New Jersey Revised Statutes
Title 17B - Insurance
Section 17B:27-66 - Renewal of coverage; exceptions

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 the option of the policy holder, except that:
a. A health insurer may discontinue the coverage only if:
(1) the policy holder has failed to pay premiums or contributions in accordance with the terms of the health insurance coverage or the insurer has not received timely premium payments;
(2) the policy holder has performed an act or practice that constitutes fraud or made an intentional misrepresentation of material fact under the terms of the health insurance coverage; and
(3) in the case of a health insurer which offers a group health plan through a network plan, there is no longer any enrollee in the plan who lives, resides or works in the service area of the insurer or in the area for which the insurer is authorized to do business; or
b. A health insurer may not renew the health insurance coverage only if:
(1) the policy holder has failed to comply with a material plan provision relating to employer contribution or group participation rules; or
(2) the insurer is ceasing to offer coverage in the market in accordance with State and federal law.
c. A health insurer may cease offering and not renew a particular type of health insurance coverage only if:
(1) the insurer provides notice to each certificate or policy holder who is provided coverage of this type, and to participants and beneficiaries covered under the coverage of the nonrenewal at least 90 days prior to the date of the nonrenewal of the coverage;
(2) the insurer offers the option to purchase all or any other health insurance coverage that the insurer offers; and
(3) in exercising the option to not renew coverage of a particular type and in offering the option to purchase all or any other health insurance coverage that the insurer offers, the insurer acts uniformly without regard to the claims experience of the certificate or policy holder or any health status-related factor relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for the coverage.
d. A health insurer may cease offering and not renew all health insurance coverage only if:
(1) the insurer provides notice to the Department of Banking and Insurance and each employer and participants and beneficiaries covered under the health insurance coverage, of the nonrenewal at least 180 days prior to the date of the nonrenewal;
(2) the insurer ceases offering all health insurance coverage issued or delivered for issuance in the State for groups under the provisions of sections 14 through 27 of P.L.1997, c.146 (C.17B:27-54 through C.17B:27-67) and coverage under the health insurance coverage is not renewed; and
(3) the insurer may not provide for the issuance of any health insurance coverage for groups in this State under the provisions of sections 14 through 27 of P.L.1997, c.146 (C.17B:27-54 through C.17B:27-67), during a five-year period beginning on the termination date of the last health insurance coverage that was not renewed.
L.1997,c.146,s.26.

Structure New Jersey Revised Statutes

New Jersey Revised Statutes

Title 17B - Insurance

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:17-18 - Purpose

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:18-10 - Election of directors of mutual insurer pursuant to provision in certificate of incorporation

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:18-18 - Choosing of directors for mutual life insurers having in excess of ten million policies in force

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:18-26 - Method of election when demand is made by public directors that other candidates be nominated

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:18-53 - Reporting amount of stock owned and changes therein by director, officer, and principal stockholders of domestic stock insurers

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:18-56 - Stock insurers; change of name, extension of corporate existence or amendment of charter or certificate of incorporation

Section 17B:18-57 - Mutual insurers; change of name, extension of corporate existence or amendment of charter or certificate of incorporation

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 - Annual valuation of reserve liabilities for outstanding policies; foreign and alien insurers.

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:21-7 - Fees

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:23-6 - Purpose

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:24-2 - Minors

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:24-11 - Participating and nonparticipating policies--right to issue; payment of commissions thereon

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:25-7 - Dividends

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:25-14 - Title

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:25-32 - Rules.

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:25-37 - Certain annuities excluded; annuities buyer's guide; annuity contract disclosure statement.

Section 17B:25-38 - Certain annuities excluded, information recorded; determination as to suitability of annuity for consumer; system of supervision.

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:26-2.1d - Individual health insurance policy to pay benefits for treatment of Wilm's tumor

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:26-2.1i - Requirements for individual health insurer providing benefits for pharmacy services.

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:26-2.1m - Coverage for minimum inpatient care following mastectomy by individual hospital, medical expense benefits policy

Section 17B:26-2.1n - Applicability of Health Care Quality Act

Section 17B:26-2.1o - Coverage for treatment of inherited metabolic diseases by individual health insurance policy.

Section 17B:26-2.1p - Health insurance policy to cover certain audiology, speech-language pathology services.

