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Title: 17B - INSURANCE

Chapter: 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-4.3: Eligibility for enrollment in individual health benefits plan

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-7.10: 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-7.17: Individual health benefits plan to provide coverage for oral anticancer medication.

17b:27A-7.18: Individual health benefits plan to provide coverage for sickle cell anemia.

17b:27A-7.19: Individual health benefit plan to provide coverage for prescription eye drops.

17b:27A-7.2: Coverage for minimum inpatient care following mastectomy by individual health benefits plan

17b:27A-7.20: Individual health benefits plan, coverage for synchronization of prescribed medications.

17b:27A-7.21: Individual health benefits plan to provide benefits for treatment of substance use disorder.

17b:27A-7.22: Individual health benefits plan to provide coverage regardless of gender identity, expression.

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-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-19.10: 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-19.2: Coverage for birth and natal care; small employer health policy.

17b:27A-19.20: Small employer health benefits plan to provide benefits for treatment of autism or other developmental disability.

17b:27A-19.21: Small employer health benefits plan to provide coverage for oral anticancer medications.

17b:27A-19.22: Small employer health benefits plan to provide coverage for sickle cell anemia.

17b:27A-19.23: Small employer health benefits plan to provide coverage for prescription eye drops.

17b:27A-19.24: Small employer health benefits plan, coverage for synchronization of prescribed medications.

17b:27A-19.25: Small employer health benefits plan to provide benefits for treatment of substance use disorder.

17b:27A-19.26: Small employer health benefits plan to provide coverage regardless of gender identity, expression.

17b:27A-19.3: Regulations governing rating methodology, calculation of loss ratios

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-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-23: Policies, contracts renewable; exceptions.

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-31: Contents of plan of operation

17b:27A-32: Authority of board

17b:27A-33: Formulation of five health benefits plans

17b:27A-41: Violations, penalty

17b:27A-43: Violations, penalties

17b:27A-44: Assessments not charged to policyholders, public

17b:27A-45: Standard claim form

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.