N.J. Stat. tit. 17B, ch. 27A

N.J. Stat. tit. 17B, ch. 27A

in effect

Contents

section27A-1. Filing of paid hospital expense claims; definitions section27A-2. Definitions.section27A-2.1. Regulations.section27A-2.2. Effective date.section27A-3. Individual health benefits plans, applicability of act.section27A-4. Offering of individual health benefits required by issuer of small employer health benefits plans.section27A-4.1. Individual policy, contract for hospital, medical expense benefits, coverage of subscriber's child.section27A-4.2. Requirements applicable to State Medicaid section27A-4.3. Eligibility for enrollment in individual health benefits plan section27A-5. Laws not applicable to managed care health benefits plans.section27A-6. Individual health benefits plans, requirements.section27A-6.1. Individual Health Coverage Program, open enrollment period established.section27A-7. Approval of policy and contract forms, benefit levels.section27A-7.1. Coverage for birth and natal care; individual health policy section27A-7.2. Coverage for minimum inpatient care following mastectomy by individual health benefits plan section27A-7.3. Applicability of Health Care Quality Act section27A-7.4. Coverage for treatment of inherited metabolic diseases by individual health benefits plan.section27A-7.5. Individual health benefits plan to provide coverage for mental health conditions, substance use disorders; collaborative care model.section27A-7.6. Coverage for hemophilia services by individual health policy section27A-7.7. Individual health benefits plan to provide coverage for colorectal cancer screening.section27A-7.8. Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services.section27A-7.9. Individual health benefits plan to offer coverage for domestic partner.section27A-7.10. Individual health benefits plan, mammogram examination benefits.section27A-7.11. Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances.section27A-7.12. Individual health benefits plan, coverage for contraceptives.section27A-7.13. Individual health benefits plans to provide benefits for orthotic and prosthetic appliances.section27A-7.14. Individual health benefits plan to provide coverage for hearing aids, cochlear implant for covered persons.section27A-7.15. Individual health benefits plan to provide installment payments to obstetrical provider for maternity services.section27A-7.16. Individual health benefits plan to provide benefits for treatment of autism or other developmental disability.section27A-7.17. Individual health benefits plan to provide coverage for oral anticancer medication.section27A-7.18. Individual health benefits plan to provide coverage for sickle cell anemia.section27A-7.19. Individual health benefits plan to provide coverage for prescription eye drops.section27A-7.20. Individual health benefits plan, coverage for synchronization of prescribed medications.section27A-7.21. Individual health benefits plan to provide benefits for treatment of substance use disorder.section27A-7.22. Individual health benefits plan to provide coverage regardless of gender identity, expression.section27A-7.23. Individual health benefits plan to cover digital tomosynthesis of the breast.section27A-7.24. Individual health benefits plan to provide coverage for donated human breast milk.section27A-7.25. Individual health benefits plan to provide coverage for breastfeeding support.section27A-7.26. Individual health benefits plan to meet essential health benefits requirements.section27A-7.27. Individual health benefits plan to cover preventive services.section27A-7.28. Individual health benefits plan to provide coverage for certain prescription drugs.section27A-7.29. Individual health benefits plan to cover adolescent depression screenings.section27A-7.30. Individual health benefits plan to cover newborn home nurse visitation.section27A-7.31. Individual health benefits plan, coverage, insulin for diabetes treatment.section27A-7.32. Individual health benefits plan, coverage, epinephrine auto-injector device.section27A-7.33. Individual health benefits plan, coverage, prescription asthma inhaler.section27A-7.34. Biomarker precision medical testing coverage, individual health benefits plans.section27A-7.35. Individual health benefits plan, HIV preexposure prophylaxis, HIV postexposure prophylaxis.section27A-7.36. Benefits provided under individual health benefits plans.section27A-8. Offering of certain coverage not required section27A-9. Determination of rates.section27A-10. New Jersey Individual Health Coverage Program; board of directors.section27A-10.1. Short title.section27A-10.2. Purpose of act.section27A-10.3. Definitions relative to health insurance premiums.section27A-10.4. Health Insurance Premium Security Plan.section27A-10.5. Payment parameters.section27A-10.6. Calculation of reinsurance payment.section27A-10.7. Requests for reinsurance payments.section27A-10.8. Accounting for each benefit