency by-laws; procedure
Section 17B:18-33 - National emergency; succession
Section 17B:18-34 - National emergency; relocation of principal place of business
Section 17B:18-37 - Definitions; deposit prerequisite to authorization
Section 17B:18-38 - Deposits; interest on; substitution of
Section 17B:18-39 - Deposits to do business in other jurisdictions
Section 17B:18-39.1 - Fees for services of custodian required pursuant to N.J.S.17B:18-37 et seq.
Section 17B:18-41 - Examination before commencing business
Section 17B:18-42 - Certificate of authority; when issuable.
Section 17B:18-43 - Domestic insurers, powers, duties--general corporation law
Section 17B:18-44 - Stock of other insurance company
Section 17B:18-45 - Authority to acquire, hold and convey real estate
Section 17B:18-46 - Limitation on dividends to stockholders
Section 17B:18-47 - Increase or decrease of capital stock
Section 17B:18-48 - Advertisement of assets to include liabilities
Section 17B:18-49 - Cash disbursements to be evidenced by voucher
Section 17B:18-50 - Payment of taxes, charges and fees prior to determination of invalidity
Section 17B:18-51 - Compensation of directors
Section 17B:18-52 - Insurer payments to senior officers restricted
Section 17B:18-54 - Suit for profits realized by director, officer, and principal stockholders
Section 17B:18-55 - Limitation on sale of stock by director, officer and principal stockholders
Section 17B:18-58 - Mutual insurers; adoption of amended charter or certificate of incorporation
Section 17B:18-59 - Mutualization of stock insurers
Section 17B:18-60 - Merger and consolidation of stock insurers
Section 17B:18-61 - Merger and consolidation of mutual insurers
Section 17B:18-62 - "Reinsurance" defined
Section 17B:18-63 - Reinsurance of risks
Section 17B:18-64 - Prerequisites to reinsurance
Section 17B:18-65 - Extended reinsurance
Section 17B:18-65.1 - Rules and regulations
Section 17B:18-66 - Reinsurance pooling
Section 17B:18-67 - Short title
Section 17B:18-68 - Surplus, capital required
Section 17B:18-69 - Temporary waiver of capital, surplus requirements
Section 17B:18-70 - Increase in amount of required capital, surplus
Section 17B:18-71 - Factors for determination of increase, revision, redetermination
Section 17B:18-72 - Suspension, revocation of authority to do business
Section 17B:19-1 - Expenses of investigation, analyses, and valuation of securities
Section 17B:19-1.1 - Definitions.
Section 17B:19-2.1 - Annual valuation of reserve liabilities.
Section 17B:19-3 - Additional reserves
Section 17B:19-4 - Preliminary term insurance; amount of reserve
Section 17B:19-5 - Calculations of policy and loss reserves for accident and health insurance.
Section 17B:19-7 - Abandonment of standard of valuation adopted
Section 17B:19-8 - Standard valuation law
Section 17B:19-10 - Reserves, related actuarial items; annual opinion of qualified actuary.
Section 17B:19-11 - Standards for policies issued on or after operative date of valuation manual.
Section 17B:19-12 - Establishment of reserves using principle-based valuation.
Section 17B:19-13 - Submission of certain data.
Section 17B:19-14 - "Confidential information."
Section 17B:20-1 - Investments of domestic insurers.
Section 17B:20-2 - Limitation of investments.
Section 17B:20-3 - Incidental acquisition of corporate stock or securities, construction of chapter
Section 17B:20-4 - Stock of subsidiary or alien corporations
Section 17B:20-5 - Securities of foreign country or property therein
Section 17B:20-6 - Reasonable and temporary additional restrictions
Section 17B:20-7 - Securities of domestic insurers
Section 17B:20-8 - Valuation of securities; violations; penalties
Section 17B:21-1 - Annual statement; forms
Section 17B:21-2 - Penalty for not filing annual statement; penalty for other violations
Section 17B:23-1 - Translation of business by foreign and alien insurers
Section 17B:23-2 - Prerequisites to admission
Section 17B:23-3 - Deposit by alien insurers
Section 17B:23-4 - Revocation of authority to do business
Section 17B:23-5 - Retaliatory provision.
