N.J. Stat. tit. 17, ch. 48E
N.J. Stat. tit. 17, ch. 48E
in effectContents
section48E-1. Definitions.section48E-2. Establishment of health service corporationsection48E-3. Health service corporations.section48E-4. Certificate of authoritysection48E-5. Merger proceduresection48E-6. Board of health service corporation formed through merger.section48E-7. Board of directors of health service corporation.section48E-8. Vacancy proceduresection48E-9. Executive committeesection48E-10. Agreements with service providerssection48E-10.1. Health service corporation to receive, transmit transactions electronically; standards.section48E-10.2. Payment of out-of-network dental benefits by health service corporation.section48E-11. Professional Advisory Committeesection48E-12. Eligible providers' services.section48E-13. Approval of formssection48E-13.1. Health service corporation contract; compliancesection48E-13.2. Filing of contract or related formsection48E-13.3. Contract forms; certification memorandumsection48E-14. Individual contract requirementssection48E-15. Classification permittedsection48E-15.1. Eligibility for enrollment in health service corporationsection48E-15.2. Health service corporation contract, exclusion, rates, terms based on genetic information prohibitedsection48E-16. Joint venturessection48E-17. Expense limits; investments; administrative servicessection48E-17.1. Two special contingent surplus accountssection48E-17.2. Special contingent surplus required for health service corporationsection48E-17.3. Examination of annual regulatory filings; annual audit.section48E-17.4. Health service corporation, aggregate benefits.section48E-18. Annual contract, renewal; family coveragesection48E-19. Provisions of subscription certificatessection48E-20. Coverage for newborn child.section48E-21. Coverage for former spousesection48E-22. Coverage for child with intellectual disability, physical handicap.section48E-23. Group contractssection48E-24. Provisions of group contract formssection48E-25. "Employee" coveragesection48E-26. Experience ratingsection48E-27. Rate schedule filingsection48E-27.1. Individual contract rate changessection48E-28. Group coverage for newborn child.section48E-29. Nongroup coverage for former spousesection48E-30. Group coverage for child with intellectual disability, physical handicap.section48E-30.1. Coverage for certain dependents until age 31 by health service corporation.section48E-31. Family coverage after member's deathsection48E-32. Continuation of coverage for totally disabledsection48E-32.1. Coverage provided by health service corporation for subscriber's child.section48E-32.2. Requirements applicable to State Medicaidsection48E-33. Second, third surgical opinionssection48E-35. Reconstructive breast surgery benefitssection48E-35.1. Benefits for home treatment of hemophiliasection48E-35.2. Health service corporation insurance benefits for preexisting condition.section48E-35.3. Health service corporation to pay benefits for treatment of Wilm's tumorsection48E-35.4. Health service corporation contract, mammogram examination benefits.section48E-35.5. Health service corporation, benefits for "off-label" drugs requiredsection48E-35.6. Health service corporation, benefits for health promotionsection48E-35.7. Requirements for health service corporation providing benefits for pharmacy services.section48E-35.8. Benefits for certain cancer treatmentssection48E-35.9. Coverage for birth and natal care; health service corporationsection48E-35.10. Health service corporation contracts, child screening, blood lead, hearing loss; immunizations.section48E-35.11. Coverage for diabetes treatment by individual group health service corporation.section48E-35.12. Health service corporation contract, Pap smear benefitssection48E-35.13. Health service corporation contract, prostate cancer testingsection48E-35.14. Coverage for minimum inpatient care following mastectomy by individual, group health service corporationsection48E-35.15. Applicability of Health Care Quality Actsection48E-35.16. Coverage for treatment of inherited metabolic diseases by health service corporation.section48E-35.17. Health service corporation to cover certain audiology, speech-language pathology services.section48E-35.18. Coverage for treatment of domestic violence injuries by health service corporation.section48E-35.19. Coverage for certain dental procedures for the severely disabled or child age five or under by health service corporationsection48E-35.20. Health service corporation to provide coverage for mental health conditions, substance use disorders; collaborative care model.section48E-35.21. Coverage for hemophilia services by health service corporationsection48E-35.22. Health service corporation to provide coverage for treatment of infertility.section48E-35.23. Health service corporation to provide coverage for colorectal cancer screening.section48E-35.24. Health service corporation prescription drug plans to cover certain infant formulas.section48E-35.25. Contract issued under C.17:48E-1 et seq. required to cover certain out-of-network services.section48E-35.26. Health service corporation to offer coverage for domestic partner.section48E-35.27. Health service corporation, high deductible, coverage for preventive care.section48E-35.28. Health service corporation, high deductible, deductible inapplicable, certain circumstances.section48E-35.29. Health service corporation, coverage for contraceptives.section48E-35.30. Health service corporation to provide benefits for orthotic