Section 17B:26-2.1q - Coverage for treatment of domestic violence injuries by individual health insurance policy.

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

Section 17B:26-2.1s - Individual health insurers to provide coverage for mental health conditions, substance use disorders; collaborative care model.

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:26-2.1v - Individual health insurer prescription drug plans to cover certain infant formulas.

Section 17B:26-2.1w - Policy issued under Chapter 26 of Title 17B required to cover certain out-of-network services.

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:26-2.1z - Individual health insurance policies to provide benefits for orthotic and prosthetic appliances.

Section 17B:26-2.1aa - Individual health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.

Section 17B:26-2.1bb - Individual health insurance policy to provide installment payments to obstetrical provider for maternity services.

Section 17B:26-2.1cc - Individual health insurance policy to provide benefits for treatment of autism or other developmental disability.

Section 17B:26-2.1dd - Individual health insurance policy to provide coverage for oral anticancer medications.

Section 17B:26-2.1ee - Individual health insurance policy to provide coverage for sickle cell anemia.

Section 17B:26-2.1ff - Individual health insurer to provide coverage for prescription eye drops.

Section 17B:26-2.1gg - Individual health insurance policy, contract, coverage for synchronization of prescribed medications.

Section 17B:26-2.1hh - Individual health insurance policy to provide benefits for treatment of substance use disorder.

Section 17B:26-2.1ii - Individual health insurance policy to provide coverage regardless of gender identity, expression.

Section 17B:26-2.1jj - Individual health insurance policy to cover digital tomosynthesis of the breast.

Section 17B:26-2.1kk - Individual health insurance policy to provide coverage for donated human breast milk.

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:26-2.1nn - Individual health insurance policy to provide certain coverage for prescription drugs.

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:26-3.2 - Individual health insurance policy, exclusion, rates, terms based on genetic information prohibited

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:26-9.1 - Health insurer to receive, transmit transactions relative to individual policies electronically; standards.

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:26-36 - Age limit

Section 17B:26-37 - Scope of chapter

Section 17B:26-38 - Penalty

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:26-42 - Benefits

Section 17B:26-43 - Direct reimbursement to home health care providers

Section 17B:26-44 - Regulations

Section 17B:26-44.1 - Policy provision for reimbursement of dental services; payment regardless of discipline of provider

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

Section 17B:26-44.3 - Renewal date; policy with reservation of right to change premium

Section 17B:26-44.4 - Alternative dental coverage; original coverage restricted to limited number of providers

Section 17B:26-44.5 - Employer contribution

Section 17B:26-44.6 - Rules and regulations

Section 17B:26-45 - Minimum standards for form, content and sale of individual health insurance; 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:27-36.1 - Eligibility for enrollment under policy providing hospital, medical expense benefits.

Section 17B:27-36.2 - Group health insurance, policy, exclusion, rates, terms based on genetic information prohibited

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:27-44.2 - Health insurer to receive, transmit transactions relative to group policies electronically; standards.

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:27-46.1i - Requirements for group health insurer providing benefits for pharmacy services.

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:27-46.1l - Group health insurance policy, child screening, blood lead, hearing loss; immunizations.

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:27-46.1r - Coverage for treatment of inherited metabolic diseases by group health insurance policy.

Section 17B:27-46.1s - Group health insurer to cover certain audiology, speech-language pathology services.

Section 17B:27-46.1t - Coverage for treatment of domestic violence injuries by group health insurance policy.

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

Section 17B:27-46.1v - Group health insurers to provide coverage for mental health conditions, substance use disorders; collaborative care model.

Section 17B:27-46.1w - Coverage for hemophilia services by group health insurers

Section 17B:27-46.1x - Group health insurance policy to provide coverage for treatment of infertility.

Section 17B:27-46.1y - Group policy to provide coverage for colorectal cancer screening.

Section 17B:27-46.1z - Group health insurer prescription drug plans to cover certain infant formulas.

Section 17B:27-46.1aa - Policy issued under Chapter 27 of Title 17B required to cover certain out-of-network services.

Section 17B:27-46.1bb - Group health insurer to offer coverage for domestic partner.

Section 17B:27-46.1cc - Group health insurance policy, high deductible, coverage for preventive care.

