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.
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.
Section 17B:27-52 - Group life and health--package policies
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:27-71 - 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-4.2 - 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-7.3 - Applicability of Health Care Quality Act
Section 17B:27A-7.6 - Coverage for hemophilia services by individual health policy
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-7.12 - Individual health benefits plan, coverage for contraceptives.
Section 17B:27A-7.18 - Individual health benefits plan to provide coverage for sickle cell anemia.
Section 17B:27A-7.23 - Individual health benefits plan to cover digital tomosynthesis of the breast.
Section 17B:27A-7.27 - Individual health benefits plan to cover preventive services.
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
Section 17B:27A-16 - Submission of rate filings by health maintenance organization not required
Section 17B:27A-16.1 - Board actions subject to provisions of section; "action" defined; procedure
Section 17B:27A-16.2 - Adoption of temporary plan of operation
Section 17B:27A-16.3 - Purchase of other insurance coverage not required
Section 17B:27A-16.4 - Adoption of standard claim form
Section 17B:27A-16.5 - Hospital, medical insurance policy renewals; filing of rates.
Section 17B:27A-17 - Definitions relative to small employer health benefits plans.
Section 17B:27A-18 - Providers of health benefits, services subject to provisions of act
Section 17B:27A-18.2 - Requirements applicable to State Medicaid
Section 17B:27A-19 - Health benefits plans offered to small employers; exceptions.
Section 17B:27A-19a - Small employer carrier, offering of high deductible plan.
Section 17B:27A-19.2 - Coverage for birth and natal care; small employer health policy.
Section 17B:27A-19.3 - Regulations governing rating methodology, calculation of loss ratios
Section 17B:27A-19.5 - Applicability of Health Care Quality Act
Section 17B:27A-19.8 - Coverage for hemophilia services by small employer plan
Section 17B:27A-19.12 - Small employer health benefits plan to offer coverage for domestic partner.
Section 17B:27A-19.13 - Small employer health benefits plan, mammogram examination benefits.
Section 17B:27A-19.15 - Small employer health benefits plan, coverage for contraceptives.
Section 17B:27A-19.31 - Small employer health benefits plan to cover preventive services.
Section 17B:27A-19.34 - Small employer health benefits plan to cover newborn home nurse visitation.
Section 17B:27A-20 - Coinsurance, deductibles applicable
Section 17B:27A-21 - Standard coordination of benefits provisions applicable
Section 17B:27A-21.1 - Eligibility for enrollment in small employer health benefits plan
Section 17B:27A-22 - Preexisting condition provisions.
Section 17B:27A-23 - Policies, contracts renewable; exceptions.
Section 17B:27A-24 - Reasonable specified minimum participation.
Section 17B:27A-25 - Premium rates; other plan requirements.
Section 17B:27A-25.2 - Definitions relative to small employer benefits purchasing alliances
Section 17B:27A-25.3 - Small Employer Purchasing Alliance, formation
Section 17B:27A-25.4 - Board of directors
Section 17B:27A-25.5 - Bylaws, contents
Section 17B:27A-25.6 - Further authority of alliance
Section 17B:27A-25.7 - Restrictions on alliances
Section 17B:27A-25.8 - Certificate from alliance to commissioner
Section 17B:27A-25.9 - Rules, regulations
Section 17B:27A-26 - Health maintenance organization coverage; exceptions
Section 17B:27A-27 - Continued coverage for certain terminated employees, dependents.
Section 17B:27A-28 - New Jersey Small Employer Health Benefits Program created
Section 17B:27A-29 - Meetings, organization of board; terms.
Section 17B:27A-29.1 - Immunity from liability for board
Section 17B:27A-29.2 - Rules, regulations for voluntary risk pooling arrangement
Section 17B:27A-30 - Submission of plan of operation
Section 17B:27A-31 - Contents of plan of operation
Section 17B:27A-32 - Authority of board
Section 17B:27A-33 - Formulation of five health benefits plans
Section 17B:27A-41 - Violations, penalty
Section 17B:27A-43 - Violations, penalties
Section 17B:27A-44 - Assessments not charged to policyholders, public
Section 17B:27A-45 - Standard claim form
Section 17B:27A-47 - Coverage obtained through out-of-State trust, compliance required
Section 17B:27A-48 - Multiple employer arrangement; requirements
Section 17B:27A-49 - Notification to commissioner by carrier of multiple employer arrangement
Section 17B:27A-50 - Change of coverage by small employer; restrictions
Section 17B:27A-51 - Board actions subject to provisions of section; "action" defined; procedure
Section 17B:27A-53 - Other insurance purchases not required
Section 17B:27A-56 - Provision of biannual surveys to DOBI by health insurers.