Section 17B:23-7 - Definitions
Section 17B:23-8 - Conditions precedent to doing business in State
Section 17B:23-9 - Actions deemed doing business in the State
Section 17B:23-10 - Enforcement
Section 17B:23-11 - Excluded actions
Section 17B:24-1.1 - Insurable interests
Section 17B:24-3 - Application as evidence
Section 17B:24-4 - Assignments
Section 17B:24-5 - Payment discharges insurer
Section 17B:24-6 - Exemption of proceeds--life insurance
Section 17B:24-7 - Exemption of proceeds--annuity contracts
Section 17B:24-8 - Exemption of proceeds--health insurance and disability provisions
Section 17B:24-9 - Exemption of proceeds--group insurance
Section 17B:24-10 - Policy settlements
Section 17B:24-12 - Separate risks and premiums
Section 17B:25-1 - "Industrial life insurance" ; definition
Section 17B:25-2 - Standard provisions required
Section 17B:25-2.1 - Cancellation of policy within 10 days after receipt
Section 17B:25-3 - Grace period
Section 17B:25-4 - Incontestability
Section 17B:25-5 - Entire contract
Section 17B:25-6 - Misstatement of age
Section 17B:25-8 - Policy loan
Section 17B:25-9 - Reinstatement
Section 17B:25-10 - Payment of premiums
Section 17B:25-10.1 - Notice mailed to holders of life insurance policy
Section 17B:25-11 - Payment of claims
Section 17B:25-12 - Beneficiary; industrial policies
Section 17B:25-13 - Nonforfeiture benefits and cash surrender values
Section 17B:25-15 - Provision prohibited
Section 17B:25-16 - Excluded or restricted coverage
Section 17B:25-17 - Incontestability; limitation of liability after reinstatement
Section 17B:25-18 - Filing of forms
Section 17B:25-18.1 - Life, health insurance policy, contract; compliance
Section 17B:25-18.2 - Filing of policy, contract or related form
Section 17B:25-18.3 - Policies, contract forms; certification memorandums; exceptions
Section 17B:25-18.4 - Filing of certain forms of life insurance approved in other states.
Section 17B:25-18.5 - Certain actions taken by department employees to result in termination.
Section 17B:25-19 - Standard nonforfeiture law for life insurance.
Section 17B:25-20 - Standard nonforfeiture law for individual deferred annuities.
Section 17B:25-20.1 - Supersedure of standard nonforfeiture law, certain.
Section 17B:25-21 - Short title.
Section 17B:25-22 - Inapplicability of act.
Section 17B:25-23 - Required provisions for contract of annuity.
Section 17B:25-24 - Minimum values.
Section 17B:25-25 - Paid-up annuity benefit.
Section 17B:25-26 - Cash surrender benefits, determination of present value.
Section 17B:25-27 - Determination of present value.
Section 17B:25-28 - Determination of benefits.
Section 17B:25-29 - Notice of benefits not provided in contract.
Section 17B:25-30 - Benefits allowance for lapse of time and payments beyond schedule.
Section 17B:25-31 - Minimum nonforfeiture benefits.
Section 17B:25-33 - Effective date, applicability.
Section 17B:25-34 - Findings, declarations relative to certain annuity products.
Section 17B:25-35 - Definitions relative to certain annuity products.
Section 17B:25-36 - Use of certain terms regulated; exceptions.
Section 17B:25-39 - Cancellation provision for certain annuities.
Section 17B:25-40 - Certain annuities excluded; report to owner.
Section 17B:25-41 - Collection, maintenance of information.
Section 17B:25-42 - Violations, penalties.
Section 17B:26-1 - Filing of forms
Section 17B:26-2 - Form of policy; requirements.
Section 17B:26-2.1a - Reconstructive breast surgery; benefits
Section 17B:26-2.1b - Health insurance policies
Section 17B:26-2.1c - Benefits for equipment for home treatment of hemophilia
Section 17B:26-2.1e - Individual health insurance policy, mammogram examination benefits.
Section 17B:26-2.1f - Individual health insurance benefits for certain nursing services
Section 17B:26-2.1g - Individual health insurance policy, benefits for "off-label" drugs required
Section 17B:26-2.1h - Individual health insurer, benefits for health promotion
Section 17B:26-2.1j - Benefits for certain cancer treatments
Section 17B:26-2.1k - Coverage for birth and natal care; health insurance policy
Section 17B:26-2.1l - Coverage for diabetes treatment by individual health insurance policy
Section 17B:26-2.1n - Applicability of Health Care Quality Act
Section 17B:26-2.1t - Coverage for hemophilia services by individual health insurers
Section 17B:26-2.1u - Individual policy to provide coverage for colorectal cancer screening.
Section 17B:26-2.1x - Individual health insurer to offer coverage for domestic partner.
Section 17B:26-2.1y - Individual health insurer, coverage for contraceptives.
Section 17B:26-2.1ff - Individual health insurer to provide coverage for prescription eye drops.
Section 17B:26-2.1ll - Individual health insurer to provide coverage for breastfeeding support.
