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 N.J.S.17B:27-26 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act shall provide benefits for a minimum of 72 hours of inpatient care following a modified radical mastectomy and a minimum of 48 hours of inpatient care following a simple mastectomy. The policy shall not require a health care provider to obtain authorization from the insurer for prescribing 72 or 48 hours, as appropriate, of inpatient care as provided for in this section.
The provisions of this section shall not be construed to: require a patient to receive inpatient care for 72 or 48 hours, as appropriate, if the patient in consultation with the patient's physician determines that a shorter length of stay is medically appropriate; or relieve a patient or a patient's physician, if appropriate, of any notification requirements to the insurer under the policy.
The benefits shall be provided to the same extent as for any other sickness under the policy.
The provisions of this section shall apply to all policies in which the insurer has reserved the right to change the premium.
b. The Commissioner of Banking and Insurance shall adopt regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to implement the provisions of this section.
L.1997,c.149,s.5.
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:27-51.12 - Total disability of employee or member; continuation under gro