Section 17B:27A-57 - "Health Insurance Exchange Trust Fund."
Section 17B:27A-59 - Rules, regulations.
Section 17B:27A-59.1 - Definitions.
Section 17B:27A-59.2 - "New Jersey Easy Enrollment Health Insurance Program" established.
Section 17B:27A-59.3 - Assistance eligibility, Department of Banking and Insurance.
Section 17B:27A-59.5 - Data privacy, security safeguards.
Section 17B:27A-59.6 - Tax return, individual not covered, minimum essential coverage.
Section 17B:27A-59.7 - Consenting to information sharing, system established.
Section 17B:27A-60 - Essential health benefits defined.
Section 17B:27A-61 - Carrier seeking rate increase.
Section 17B:27A-62 - Information to support, justify rate requests.
Section 17B:27A-63 - Additional information requested by department.
Section 17B:27A-64 - Disclosure of information.
Section 17B:27A-65 - Definitions relative to certain assessments.
Section 17B:27A-66 - Filing of net written premiums.
Section 17B:27A-67 - "Health Insurance Affordability Fund."
Section 17B:27B-1 - Definitions relative to third party administrators, billing services.
Section 17B:27B-2 - Licensure, registration required for third party administrators.
Section 17B:27B-3 - Additional information required for licensure, registration.
Section 17B:27B-4 - Issuance of license, approval of application for registration.
Section 17B:27B-5 - Denial of license, registration.
Section 17B:27B-6 - Provisions of written agreement; requirements.
Section 17B:27B-7 - Access to books, records.
Section 17B:27B-8 - Payment to third party administrators not based solely on claims denials.
Section 17B:27B-9 - Fiduciary responsibility of third party administrators.
Section 17B:27B-10 - Separate accounts for funds remitted.
Section 17B:27B-11 - Prompt delivery of communications to enrollees.
Section 17B:27B-12 - Notification of material changes to commissioner.
Section 17B:27B-13 - Annual reports.
Section 17B:27B-14 - Suspension, revocation of license, registration.
Section 17B:27B-15 - Immediate suspension of license, registration, grounds.
Section 17B:27B-16 - Certification required for third party billing services.
Section 17B:27B-17 - Additional information to be filed by third party billing services.
Section 17B:27B-18 - Approval of applications for certification.
Section 17B:27B-19 - Denial of applications for certification.
Section 17B:27B-21 - Fiduciary responsibility of third party billing services.
Section 17B:27B-22 - Notification of material changes to commissioner.
Section 17B:27B-23 - Suspension, revocation of certification.
Section 17B:27B-24 - Violations, penalties.
Section 17B:27B-25 - Rules, regulations.
Section 17B:27C-1 - Short title.
Section 17B:27C-2 - Purposes of act.
Section 17B:27C-3 - Definitions relative to self-funded multiple employer welfare arrangements.
Section 17B:27C-4 - Annual registration, fee.
Section 17B:27C-5 - Deposit, maintenance of cash, securities.
Section 17B:27C-6 - Required filings.
Section 17B:27C-7 - Liability of members.
Section 17B:27C-8 - Inapplicability of insurance laws in certain circumstances.
Section 17B:27C-9 - Examination of loss reserves.
Section 17B:27C-10 - Revocation, suspension of certificate of registration; violations, penalties.
Section 17B:27C-11 - Rehabilitation, liquidation, conservation, dissolution.
Section 17B:27C-12 - Rules, regulations.
Section 17B:27D-1 - Findings, declarations relative to mandated health benefits
Section 17B:27D-2 - Definitions relative to mandated health benefits
Section 17B:27D-3 - Mandated Health Benefits Advisory Commission
Section 17B:27D-4 - Membership; terms; vacancies.
