State Codes and Statutes

Statutes > New-jersey > Title-17b > Section-17b-27a

17B:27A-1 - Filing of paid hospital expense claims; definitions 
17B:27A-2 - Definitions
17B:27A-2.1 - Regulations
17B:27A-2.2 - Effective date
17B:27A-3 - Individual health benefits plans, applicability of act
17B:27A-4 - Offering of individual health benefits required by issuer of small employer health benefits plans
17B:27A-4.1 - Individual policy, contract for hospital, medical expense benefits, coverage of subscriber's child
17B:27A-4.2 - Requirements applicable to State Medicaid
17B:27A-4.4 - Findings, declarations relative to exclusive provider organization health benefit plans
17B:27A-4.5 - Carrier offering plans pursuant to C.17B:27A-2 et seq. to offer EPO; coverages
17B:27A-4.6 - Evaluation as to effectiveness of act
17B:27A-4.7 - Carrier offering plans pursuant to C.17B:27A-2 et seq. may offer additional plan with certain limited benefits
17B:27A-5 - Laws not applicable to plans 
17B:27A-6 - Individual health benefits plans, requirements
17B:27A-7 - Establishment of policy; contract forms; high deductible health plan; benefit levels
17B:27A-7.1 - Coverage for birth and natal care; individual health policy 
17B:27A-7.2 - Coverage for minimum inpatient care following mastectomy by individual health benefits plan
17B:27A-7.3 - Applicability of Health Care Quality Act
17B:27A-7.4 - Coverage for treatment of inherited metabolic diseases by individual health benefits plan
17B:27A-7.5 - Individual health benefits plan to provide coverage for biologically-based mental illness
17B:27A-7.6 - Coverage for hemophilia services by individual health policy
17B:27A-7.7 - Individual health benefits plan to provide coverage for colorectal cancer screening
17B:27A-7.8 - Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services
17B:27A-7.9 - Individual health benefits plan to offer coverage for domestic partner
17B:27A-7.10 - Individual health benefits plan, mammogram examination benefits
17B:27A-7.11 - Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances
17B:27A-7.12 - Individual health benefits plan, coverage for prescription female contraceptives
17B:27A-7.13 - Individual health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-7.14 - Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-7.15 - Individual health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-7.16 - Individual health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-8 - Offering of certain coverage not required
17B:27A-9 - Determination of rates
17B:27A-10 - New Jersey Individual Health Coverage Program; board of directors
17B:27A-11 - Powers, authority of program, board
17B:27A-12 - Procedures for equitable sharing of program losses
17B:27A-12.1 - Exemption from liability, certain, for HMO formed by UMDNJ
17B:27A-13 - Statement of net paid losses 
17B:27A-14 - Determination of disproportionate share of substandard risks
17B:27A-15 - Sale of health benefits plan 
17B:27A-16 - Submission of rate filings by health maintenance organization not required 
17B:27A-16.1 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-16.2 - Adoption of temporary plan of operation 
17B:27A-16.3 - Purchase of other insurance coverage not required 
17B:27A-16.4 - Adoption of standard claim form 
17B:27A-16.5 - Hospital, medical insurance policy renewals; filing of rates
17B:27A-17 - Definitions relative to small employer health benefits plans
17B:27A-18 - Providers of health benefits, services subject to provisions of act
17B:27A-18.1 - Provision of benefits to subscriber's child under small employer policy, contract
17B:27A-18.2 - Requirements applicable to State Medicaid
17B:27A-19 - Health benefits plans offered to small employers; exceptions
17B:27A-19a - Small employer carrier, offering of high deductible plan
17B:27A-19.1 - Hospital confinement, other supplemental limited benefit insurance plans; requirements 
17B:27A-19.2 - Coverage for birth and natal care; small employer health policy. 
17B:27A-19.4 - Coverage for minimum inpatient care following mastectomy by small employer health benefits plan
17B:27A-19.5 - Applicability of Health Care Quality Act
17B:27A-19.6 - Coverage for treatment of inherited metabolic diseases by small employer health benefits plan
17B:27A-19.7 - Small employer health benefits plan to provide coverage for biologically-based mental illness
17B:27A-19.8 - Coverage for hemophilia services by small employer plan
17B:27A-19.9 - Small employer health benefits plan to provide coverage for colorectal cancer screening
17B:27A-19.10 - Policy, contract issued under C.17B:27A-17 et seq. required to cover certain out-of-network services
17B:27A-19.11 - Carrier offering plans pursuant to C.17B:27A-17 et seq. may offer additional plan with certain limited benefits
17B:27A-19.12 - Small employer health benefits plan to offer coverage for domestic partner
17B:27A-19.13 - Small employer health benefits plan, mammogram examination benefits
17B:27A-19.14 - High deductible health plan, small employer, deductible inapplicable, certain circumstances
17B:27A-19.15 - Small employer health benefits plan, coverage for prescription female contraceptives
17B:27A-19.16 - Coverage for certain dependents until age 31 by small employer health benefits plan
17B:27A-19.17 - Small employer health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-19.18 - Small employer health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-19.19 - Small employer health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-19.20 - Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-20 - Coinsurance, deductibles applicable 
17B:27A-21 - Standard coordination of benefits provisions applicable 
17B:27A-21.1 - Eligibility for enrollment in small employer health benefits plan
17B:27A-22 - Preexisting condition provisions
17B:27A-24 - Reasonable specified minimum participation
17B:27A-25 - Premium rates; other plan requirements
17B:27A-25.1 - Findings, declarations relative to small employer health benefits purchasing alliances
17B:27A-25.2 - Definitions relative to small employer benefits purchasing alliances
17B:27A-25.3 - Small Employer Purchasing Alliance, formation
17B:27A-25.4 - Board of directors
17B:27A-25.5 - Bylaws, contents
17B:27A-25.6 - Further authority of alliance
17B:27A-25.7 - Restrictions on alliances
17B:27A-25.8 - Certificate from alliance to commissioner
17B:27A-25.9 - Rules, regulations
17B:27A-26 - Health maintenance organization coverage; exceptions
17B:27A-27 - Continued coverage for certain terminated employees, dependents
17B:27A-28 - New Jersey Small Employer Health Benefits Program created 
17B:27A-29 - Meetings, organization of board; terms
17B:27A-29.1 - Immunity from liability for board
17B:27A-29.2 - Rules, regulations for voluntary risk pooling arrangement
17B:27A-30 - Submission of plan of operation 
17B:27A-33 - Formulation of five health benefits plans
17B:27A-43 - Violations, penalties 
17B:27A-44 - Assessments not charged to policyholders, public 
17B:27A-47 - Coverage obtained through out-of-State trust, compliance required 
17B:27A-48 - Multiple employer arrangement; requirements 
17B:27A-49 - Notification to commissioner by carrier of multiple employer arrangement 
17B:27A-50 - Change of coverage by small employer; restrictions 
17B:27A-51 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-53 - Other insurance purchases not required 
17B:27A-54 - Commissioner authorized to approve establishment of arrangement; rules, regulations 
17B:27A-55 - Written notice required for issuance, renewal of high deductible health plan; declaration of understanding
17B:27A-56 - Provision of biannual surveys to DOBI by health insurers