and prosthetic appliances.section48E-35.31. Health service corporation to provide coverage for hearing aids, cochlear implant for covered persons.section48E-35.32. Individual, group health service corporation to provide installment payments to obstetrical provider for maternity services.section48E-35.33. Health service corporation to provide benefits for treatment of autism or other developmental disability.section48E-35.34. Health service corporation to provide coverage for oral anticancer medications.section48E-35.35. Health service corporation to provide coverage for sickle cell anemia.section48E-35.36. Health service corporation to provide coverage for prescription eye drops.section48E-35.37. Health service corporation contract, coverage for synchronization of prescribed medications.section48E-35.38. Health service corporation to provide benefits for treatment of substance use disorder.section48E-35.39. Health service corporation to provide coverage regardless of gender identity, expression.section48E-35.40. Health service corporation contract to cover digital tomosynthesis of the breast.section48E-35.41. Health service corporation to provide coverage for donated human breast milk.section48E-35.42. Health service corporation to provide coverage for standard fertility preservation services.section48E-35.43. Health service corporation to provide coverage for breastfeeding support.section48E-35.44. Health service corporation to cover preventive services.section48E-35.45. Health service corporation to provide certain coverage for prescription drugs.section48E-35.46. Health service corporation to cover adolescent depression screenings.section48E-35.47. Health service corporation to cover newborn home nurse visitations.section48E-35.48. Individual, group health service corporation contract, coverage, epinephrine auto-injector device.section48E-35.49. Individual, group health service corporation contract, coverage, prescription asthma inhaler.section48E-35.50. Biomarker precision medical testing coverage, health service corporation contracts.section48E-35.51. Group, individual health service corporation contracts, HIV preexposure prophylaxis, HIV postexposure prophylaxis.section48E-35.52. Benefits provided under health service corporation contracts.section48E-36. Annual financial statementsection48E-37. Examination authoritysection48E-37.1. Definitions.section48E-37.2. Increase in amount of capital or surplus required of health service corporation.section48E-37.3. Determination of increase, revision or redetermination; factors.section48E-37.4. Suspension, revocation of authority to do business.section48E-37.5. Rules, regulations.section48E-38. Fee schedulesection48E-39. Penalties for violationssection48E-41. Health service corporation, exemption from taxessection48E-42. For-profit corporations excludedsection48E-43. Subject to reviewsection48E-44. Rules, regulationssection48E-45. Definitions relative to conversionsection48E-46. Conversion of health service corporation to domestic mutual insurersection48E-46.1. Findings, declarations relative to the reorganization of a health service corporationsection48E-46.2. Definitions relative to the reorganization of a health service corporationsection48E-46.3. Mutual holding company, not for pecuniary profit, missionsection48E-46.4. Health service corporation to reorganize into mutual holding company systemsection48E-46.5. Health service corporation applicationto form mutual holding company systemsection48E-46.6. Monitoring mutual holding company's operationssection48E-46.7. Investments; supplier program; mutualization; reorganization planssection48E-46.8. Non-obligation of distribution payment to members, policyholderssection48E-46.9. Membership in mutual holding companysection48E-46.10. Plan of dissolutionsection48E-46.11. Annual statements; report to the Governorsection48E-46.12. Public recordssection48E-46.13. Initial and annual assessmentssection48E-46.14. Mutual holding companysection48E-46.15. Board of the mutual holding company; membership, transitional period, diversitysection48E-46.16. Full-time employees maintained for 36 months following transitionsection48E-46.17. Severabilitysection48E-47. Filing, approval of conversion plansection48E-48. Directors and officers, termssection48E-49. Definitions relative to conversion of health service corporation to domestic stock insurer.section48E-50. Procedure for conversion.section48E-51. Filing of application.section48E-52. Approval of plan, certificate of authority.section48E-53. Issuance of subsequent order.section48E-54. Transfer of fair market value.section48E-55. Continuation of health service corporation.section48E-56. Conversion of policies.section48E-57. Receipt of compensation contingent upon approval of plan prohibited.section48E-58. Documents considered public records; exceptions.section48E-59. Conversion effective; conditions.section48E-60. Abandonment, amendment of plan of conversion.section48E-61. Directors, officers continue to serve.section48E-62. Participation of Attorney General.section48E-63. Orders, rules, regulations.section48E-64. Construction of act.section48E-65. Requirements prior to action constituting material change in form.section48E-66. Notification of action constituting material change in form, procedure.section48E-67. Petition for review of foundation plan.section48E-68. Foundations; board, membership.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://www.njleg.state.nj.us/legislative-activity/statutesFetched: 10/17/2026