Section 17B:27-46.1dd - Group health insurance policy, high deductible, deductible inapplicable, certain circumstances.

Section 17B:27-46.1ee - Group health insurers, coverage for contraceptives.

Section 17B:27-46.1ff - Group health insurance policies to provide benefits for orthotic and prosthetic appliances.

Section 17B:27-46.1gg - Group health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.

Section 17B:27-46.1hh - Group health insurance policy to provide installment payments to obstetrical provider for maternity services.

Section 17B:27-46.1ii - Group health insurance policy to provide benefits for treatment of autism or other developmental disability.

Section 17B:27-46.1jj - Group health insurance policy to provide coverage for oral anticancer medications.

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:27-46.1mm - Group health insurance policy, contract, coverage for synchronization of prescribed medications.

Section 17B:27-46.1nn - Group health insurance to provide benefits for treatment of substance use disorder.

Section 17B:27-46.1oo - Group health insurance policy to provide coverage regardless of gender identity, expression.

Section 17B:27-46.1pp - Group health insurance policy to cover digital tomosynthesis of the breast.

Section 17B:27-46.1qq - Group health insurance policy to provide coverage for donated human breast milk.

Section 17B:27-46.1rr - Group health insurance policy to provide coverage for standard fertility preservation services.

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:27-46.1uu - Group health insurance policy to provide certain coverage for prescription drugs.

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:27-47 - Group health or blanket insurance--provisions as favorable; policies issued outside State

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:27-51.8 - Policy provision for reimbursement of dental services; payment regardless of discipline of provider

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

Section 17B:27-51.10 - Renewal date; policy with reservation of right to change premium

Section 17B:27-51.10a - Alternative dental coverage; original coverage restricted to limited number of providers

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 group policy; conditions

Section 17B:27-51.13 - Inapplicability to policy without right of insurer to terminate without consent of insured

Section 17B:27-51.14 - Insurer provide health benefits plan, aggregate benefits.

Section 17B:27-52 - Group life and health--package policies

Section 17B:27-53 - Group life and health--rate reductions and application of dividends; excess over employer's cost

Section 17B:27-54 - Application of provisions; definitions.

Section 17B:27-60 - Written certification of creditable coverage under COBRA

Section 17B:27-61 - Affiliation period imposed by HMO

Section 17B:27-62 - Permission to enroll for group coverage

Section 17B:27-63 - Dependent special enrollment period

Section 17B:27-64 - Rules for eligibility, health status-related factors prohibited

Section 17B:27-65 - Premiums, contributions regulated

Section 17B:27-66 - Renewal of coverage; exceptions

Section 17B:27-67 - Modification of coverage

Section 17B:27-68 - Conditions for issuance, delivery of group life insurance.

Section 17B:27-69 - Conditions for issuance, delivery of group life insurance to groups not included in C.17B:27-68.

Section 17B:27-70 - Written notice to prospective insureds of noncompliance with C.17B:27-68; definitions.

Section 17B:27-71 - Extension to dependents of group life insurance policy.

Section 17B:27-72 - Required provisions for delivery, issuance of group life insurance policy.

Section 17B:27-73 - Issuance, delivery of individual policy of life insurance.

Section 17B:27-74 - Filing of form required for delivery, issuance of group life insurance.

Section 17B:27-75 - Payment of benefits.

Section 17B:27A-1 - Filing of paid hospital expense claims; definitions

Section 17B:27A-2 - Definitions.

Section 17B:27A-2.1 - Regulations.

Section 17B:27A-2.2 - Effective date.

Section 17B:27A-3 - Individual health benefits plans, applicability of act.

Section 17B:27A-4 - Offering of individual health benefits required by issuer of small employer health benefits plans.

Section 17B:27A-4.1 - Individual policy, contract for hospital, medical expense benefits, coverage of subscriber's child.

Section 17B:27A-4.2 - Requirements applicable to State Medicaid

Section 17B:27A-4.3 - Eligibility for enrollment in individual health benefits plan

Section 17B:27A-5 - Laws not applicable to managed care health benefits plans.

Section 17B:27A-6 - Individual health benefits plans, requirements.

Section 17B:27A-6.1 - Individual Health Coverage Program, open enrollment period established.

Section 17B:27A-7 - Approval of policy and contract forms, benefit levels.