State Codes and Statutes

Statutes > New-jersey > Title-17b > Section-17b-27a

17B:27A-1 - Filing of paid hospital expense claims; definitions 
17B:27A-2 - Definitions
17B:27A-2.1 - Regulations
17B:27A-2.2 - Effective date
17B:27A-3 - Individual health benefits plans, applicability of act
17B:27A-4 - Offering of individual health benefits required by issuer of small employer health benefits plans
17B:27A-4.1 - Individual policy, contract for hospital, medical expense benefits, coverage of subscriber's child
17B:27A-4.2 - Requirements applicable to State Medicaid
17B:27A-4.4 - Findings, declarations relative to exclusive provider organization health benefit plans
17B:27A-4.5 - Carrier offering plans pursuant to C.17B:27A-2 et seq. to offer EPO; coverages
17B:27A-4.6 - Evaluation as to effectiveness of act
17B:27A-4.7 - Carrier offering plans pursuant to C.17B:27A-2 et seq. may offer additional plan with certain limited benefits
17B:27A-5 - Laws not applicable to plans 
17B:27A-6 - Individual health benefits plans, requirements
17B:27A-7 - Establishment of policy; contract forms; high deductible health plan; benefit levels
17B:27A-7.1 - Coverage for birth and natal care; individual health policy 
17B:27A-7.2 - Coverage for minimum inpatient care following mastectomy by individual health benefits plan
17B:27A-7.3 - Applicability of Health Care Quality Act
17B:27A-7.4 - Coverage for treatment of inherited metabolic diseases by individual health benefits plan
17B:27A-7.5 - Individual health benefits plan to provide coverage for biologically-based mental illness
17B:27A-7.6 - Coverage for hemophilia services by individual health policy
17B:27A-7.7 - Individual health benefits plan to provide coverage for colorectal cancer screening
17B:27A-7.8 - Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services
17B:27A-7.9 - Individual health benefits plan to offer coverage for domestic partner
17B:27A-7.10 - Individual health benefits plan, mammogram examination benefits
17B:27A-7.11 - Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances
17B:27A-7.12 - Individual health benefits plan, coverage for prescription female contraceptives
17B:27A-7.13 - Individual health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-7.14 - Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-7.15 - Individual health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-7.16 - Individual health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-8 - Offering of certain coverage not required
17B:27A-9 - Determination of rates
17B:27A-10 - New Jersey Individual Health Coverage Program; board of directors
17B:27A-11 - Powers, authority of program, board
17B:27A-12 - Procedures for equitable sharing of program losses
17B:27A-12.1 - Exemption from liability, certain, for HMO formed by UMDNJ
17B:27A-13 - Statement of net paid losses 
17B:27A-14 - Determination of disproportionate share of substandard risks
17B:27A-15 - Sale of health benefits plan 
17B:27A-16 - Submission of rate filings by health maintenance organization not required 
17B:27A-16.1 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-16.2 - Adoption of temporary plan of operation 
17B:27A-16.3 - Purchase of other insurance coverage not required 
17B:27A-16.4 - Adoption of standard claim form 
17B:27A-16.5 - Hospital, medical insurance policy renewals; filing of rates
17B:27A-17 - Definitions relative to small employer health benefits plans
17B:27A-18 - Providers of health benefits, services subject to provisions of act
17B:27A-18.1 - Provision of benefits to subscriber's child under small employer policy, contract
17B:27A-18.2 - Requirements applicable to State Medicaid
17B:27A-19 - Health benefits plans offered to small employers; exceptions
17B:27A-19a - Small employer carrier, offering of high deductible plan
