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2018 New Jersey Revised Statutes
Title 17B - INSURANCE
Chapter 27A
- 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-4.4 - Findings, declarations relative to exclusive provider organization health benefit plans.
- Section 17b:27A-4.5 - Carrier offering plans pursuant to C.17B:27A-2 et seq. to offer EPO; coverages.
- Section 17b:27A-4.6 - Evaluation as to effectiveness of act.
- Section 17b:27A-4.7 - Carrier offering plans pursuant to C.17B:27A-2 et seq. may offer additional plan with certain limited benefits.
- Section 17b:27A-5 - Laws not applicable to plans
- Section 17b:27A-6 - Individual health benefits plans, requirements.
- Section 17b:27A-7 - Establishment of policy; contract forms; high deductible health plan; 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 biologically-based mental illness.
- 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 prescription female 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 benefit 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-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-18.1 - Provision of benefits to subscriber's child under small employer policy, contract
- 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-19.1 - Hospital confinement, other supplemental limited benefit insurance plans; requirements
- 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-19.4 - Coverage for minimum inpatient care following mastectomy by small employer health benefits plan
- Section 17b:27A-19.5 - Applicability of Health Care Quality Act
- Section 17b:27A-19.6 - Coverage for treatment of inherited metabolic diseases by small employer health benefits plan.
- Section 17b:27A-19.7 - Small employer health benefits plan to provide coverage for biologically-based mental illness.
- Section 17b:27A-19.8 - Coverage for hemophilia services by small employer plan
- Section 17b:27A-19.9 - Small employer health benefits plan to provide coverage for colorectal cancer screening.
- Section 17b:27A-19.10 - Policy, contract issued under C.17B:27A-17 et seq. required to cover certain out-of-network services.
- Section 17b:27A-19.11 - Carrier offering plans pursuant to C.17B:27A-17 et seq. may offer additional plan with certain limited benefits.
- 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-19.14 - High deductible health plan, small employer, deductible inapplicable, certain circumstances.
- Section 17b:27A-19.15 - Small employer health benefits plan, coverage for prescription female contraceptives.
- Section 17b:27A-19.16 - Coverage for certain dependents until age 31 by small employer health benefits plan.
- Section 17b:27A-19.17 - Small employer health benefits plans to provide benefits for orthotic and prosthetic appliances.
- Section 17b:27A-19.18 - Small employer health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger.
- Section 17b:27A-19.19 - Small employer health benefits plan to provide installment payments to obstetrical provider for maternity services.
- Section 17b:27A-19.20 - Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability.
- Section 17b:27A-19.21 - Small employer health benefits plan to provide coverage for oral anticancer medications.
- Section 17b:27A-19.22 - Small employer health benefits plan to provide coverage for sickle cell anemia.
- Section 17b:27A-19.23 - Small employer health benefits plan to provide coverage for prescription eye drops.
- Section 17b:27A-19.24 - Small employer health benefits plan, coverage for synchronization of prescribed medications.
- Section 17b:27A-19.25 - Small employer health benefits plan to provide benefits for treatment of substance use disorder.
- Section 17b:27A-19.26 - Small employer health benefits plan to provide coverage regardless of gender identity, expression.
- Section 17b:27A-19.27 - Small employer health benefits plan to cover digital tomosynthesis of the breast.
- Section 17b:27A-19.28 - Small employer health benefits plan to provide coverage for donated human breast milk.
- 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-25.1 - Findings, declarations relative to small employer health benefits purchasing alliances
- 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-54 - Commissioner authorized to approve establishment of arrangement; rules, regulations
- Section 17b:27A-55 - Written notice required for issuance, renewal of high deductible health plan; declaration of understanding.
- Section 17b:27A-56 - Provision of biannual surveys to DOBI by health insurers.
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