Section 17B:27D-5 - Election of chairman, vice chairman, appointment of secretary; meetings.
Section 17B:27D-6 - Duties of commission relative to review of bills.
Section 17B:27D-7 - Contents of review of bill.
Section 17B:27D-8 - Development of system of data collection; review, comment.
Section 17B:27D-9 - Report to Governor, Legislature
Section 17B:27D-10 - Report by Mandated Health Benefits Advisory Commission.
Section 17B:27D-11 - Work group regarding risk factors for breast cancer, breast imaging options.
Section 17B:27E-1 - Purpose of act on long-term care insurance
Section 17B:27E-2 - Application of act
Section 17B:27E-3 - Short title
Section 17B:27E-4 - Definitions relative to long-term care insurance.
Section 17B:27E-5 - Compliance required
Section 17B:27E-6 - Prohibitions relative to long-term care insurance.
Section 17B:27E-7 - Grounds for rescinding policy, denying a claim
Section 17B:27E-8 - Conditions for delivery, issuance of policy
Section 17B:27E-9 - Regulations
Section 17B:27E-10 - Prior approval of commissioner required
Section 17B:27E-11 - Insurer to file rates, rating schedule, supporting documentation
Section 17B:27E-12 - Additional penalties
Section 17B:27F-1 - Definitions relative to pharmacy benefits managers.
Section 17B:27F-2 - Duties of pharmacy benefits manager relative to contracts.
Section 17B:27F-3 - Requirements for placing prescription drug on multiple source generic list.
Section 17B:27F-4 - Process for appeals, investigation and dispute.
Section 17B:27F-5 - Rules, regulations.
Section 17B:27F-6 - Regulations relative to pharmacy benefits managers.
Section 17B:27F-7 - "Clean Claim" made by a pharmacy, actions of pharmaceutical benefits managers.
Section 17B:27F-8 - Commissioner review, approval.
Section 17B:27F-9 - Applicability of C.17B:27F-1 et seq.
Section 17B:27F-10 - Violations, penalties.
Section 17B:28-2 - Qualification of insurer
Section 17B:28-3 - Certificate to sell
Section 17B:28-4 - Required statements; procedure
Section 17B:28-5 - Form of contract
Section 17B:28-6 - Administration
Section 17B:28-7 - Separate accounts; approval by commissioner
Section 17B:28-8 - Amounts placed in account; liabilities
Section 17B:28-9 - Investment of assets; eligibility; definition
Section 17B:28-10 - Valuation of assets
Section 17B:28-11 - Reserve liability
Section 17B:28A-2 - Limitation on benefit and protection
Section 17B:28A-3 - Undertaking or continuance; approval of commissioner; rules and regulations
Section 17B:28A-4 - Form of policy; submission to commissioner
Section 17B:28A-5 - Foreign or alien insurers; conditions for qualification to issue
Section 17B:28A-6 - Rules and regulations
Section 17B:29-2 - Definitions
Section 17B:29-3 - Forms of credit life insurance and credit health insurance
Section 17B:29-3.1 - Insurance offered with credit involuntary unemployment insurance
Section 17B:29-4 - Amount of credit life insurance and credit health insurance
Section 17B:29-5 - Term of credit life insurance and credit health insurance
Section 17B:29-6 - Provisions of policies and certificates of insurance: disclosure to debtors
Section 17B:29-7 - Filing of forms; premium rate schedules
Section 17B:29-8 - Premiums and refunds
Section 17B:29-9 - Issuance of policies
Section 17B:29-11 - Existing insurance--choice of insurer
Section 17B:29-12 - Enforcement
Section 17B:29-13 - Judicial review
Section 17B:30-1 - Declaration of purpose
Section 17B:30-2 - Practices prohibited
Section 17B:30-3 - Misrepresentations and false advertising of policies or annuity contracts
Section 17B:30-4 - False information and advertising
Section 17B:30-5 - False financial statements
Section 17B:30-6 - "Twisting" prohibited
Section 17B:30-8 - Boycott, coercion and intimidation
Section 17B:30-9 - Stock operations and advisory board contracts
Section 17B:30-10 - Stock acquisition, common management
Section 17B:30-11 - Interlocking directorate
Section 17B:30-12 - Discrimination prohibited; terms defined.