Section 17B:26-2.1mm - Individual health insurer policy to cover preventive services.
Section 17B:26-2.1oo - Individual health insurance policy to cover adolescent depression screenings.
Section 17B:26-2.1pp - Individual policy to cover newborn home nurse visitation.
Section 17B:26-2.2 - Second surgical opinions; definitions
Section 17B:26-2.3 - Policy benefits for second surgical opinion
Section 17B:26-2.4 - Benefit payments
Section 17B:26-2.5 - Third surgical opinion
Section 17B:26-2.6 - Excluded surgical procedures
Section 17B:26-2.7 - Payment for opinion services of physician
Section 17B:26-2.8 - Application of act
Section 17B:26-3 - Required provisions
Section 17B:26-3.1 - Cancellation of policy within 10 days after receipt
Section 17B:26-4 - Entire contract; changes
Section 17B:26-5 - Time limit on certain defenses
Section 17B:26-6 - Grace period
Section 17B:26-7 - Reinstatement
Section 17B:26-8 - Notice of claim
Section 17B:26-9 - Claim forms
Section 17B:26-10 - Proofs of loss
Section 17B:26-11 - Time of payment of claims
Section 17B:26-12 - Payment of claims
Section 17B:26-13 - Physical examinations and autopsy
Section 17B:26-14 - Legal actions
Section 17B:26-15 - Change of beneficiary
Section 17B:26-16 - Optional policy provisions
Section 17B:26-17 - Change of occupation
Section 17B:26-18 - Misstatement of age
Section 17B:26-19 - Other insurance in this insurer
Section 17B:26-20 - Insurance with other insurers
Section 17B:26-21 - Insurance with other insurers
Section 17B:26-22 - Relation of earnings to insurance
Section 17B:26-23 - Unpaid premium
Section 17B:26-24 - Cancellation
Section 17B:26-25 - Conformity with State statutes
Section 17B:26-26 - Illegal occupation
Section 17B:26-27 - Intoxicants and narcotics
Section 17B:26-28 - Inapplicable or inconsistent provisions
Section 17B:26-29 - Order of certain policy provisions
Section 17B:26-30 - Third party ownership
Section 17B:26-31 - Requirements of other jurisdictions
Section 17B:26-32 - Other policy provisions
Section 17B:26-33 - Policy conflicting with this chapter
Section 17B:26-34 - Time limit on certain defenses with respect to reinstatement
Section 17B:26-35 - Waiver of rights of insurer
Section 17B:26-37 - Scope of chapter
Section 17B:26-39 - Legislative findings and declarations
Section 17B:26-40 - Definitions
Section 17B:26-41 - Home health care; requirement for provisions for coverage
Section 17B:26-43 - Direct reimbursement to home health care providers
Section 17B:26-44 - Regulations
Section 17B:26-44.3 - Renewal date; policy with reservation of right to change premium
Section 17B:26-44.5 - Employer contribution
Section 17B:26-44.6 - Rules and regulations
Section 17B:26-46 - Violations; penalty; collection and enforcement
Section 17B:26-47 - Injunction
Section 17B:26A-1 - Definitions
Section 17B:26A-2 - Regulations; medicare supplement policies
Section 17B:26A-3 - Prohibited provisions
Section 17B:26A-4 - Preexisting condition; denial of claim for losses
Section 17B:26A-5 - Regulations
Section 17B:26A-6 - Medicare supplement policy or certificate, requirements
Section 17B:26A-7 - Outline of coverage, regulations
Section 17B:26A-8 - 30-day examination period, refunds
Section 17B:26A-9 - Applicability
Section 17B:26A-10 - Filing of copies of advertising materials, regulations
Section 17B:26A-11 - Additional remedies
Section 17B:26A-12 - Findings, declarations relative to Medicare supplement insurance.
Section 17B:26A-13 - Medicare supplement plans offered.
Section 17B:26A-14 - Rules, regulations; rates; plan provisions.
Section 17B:26A-15 - Procedures for equitable sharing of losses; conditions; filing statement
Section 17B:26A-16 - Audit required, conditions
Section 17B:26A-17 - Definitions.
Section 17B:27-26 - Definitions and requirements
Section 17B:27-27 - Employer, trustee, labor union, association groups
Section 17B:27-28 - Other groups as permitted under group life insurance
Section 17B:27-29 - Discretionary groups
Section 17B:27-30 - Dependents.
Section 17B:27-30.1 - Benefits provided by group policy to subscriber's child.
Section 17B:27-30.2 - Requirements applicable to State Medicaid
Section 17B:27-30.3 - Coverage provided by group health plan to subscriber's child.