year.section27A-10.9. Application for waiver of ACA.section27A-10.10. New Jersey Health Insurance Premium Security Fund.section27A-10.11. Annual report.section27A-10.12. Violations, penalties.section27A-10.13. Rules, regulations.section27A-10.14. Study, Department of Banking and Insurance, New Jersey Individual Health Coverage Program, New Jersey Small Employer Health Benefits Program; report, Governor, Legislature.section27A-11. Powers, authority of program, board.section27A-12. Procedures for equitable sharing of program losses.section27A-12.1. Exemption from liability, certain, for HMO formed by UMDNJ.section27A-13. Statement of net paid losses section27A-14. Determination of disproportionate share of substandard risks section27A-15. Sale of health benefits plan section27A-16. Submission of rate filings by health maintenance organization not required section27A-16.1. Board actions subject to provisions of section; "action" defined; procedure section27A-16.2. Adoption of temporary plan of operation section27A-16.3. Purchase of other insurance coverage not required section27A-16.4. Adoption of standard claim form section27A-16.5. Hospital, medical insurance policy renewals; filing of rates.section27A-17. Definitions relative to small employer health benefits plans.section27A-18. Providers of health benefits, services subject to provisions of act section27A-18.1. Provision of benefits to subscriber's child under small employer policy, contract.section27A-18.2. Requirements applicable to State Medicaid section27A-19. Health benefits plans offered to small employers; exceptions.section27A-19a. Small employer carrier, offering of high deductible plan.section27A-19.1. Hospital confinement, other supplemental limited benefit insurance plans; requirements section27A-19.2. Coverage for birth and natal care; small employer health policy.section27A-19.3. Regulations governing rating methodology, calculation of loss ratios section27A-19.4. Coverage for minimum inpatient care following mastectomy by small employer health benefits plan section27A-19.5. Applicability of Health Care Quality Act section27A-19.6. Coverage for treatment of inherited metabolic diseases by small employer health benefits plan.section27A-19.7. Small employer health benefits plan to provide coverage for mental health conditions, substance use disorders; collaborative care model.section27A-19.8. Coverage for hemophilia services by small employer plan section27A-19.9. Small employer health benefits plan to provide coverage for colorectal cancer screening.section27A-19.10. Policy, contract issued under C.17B:27A-17 et seq. required to cover certain out-of-network services.section27A-19.11. Carrier offering plans pursuant to C.17B:27A-17 et seq. may offer additional plan with certain limited benefits.section27A-19.12. Small employer health benefits plan to offer coverage for domestic partner.section27A-19.13. Small employer health benefits plan, mammogram examination benefits.section27A-19.14. High deductible health plan, small employer, deductible inapplicable, certain circumstances.section27A-19.15. Small employer health benefits plan, coverage for contraceptives.section27A-19.16. Coverage for certain dependents until age 31 by small employer health benefits plan.section27A-19.17. Small employer health benefits plans to provide benefits for orthotic and prosthetic appliances.section27A-19.18. Small employer health benefits plan to provide coverage for hearing aids, cochlear implant for covered persons.section27A-19.19. Small employer health benefits plan to provide installment payments to obstetrical provider for maternity services.section27A-19.20. Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability.section27A-19.21. Small employer health benefits plan to provide coverage for oral anticancer medications.section27A-19.22. Small employer health benefits plan to provide coverage for sickle cell anemia.section27A-19.23. Small employer health benefits plan to provide coverage for prescription eye drops.section27A-19.24. Small employer health benefits plan, coverage for synchronization of prescribed medications.section27A-19.24a. Carrier, small-employer health benefits plan, prescription drug formulary, flexibility, limitations.section27A-19.24b. Carrier, prescription drug formulary, exceptions and appeals process.section27A-19.25. Small employer health benefits plan to provide benefits for treatment of substance use disorder.section27A-19.26. Small employer health benefits plan to provide coverage regardless of gender identity, expression.section27A-19.27. Small employer health benefits plan to cover digital tomosynthesis of the breast.section27A-19.28. Small employer health benefits plan to provide coverage for donated human breast milk.section27A-19.29. Small employer health benefits plan to provide coverage for breastfeeding support.section27A-19.30. Small employer health benefits plan to meet essential health