Section 17B:30-13 - Rebates and special inducements
Section 17B:30-13.1 - Unfair claim settlement practices
Section 17B:30-13.2 - Record of complaints
Section 17B:30-14 - Exceptions to discrimination and rebates
Section 17B:30-15 - Enumeration of acts not exclusive
Section 17B:30-16 - Commissioner's powers of investigation
Section 17B:30-17 - Desist orders for prohibited practices; penalty
Section 17B:30-18 - Procedures as to undefined practices
Section 17B:30-19 - Appeal by intervenor
Section 17B:30-20 - Violation of cease and desist order; penalty
Section 17B:30-21 - Provisions of chapter additional to existing laws
Section 17B:30-22 - Immunity from prosecution
Section 17B:30-24 - Regulations.
Section 17B:30-26 - Definitions relative to payment of health and dental insurance plans.
Section 17B:30-27 - Applicability.
Section 17B:30-28 - Provision of information.
Section 17B:30-29 - Provision of toll-free telephone number.
Section 17B:30-30 - Maintenance of claims records; audit required.
Section 17B:30-31 - Additional record of claims.
Section 17B:30-32 - Overdue capitation payment.
Section 17B:30-33 - Regulations.
Section 17B:30-34 - Inapplicability of act.
Section 17B:30-35 - Definitions relative to standardized pharmacy identification cards
Section 17B:30-37 - Exceptions for issuance of card
Section 17B:30-38 - Provision of new pharmacy identification card
Section 17B:30-39 - Rules, regulations
Section 17B:30-41 - Findings, declarations relative to collection of unpaid hospital accounts.
Section 17B:30-42 - Definitions relative to collection of unpaid hospital accounts.
Section 17B:30-44 - "New Jersey Hospital Care Payment Fund."
Section 17B:30-45 - Authority of department.
Section 17B:30-46 - Decisions of department constitute final agency action.
Section 17B:30-47 - Procedures for participating hospitals.
Section 17B:30-48 - Short title.
Section 17B:30-49 - Findings, declarations relative to processing health claims.
Section 17B:30-50 - Definitions relative to processing health claims.
Section 17B:30-51 - Information required from payer.
Section 17B:30-52 - Response by payer to request for authorization of health care services.
Section 17B:30-53 - Reimbursement for covered services, conditions.
Section 17B:30-54 - Reimbursement according to provider contract.
Section 17B:30-55 - Violations, penalties; rules, regulations.
Section 17B:30-56 - Rules, regulations.
Section 17B:30-57 - Liberal construction.
Section 17B:30-58 - Definitions relative to reimbursement for certain ambulance services.
Section 17B:30-60 - Definitions relative to certain dental provider networks.
Section 17B:30-61 - Third party access.
Section 17B:30-62 - Inapplicability.
Section 17B:30-63 - Rules, regulations.
Section 17B:30B-1 - Short title.
Section 17B:30B-2 - Definitions relative to viatical settlements.
Section 17B:30B-3 - License to operate as viatical settlement provider.
Section 17B:30B-4 - Refusal to issue, suspension, revocation, refusal to renew license.
Section 17B:30B-5 - Approval of viatical settlement forms by commissioner.
Section 17B:30B-6 - Filing of annual statement.
Section 17B:30B-7 - Examinations of licensees by commissioner.
Section 17B:30B-8 - Disclosures to viator, procedure.
Section 17B:30B-9 - Material required prior to entering into viatical settlement contract.
Section 17B:30B-11 - Advertisement of viatical settlement contracts; guidelines, standards.
Section 17B:30B-13 - Injunction in addition to penalties, enforcement provisions.
Section 17B:30B-14 - Violation considered unfair trade practice; penalties.
Section 17B:30B-15 - Regulations, authority of commissioner.
Section 17B:30B-16 - Construction of act with Uniform Securities Law.
Section 17B:30B-18 - Engaging in stranger-originated life insurance prohibited.
Section 17B:30B-19 - Violations, remedies, penalties.
Section 17B:30B-20 - Regulations.