Section 17B:27A-7.1 - Coverage for birth and natal care; individual health policy

Section 17B:27A-7.2 - Coverage for minimum inpatient care following mastectomy by individual health benefits plan

Section 17B:27A-7.3 - Applicability of Health Care Quality Act

Section 17B:27A-7.4 - Coverage for treatment of inherited metabolic diseases by individual health benefits plan.

Section 17B:27A-7.5 - Individual health benefits plan to provide coverage for mental health conditions, substance use disorders; collaborative care model.

Section 17B:27A-7.6 - Coverage for hemophilia services by individual health policy

Section 17B:27A-7.7 - Individual health benefits plan to provide coverage for colorectal cancer screening.

Section 17B:27A-7.8 - Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services.

Section 17B:27A-7.9 - Individual health benefits plan to offer coverage for domestic partner.

Section 17B:27A-7.10 - Individual health benefits plan, mammogram examination benefits.

Section 17B:27A-7.11 - Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances.

Section 17B:27A-7.12 - Individual health benefits plan, coverage for contraceptives.

Section 17B:27A-7.13 - Individual health benefits plans to provide benefits for orthotic and prosthetic appliances.

Section 17B:27A-7.14 - Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger.

Section 17B:27A-7.15 - Individual health benefits plan to provide installment payments to obstetrical provider for maternity services.

Section 17B:27A-7.16 - Individual health benefits plan to provide benefits for treatment of autism or other developmental disability.

Section 17B:27A-7.17 - Individual health benefits plan to provide coverage for oral anticancer medication.

Section 17B:27A-7.18 - Individual health benefits plan to provide coverage for sickle cell anemia.

Section 17B:27A-7.19 - Individual health benefits plan to provide coverage for prescription eye drops.

Section 17B:27A-7.20 - Individual health benefits plan, coverage for synchronization of prescribed medications.

Section 17B:27A-7.21 - Individual health benefits plan to provide benefits for treatment of substance use disorder.

Section 17B:27A-7.22 - Individual health benefits plan to provide coverage regardless of gender identity, expression.

Section 17B:27A-7.23 - Individual health benefits plan to cover digital tomosynthesis of the breast.

Section 17B:27A-7.24 - Individual health benefits plan to provide coverage for donated human breast milk.

Section 17B:27A-7.25 - Individual health benefits plan to provide coverage for breastfeeding support.

Section 17B:27A-7.26 - Individual health benefits plan to meet essential health benefits requirements.

Section 17B:27A-7.27 - Individual health benefits plan to cover preventive services.

Section 17B:27A-7.28 - Individual health benefits plan to provide coverage for certain prescription drugs.

Section 17B:27A-7.29 - Individual health benefits plan to cover adolescent depression screenings.

Section 17B:27A-7.30 - Individual health benefits plan to cover newborn home nurse visitation.

Section 17B:27A-8 - Offering of certain coverage not required

Section 17B:27A-9 - Determination of rates.

Section 17B:27A-10 - New Jersey Individual Health Coverage Program; board of directors.

Section 17B:27A-10.1 - Short title.

Section 17B:27A-10.2 - Purpose of act.

Section 17B:27A-10.3 - Definitions relative to health insurance premiums.

Section 17B:27A-10.4 - Health Insurance Premium Security Plan.

Section 17B:27A-10.5 - Payment parameters.

Section 17B:27A-10.6 - Calculation of reinsurance payment.

Section 17B:27A-10.7 - Requests for reinsurance payments.

Section 17B:27A-10.8 - Accounting for each benefit year.

Section 17B:27A-10.9 - Application for waiver of ACA.

Section 17B:27A-10.10 - New Jersey Health Insurance Premium Security Fund.

Section 17B:27A-10.11 - Annual report.

Section 17B:27A-10.12 - Violations, penalties.

Section 17B:27A-10.13 - Rules, regulations.

Section 17B:27A-11 - Powers, authority of program, board.

Section 17B:27A-12 - Procedures for equitable sharing of program losses.

Section 17B:27A-12.1 - Exemption from liability, certain, for HMO formed by UMDNJ.

Section 17B:27A-13 - Statement of net paid losses

Section 17B:27A-14 - Determination of disproportionate share of substandard risks

Section 17B:27A-15 - Sale of health benefits plan