17B:27A-19.1 - Hospital confinement, other supplemental limited benefit insurance plans; requirements 
17B:27A-19.2 - Coverage for birth and natal care; small employer health policy. 
17B:27A-19.4 - Coverage for minimum inpatient care following mastectomy by small employer health benefits plan
17B:27A-19.5 - Applicability of Health Care Quality Act
17B:27A-19.6 - Coverage for treatment of inherited metabolic diseases by small employer health benefits plan
17B:27A-19.7 - Small employer health benefits plan to provide coverage for biologically-based mental illness
17B:27A-19.8 - Coverage for hemophilia services by small employer plan
17B:27A-19.9 - Small employer health benefits plan to provide coverage for colorectal cancer screening
17B:27A-19.10 - Policy, contract issued under C.17B:27A-17 et seq. required to cover certain out-of-network services
17B:27A-19.11 - Carrier offering plans pursuant to C.17B:27A-17 et seq. may offer additional plan with certain limited benefits
17B:27A-19.12 - Small employer health benefits plan to offer coverage for domestic partner
17B:27A-19.13 - Small employer health benefits plan, mammogram examination benefits
17B:27A-19.14 - High deductible health plan, small employer, deductible inapplicable, certain circumstances
17B:27A-19.15 - Small employer health benefits plan, coverage for prescription female contraceptives
17B:27A-19.16 - Coverage for certain dependents until age 31 by small employer health benefits plan
17B:27A-19.17 - Small employer health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-19.18 - Small employer health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-19.19 - Small employer health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-19.20 - Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-20 - Coinsurance, deductibles applicable 
17B:27A-21 - Standard coordination of benefits provisions applicable 
17B:27A-21.1 - Eligibility for enrollment in small employer health benefits plan
17B:27A-22 - Preexisting condition provisions
17B:27A-24 - Reasonable specified minimum participation
17B:27A-25 - Premium rates; other plan requirements
17B:27A-25.1 - Findings, declarations relative to small employer health benefits purchasing alliances
17B:27A-25.2 - Definitions relative to small employer benefits purchasing alliances
17B:27A-25.3 - Small Employer Purchasing Alliance, formation
17B:27A-25.4 - Board of directors
17B:27A-25.5 - Bylaws, contents
17B:27A-25.6 - Further authority of alliance
17B:27A-25.7 - Restrictions on alliances
17B:27A-25.8 - Certificate from alliance to commissioner
17B:27A-25.9 - Rules, regulations
17B:27A-26 - Health maintenance organization coverage; exceptions
17B:27A-27 - Continued coverage for certain terminated employees, dependents
17B:27A-28 - New Jersey Small Employer Health Benefits Program created 
17B:27A-29 - Meetings, organization of board; terms
17B:27A-29.1 - Immunity from liability for board
17B:27A-29.2 - Rules, regulations for voluntary risk pooling arrangement
17B:27A-30 - Submission of plan of operation 
17B:27A-33 - Formulation of five health benefits plans
17B:27A-43 - Violations, penalties 
17B:27A-44 - Assessments not charged to policyholders, public 
17B:27A-47 - Coverage obtained through out-of-State trust, compliance required 
17B:27A-48 - Multiple employer arrangement; requirements 
17B:27A-49 - Notification to commissioner by carrier of multiple employer arrangement 
17B:27A-50 - Change of coverage by small employer; restrictions 
17B:27A-51 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-53 - Other insurance purchases not required 
17B:27A-54 - Commissioner authorized to approve establishment of arrangement; rules, regulations 
17B:27A-55 - Written notice required for issuance, renewal of high deductible health plan; declaration of understanding
17B:27A-56 - Provision of biannual surveys to DOBI by health insurers