Section 17B:32-31 - Short title, purpose of act
Section 17B:32-32 - Application of authorized proceedings
Section 17B:32-33 - Definitions
Section 17B:32-34 - Jurisdiction over delinquency proceedings
Section 17B:32-35 - Restraining orders, injunctions
Section 17B:32-36 - Cooperation with commissioner in proceedings
Section 17B:32-38 - Prohibitions relative to insurer subject to delinquency proceeding
Section 17B:32-39 - Filing of petition; court orders
Section 17B:32-40 - Confidentiality of documents, files, records, papers
Section 17B:32-41 - Petition for authority to rehabilitate insurer
Section 17B:32-42 - Appointment of rehabilitator
Section 17B:32-43 - Powers of rehabilitator
Section 17B:32-44 - Staying of pending actions
Section 17B:32-45 - Petition for order of liquidation
Section 17B:32-46 - Basis for order of liquidation
Section 17B:32-47 - Appointment of liquidator
Section 17B:32-48 - Policies to continue in force
Section 17B:32-49 - Petition for dissolution
Section 17B:32-50 - Powers of liquidator
Section 17B:32-51 - Notice of liquidation order
Section 17B:32-52 - Provision of information to liquidator by agents, licensing affected
Section 17B:32-53 - Actions against or by insurer, liquidator
Section 17B:32-54 - Preparation of list of insurer's assets
Section 17B:32-55 - Transfers, obligations deemed fraudulent
Section 17B:32-56 - Transfer of real property deemed valid
Section 17B:32-57 - Preferences
Section 17B:32-58 - Claims of creditor
Section 17B:32-59 - Mutual debts, credits
Section 17B:32-60 - Report by liquidator
Section 17B:32-61 - Amount recoverable not affected by delinquency proceedings
Section 17B:32-62 - Payment of unpaid premium, violations; penalties; appeals
Section 17B:32-63 - Proposal to disburse assets
Section 17B:32-64 - Filing of proof of claims
Section 17B:32-65 - Statement to proof of claim
Section 17B:32-66 - Contingent, absolute, limited claims
Section 17B:32-67 - Third party, insured claims
Section 17B:32-68 - Denial of claims
Section 17B:32-69 - Proving, filing of claim of subrogee
Section 17B:32-70 - Determination of value of security
Section 17B:32-71 - Priority of distribution of claims
Section 17B:32-72 - Review of claims
Section 17B:32-73 - Payment of distributions
Section 17B:32-74 - Distribution of unclaimed funds
Section 17B:32-75 - Application for discharge
Section 17B:32-76 - Petition for reopening of proceedings
Section 17B:32-77 - Retaining, destruction of records
Section 17B:32-78 - Audits of receiverships
Section 17B:32-79 - Grounds for appointment of conservator
Section 17B:32-80 - Grounds for liquidation of assets of insurer
Section 17B:32-81 - Vesting of title with domiciliary liquidator
Section 17B:32-82 - Petition for appointment as ancillary receiver
Section 17B:32-83 - Institution of proceedings
Section 17B:32-84 - Claims filed in liquidation proceedings begun in State
Section 17B:32-85 - Claims filed in liquidation proceedings in reciprocal state
Section 17B:32-86 - Actions, proceedings prohibited during pendency of liquidation proceeding
Section 17B:32-87 - Order of distribution of claims
Section 17B:32-88 - Failure of ancillary receiver to transfer assets
Section 17B:32-89 - Persons entitled to protection
Section 17B:32-90 - Commissioner's powers unaffected
Section 17B:32-91 - Rules, regulations
Section 17B:32-92 - Rights relative to certain financial agreements; terms defined.
Section 17B:32A-1 - Short title
Section 17B:32A-2 - Purpose; protection from hardship.