benefits requirements.section27A-19.31. Small employer health benefits plan to cover preventive services.section27A-19.32. Small employer health benefits plan to provide certain coverage for prescription drugs.section27A-19.33. Small employer health benefits plan to cover adolescent depression screenings.section27A-19.34. Small employer health benefits plan to cover newborn home nurse visitation.section27A-19.35. Small employer health benefits plan, coverage, insulin for diabetes treatment.section27A-19.36. Small employer health benefits plan, coverage, epinephrine auto-injector device.section27A-19.37. Small employer health benefits plan, coverage, prescription asthma inhaler.section27A-19.38. Biomarker precision medical testing coverage, small employer health benefits plans.section27A-19.39. Small employer health benefits plan, HIV preexposure prophylaxis, HIV postexposure prophylaxis.section27A-19.40. Benefits provided under small employer health benefits plans.section27A-20. Coinsurance, deductibles applicable section27A-20.1. Rules, regulations.section27A-21. Standard coordination of benefits provisions applicable section27A-21.1. Eligibility for enrollment in small employer health benefits plan section27A-22. Preexisting condition provisions.section27A-23. Policies, contracts renewable; exceptions.section27A-24. Reasonable specified minimum participation.section27A-25. Premium rates; other plan requirements.section27A-25.1. Findings, declarations relative to small employer health benefits purchasing alliances section27A-25.2. Definitions relative to small employer benefits purchasing alliances section27A-25.3. Small Employer Purchasing Alliance, formation section27A-25.4. Board of directors section27A-25.5. Bylaws, contents section27A-25.6. Further authority of alliance section27A-25.7. Restrictions on alliances section27A-25.8. Certificate from alliance to commissioner section27A-25.9. Rules, regulations section27A-26. Health maintenance organization coverage; exceptions section27A-27. Continued coverage for certain terminated employees, dependents.section27A-28. New Jersey Small Employer Health Benefits Program created section27A-29. Meetings, organization of board; terms.section27A-29.1. Immunity from liability for board section27A-29.2. Rules, regulations for voluntary risk pooling arrangement section27A-30. Submission of plan of operation section27A-31. Contents of plan of operation section27A-32. Authority of board section27A-33. Formulation of five health benefits plans section27A-33.1. Short title.section27A-33.2. Annual review, small-employer health benefits plans, publish findings, report, Department of Banking and Insurance website.section27A-41. Violations, penalty section27A-43. Violations, penalties section27A-44. Assessments not charged to policyholders, public section27A-45. Standard claim form section27A-47. Coverage obtained through out-of-State trust, compliance required section27A-48. Multiple employer arrangement; requirements section27A-49. Notification to commissioner by carrier of multiple employer arrangement section27A-50. Change of coverage by small employer; restrictions section27A-51. Board actions subject to provisions of section; "action" defined; procedure section27A-53. Other insurance purchases not required section27A-54. Commissioner authorized to approve establishment of arrangement; rules, regulations section27A-55. Written notice required for issuance, renewal of high deductible health plan; declaration of understanding.section27A-56. Provision of biannual surveys to DOBI by health insurers.section27A-57. "Health Insurance Exchange Trust Fund."section27A-58. Authority to operate a State-based exchange, coordinate operations with other entities; advisory committee.section27A-59. Rules, regulations.section27A-59.1. Definitions.section27A-59.2. "New Jersey Easy Enrollment Health Insurance Program" established.section27A-59.3. Assistance eligibility, Department of Banking and Insurance.section27A-59.4. Special enrollment period, New Jersey individual health insurance market, established.section27A-59.5. Data privacy, security safeguards.section27A-59.6. Tax return, individual not covered, minimum essential coverage.section27A-59.7. Consenting to information sharing, system established.section27A-59.8. Unemployment claim, indication of interest in obtaining minimum coverage, information sharing, consent.section27A-60. Essential health benefits defined.section27A-61. Carrier seeking rate increase.section27A-62. Information to support, justify rate requests.section27A-63. Additional information requested by department.section27A-64. Disclosure of information.section27A-65. Definitions relative to certain assessments.section27A-66. Filing of net written premiums.section27A-67. "Health Insurance Affordability Fund."

Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://www.njleg.state.nj.us/legislative-activity/statutesFetched: 10/17/2026