State Codes and Statutes

State Codes and Statutes

Statutes > New-jersey > Title-17b > Section-17b-27a

17B:27A-1 - Filing of paid hospital expense claims; definitions 
17B:27A-2 - Definitions
17B:27A-2.1 - Regulations
17B:27A-2.2 - Effective date
17B:27A-3 - Individual health benefits plans, applicability of act
17B:27A-4 - Offering of individual health benefits required by issuer of small employer health benefits plans
17B:27A-4.1 - Individual policy, contract for hospital, medical expense benefits, coverage of subscriber's child
17B:27A-4.2 - Requirements applicable to State Medicaid
17B:27A-4.4 - Findings, declarations relative to exclusive provider organization health benefit plans
17B:27A-4.5 - Carrier offering plans pursuant to C.17B:27A-2 et seq. to offer EPO; coverages
17B:27A-4.6 - Evaluation as to effectiveness of act
17B:27A-4.7 - Carrier offering plans pursuant to C.17B:27A-2 et seq. may offer additional plan with certain limited benefits
17B:27A-5 - Laws not applicable to plans 
17B:27A-6 - Individual health benefits plans, requirements
17B:27A-7 - Establishment of policy; contract forms; high deductible health plan; benefit levels
17B:27A-7.1 - Coverage for birth and natal care; individual health policy 
17B:27A-7.2 - Coverage for minimum inpatient care following mastectomy by individual health benefits plan
17B:27A-7.3 - Applicability of Health Care Quality Act
17B:27A-7.4 - Coverage for treatment of inherited metabolic diseases by individual health benefits plan
17B:27A-7.5 - Individual health benefits plan to provide coverage for biologically-based mental illness
17B:27A-7.6 - Coverage for hemophilia services by individual health policy
17B:27A-7.7 - Individual health benefits plan to provide coverage for colorectal cancer screening
17B:27A-7.8 - Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services
17B:27A-7.9 - Individual health benefits plan to offer coverage for domestic partner
17B:27A-7.10 - Individual health benefits plan, mammogram examination benefits
17B:27A-7.11 - Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances
17B:27A-7.12 - Individual health benefits plan, coverage for prescription female contraceptives
17B:27A-7.13 - Individual health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-7.14 - Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-7.15 - Individual health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-7.16 - Individual health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-8 - Offering of certain coverage not required
17B:27A-9 - Determination of rates
17B:27A-10 - New Jersey Individual Health Coverage Program; board of directors
17B:27A-11 - Powers, authority of program, board
17B:27A-12 - Procedures for equitable sharing of program losses
17B:27A-12.1 - Exemption from liability, certain, for HMO formed by UMDNJ
17B:27A-13 - Statement of net paid losses 
17B:27A-14 - Determination of disproportionate share of substandard risks
17B:27A-15 - Sale of health benefits plan 
17B:27A-16 - Submission of rate filings by health maintenance organization not required 
17B:27A-16.1 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-16.2 - Adoption of temporary plan of operation 
17B:27A-16.3 - Purchase of other insurance coverage not required 
17B:27A-16.4 - Adoption of standard claim form 
17B:27A-16.5 - Hospital, medical insurance policy renewals; filing of rates
17B:27A-17 - Definitions relative to small employer health benefits plans
17B:27A-18 - Providers of health benefits, services subject to provisions of act
17B:27A-18.1 - Provision of benefits to subscriber's child under small employer policy, contract
17B:27A-18.2 - Requirements applicable to State Medicaid
17B:27A-19 - Health benefits plans offered to small employers; exceptions
17B:27A-19a - Small employer carrier, offering of high deductible plan
17B:27A-19.1 - Hospital confinement, other supplemental limited benefit insurance plans; requirements 