Section 17B:27-30.4 - Requirements applicable to State Medicaid
Section 17B:27-30.5 - Coverage for certain dependents until age 31 by group health insurance policy.
Section 17B:27-31 - "Employees" defined
Section 17B:27-32 - Blanket insurance
Section 17B:27-33 - Standard provisions
Section 17B:27-34 - Application; statements
Section 17B:27-35 - Policy changes
Section 17B:27-36 - New entrants
Section 17B:27-37 - Payment of premiums
Section 17B:27-38 - Certificate
Section 17B:27-39 - Age limits
Section 17B:27-40 - Notice of loss
Section 17B:27-41 - Proof of loss
Section 17B:27-42 - Forms for proof
Section 17B:27-43 - Examination, autopsy
Section 17B:27-44 - Time of benefit payment
Section 17B:27-45 - Beneficiary; direct payment to hospitals and other purveyors of services
Section 17B:27-46 - Time limits, suits
Section 17B:27-46.1a - Reconstructive breast surgery; benefits
Section 17B:27-46.1b - Group health insurance policies
Section 17B:27-46.1c - Benefits for purchase of blood products, infusion equipment
Section 17B:27-46.1d - Commercial health insurer benefits for preexisting condition
Section 17B:27-46.1e - Group health insurance policy to pay benefits for treatment of Wilm's tumor
Section 17B:27-46.1f - Group health insurance policy, mammogram examination benefits.
Section 17B:27-46.1g - .Group health insurance policy, benefits for "off-label" drugs required
Section 17B:27-46.1h - Group health insurer, benefits for health promotion
Section 17B:27-46.1j - Benefits for certain cancer treatments
Section 17B:27-46.1k - Coverage for birth and natal care; group insurance policy
Section 17B:27-46.1m - Coverage for diabetes treatment by group health insurance policy
Section 17B:27-46.1n - Group health insurance policy, Pap smear benefits
Section 17B:27-46.1o - Group health insurance policy, prostate cancer testing
Section 17B:27-46.1p - Coverage for minimum inpatient care following mastectomy by group policy
Section 17B:27-46.1q - Applicability of Health Care Quality Act
Section 17B:27-46.1w - Coverage for hemophilia services by group health insurers
Section 17B:27-46.1y - Group policy to provide coverage for colorectal cancer screening.
Section 17B:27-46.1bb - Group health insurer to offer coverage for domestic partner.
Section 17B:27-46.1ee - Group health insurers, coverage for contraceptives.
Section 17B:27-46.1kk - Group health insurance policy to provide coverage for sickle cell anemia.
Section 17B:27-46.1ll - Group health insurer to provide coverage for prescription eye drops.
Section 17B:27-46.1pp - Group health insurance policy to cover digital tomosynthesis of the breast.
Section 17B:27-46.1ss - Group health insurer to provide coverage for breastfeeding support.
Section 17B:27-46.1tt - Group health insurer policy to cover preventive services.
Section 17B:27-46.1vv - Group health insurance policy to cover adolescent depression screenings.
Section 17B:27-46.2 - Second surgical opinions; definitions
Section 17B:27-46.3 - Group insurance policies; provision of program on request
Section 17B:27-46.4 - Payment for second surgical opinion services
Section 17B:27-46.5 - Third surgical opinion
Section 17B:27-46.6 - Reduction of benefits where no second opinion obtained
Section 17B:27-46.7 - Permissible benefit exclusions
Section 17B:27-46.8 - Payment for opinion services of physician
Section 17B:27-46.9 - Application of act
Section 17B:27-46.10 - Group health insurance policy to cover newborn home care visitation.
Section 17B:27-48 - Exceptions in same type as benefits
Section 17B:27-49 - Filing of forms
Section 17B:27-50 - Reimbursement for service of physician or practicing psychologist
Section 17B:27-50.1 - Severability
Section 17B:27-51 - Reimbursement for optometric service
Section 17B:27-51.1 - Reimbursement for service of chiropractor
Section 17B:27-51.1a - Group health insurance benefits for certain nursing services
Section 17B:27-51.2 - Legislative findings and declarations
Section 17B:27-51.3 - Definitions
Section 17B:27-51.4 - Home health care; requirement for coverage
Section 17B:27-51.5 - Benefits
Section 17B:27-51.6 - Direct reimbursement to home health care providers
Section 17B:27-51.7 - Regulations
Section 17B:27-51.10 - Renewal date; policy with reservation of right to change premium
Section 17B:27-51.10b - Employer contribution
Section 17B:27-51.10c - Rules and regulations
Section 17B:27-51.11 - Definitions
Section 17B:27-51.14 - Insurer provide health benefits plan, aggregate benefits.