Section 17B:32A-3 - Provision of coverage
Section 17B:32A-4 - Definitions
Section 17B:32A-5 - New Jersey Life and Health Insurance Guaranty Association created
Section 17B:32A-6 - Board of Directors of association
Section 17B:32A-7 - Powers of the association
Section 17B:32A-8 - Member insurers assessed to provide funding for association
Section 17B:32A-9 - Plan of operation
Section 17B:32A-10 - Additional duties, powers of commissioner
Section 17B:32A-11 - Detection, prevention of insurer insolvencies, impairments
Section 17B:32A-12 - Liabilities of impaired, insolvent insurers
Section 17B:32A-13 - Association subject to examination, regulation
Section 17B:32A-14 - Association exempt from fees, taxes
Section 17B:32A-15 - Immunity from liability
Section 17B:32A-16 - Stay of proceedings involving insolvent insurer
Section 17B:32A-17 - Association shall not be used to promote insurance sales
Section 17B:32A-18 - Member insurer may offset assessments against premium tax liability
Section 17B:32A-19 - Provisions not applicable to certain insurers
Section 17B:32B-1 - Short title.
Section 17B:32B-2 - Purpose of act.
Section 17B:32B-3 - Definitions relative to certain insolvent health maintenance organizations.
Section 17B:32B-4 - Payment for eligible services, benefits.
Section 17B:32B-5 - New Jersey Insolvent Health Maintenance Organization Assistance Association.
Section 17B:32B-6 - New Jersey Insolvent Health Maintenance Organization Assistance Fund.
Section 17B:32B-7 - Board of directors.
Section 17B:32B-8 - Maximum liability of association.
Section 17B:32B-9 - Assessment of member organizations.
Section 17B:32B-10 - Submission of plan of operation.
Section 17B:32B-11 - Additional powers, duties of the commissioner.
Section 17B:32B-12 - Tax credit permitted for member organizations.
Section 17B:32B-13 - Examination, regulation.
Section 17B:32B-14 - Exemption of association from certain fees, taxes.
Section 17B:32B-15 - Condition for receipt by providers of payments.
Section 17B:32B-16 - Immunity from liability for member organizations, etc.
Section 17B:32B-17 - Rules, regulations.
Section 17B:33-1 - Short title
Section 17B:33-2 - Acts constituting commissioner as process agent
Section 17B:33-3 - Service of process on commissioner as process agent
Section 17B:33-4 - Service of process on persons acting on behalf of unauthorized insurer
Section 17B:33-5 - Service of process by other means
Section 17B:33-6 - Judgment by default
Section 17B:33-7 - Deposit of bond by unauthorized insurer
Section 17B:33-8 - Damages for unjustified refusal to pay
Section 17B:34-1 - Applicability of chapter
Section 17B:34-2 - General policy
Section 17B:34-3 - Subsequently enacted laws
Section 17B:34-5 - Submission for approval or determination
Section 17B:34-6 - Effect of withdrawals, approvals and the like
Section 17B:34-7 - Number of copies
Section 17B:34-9 - Orders pending hearing
Section 17B:34-10 - Judicial review; stay
Section 17B:34-11 - Matters not otherwise provided for
Section 17B:34-12 - Effect of Chapter
Section 17B:35-5 - References to repealed provisions as references to provisions of this act
Section 17B:35-7 - Insurer organized under any repealed act; continuance of existence and rights
Section 17B:36-1 - Sections and acts saved from repeal
Section 17B:36-2 - Sections and acts repealed
Section 17B:36-3 - Partial Repealers
Section 17B:36-4 - Effective date
Section 17B:37-1 - Short title, findings, declarations.
Section 17B:37-2 - Definitions relative to the "Interstate Insurance Product Regulation Compact."
Section 17B:37-3 - "Interstate Insurance Product Regulation Commission."
Section 17B:37-4 - Powers of commission.
Section 17B:37-5 - Membership of commission; organization; bylaws.
Section 17B:37-6 - Meetings, actions.
Section 17B:37-7 - Rules, uniform standards, operating procedures.
Section 17B:37-9 - Resolution of disputes, issues subject to compact.
Section 17B:37-10 - Approval process for product.
Section 17B:37-11 - Disapproved product or advertisement; appeal.
Section 17B:37-12 - Payment of reasonable expenses of establishment, organization.
Section 17B:37-13 - Eligibility of states to join compact.
Section 17B:37-14 - Withdrawal, termination, reinstatement.
Section 17B:37-15 - Severability; liberal construction.
Section 17B:37-16 - Enforcement of laws of compacting state unaffected.