17B:27A-19.2 - Coverage for birth and natal care; small employer health policy. 
17B:27A-19.4 - Coverage for minimum inpatient care following mastectomy by small employer health benefits plan
17B:27A-19.5 - Applicability of Health Care Quality Act
17B:27A-19.6 - Coverage for treatment of inherited metabolic diseases by small employer health benefits plan
17B:27A-19.7 - Small employer health benefits plan to provide coverage for biologically-based mental illness
17B:27A-19.8 - Coverage for hemophilia services by small employer plan
17B:27A-19.9 - Small employer health benefits plan to provide coverage for colorectal cancer screening
17B:27A-19.10 - Policy, contract issued under C.17B:27A-17 et seq. required to cover certain out-of-network services
17B:27A-19.11 - Carrier offering plans pursuant to C.17B:27A-17 et seq. may offer additional plan with certain limited benefits
17B:27A-19.12 - Small employer health benefits plan to offer coverage for domestic partner
17B:27A-19.13 - Small employer health benefits plan, mammogram examination benefits
17B:27A-19.14 - High deductible health plan, small employer, deductible inapplicable, certain circumstances
17B:27A-19.15 - Small employer health benefits plan, coverage for prescription female contraceptives
17B:27A-19.16 - Coverage for certain dependents until age 31 by small employer health benefits plan
17B:27A-19.17 - Small employer health benefits plans to provide benefits for orthotic and prosthetic appliances
17B:27A-19.18 - Small employer health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger
17B:27A-19.19 - Small employer health benefits plan to provide installment payments to obstetrical provider for maternity services
17B:27A-19.20 - Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability
17B:27A-20 - Coinsurance, deductibles applicable 
17B:27A-21 - Standard coordination of benefits provisions applicable 
17B:27A-21.1 - Eligibility for enrollment in small employer health benefits plan
17B:27A-22 - Preexisting condition provisions
17B:27A-24 - Reasonable specified minimum participation
17B:27A-25 - Premium rates; other plan requirements
17B:27A-25.1 - Findings, declarations relative to small employer health benefits purchasing alliances
17B:27A-25.2 - Definitions relative to small employer benefits purchasing alliances
17B:27A-25.3 - Small Employer Purchasing Alliance, formation
17B:27A-25.4 - Board of directors
17B:27A-25.5 - Bylaws, contents
17B:27A-25.6 - Further authority of alliance
17B:27A-25.7 - Restrictions on alliances
17B:27A-25.8 - Certificate from alliance to commissioner
17B:27A-25.9 - Rules, regulations
17B:27A-26 - Health maintenance organization coverage; exceptions
17B:27A-27 - Continued coverage for certain terminated employees, dependents
17B:27A-28 - New Jersey Small Employer Health Benefits Program created 
17B:27A-29 - Meetings, organization of board; terms
17B:27A-29.1 - Immunity from liability for board
17B:27A-29.2 - Rules, regulations for voluntary risk pooling arrangement
17B:27A-30 - Submission of plan of operation 
17B:27A-33 - Formulation of five health benefits plans
17B:27A-43 - Violations, penalties 
17B:27A-44 - Assessments not charged to policyholders, public 
17B:27A-47 - Coverage obtained through out-of-State trust, compliance required 
17B:27A-48 - Multiple employer arrangement; requirements 
17B:27A-49 - Notification to commissioner by carrier of multiple employer arrangement 
17B:27A-50 - Change of coverage by small employer; restrictions 
17B:27A-51 - Board actions subject to provisions of section; "action" defined; procedure 
17B:27A-53 - Other insurance purchases not required 
17B:27A-54 - Commissioner authorized to approve establishment of arrangement; rules, regulations 
17B:27A-55 - Written notice required for issuance, renewal of high deductible health plan; declaration of understanding
17B:27A-56 - Provision of biannual surveys to DOBI by health insurers

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