Title 17B, Title 17B: INSURANCE

17B:27-51.13. Inapplicability to policy without right of insurer to terminate without consent of insured The provisions of this act shall not apply to any policy in which the insurer does not have the right to terminate the policy without the consent of the insured. L.1981, c. 42…

17B:27-51.14 Insurer provide health benefits plan, aggregate benefits. 4. a. Beginning with the calendar year starting on January 1, 2020, and in each calendar year thereafter, an insurer providing a health benefits plan shall return, in the form of aggregate benefits for all lar…

17B:27-51.1a. Group health insurance benefits for certain nursing services 2. a. Notwithstanding any provision of a policy of group health insurance, whenever such a policy provides for reimbursement for any service which is within the lawful scope of practice of a duly registere…

17B:27-51.2. Legislative findings and declarations The Legislature hereby finds and declares that the high cost of hospital care necessitates the establishment of alternative means of caring for patients who need some professional health care, but who do not need to remain hospit…

17B:27-51.3. Definitions As used in this act: a. "Home health care" means those nursing and other home health care services rendered to a person in his place of residence, under the following conditions: (1) On a part-time and intermittent basis, except when full-time or 24-hour …

17B:27-51.4. Home health care; requirement for coverage Notwithstanding any provision of a policy of group health insurance, hereafter delivered or issued for delivery in this State, whenever such policy provides coverage for inpatient hospital care or skilled nursing facility ca…

17B:27-51.5. Benefits Every policy shall provide benefits required by section 3 without a separate deductible or coinsurance provision for the home health care benefit. For the purpose of determining the benefits for home health care, each visit by a member of a home health care …

17B:27-51.6. Direct reimbursement to home health care providers The State Commissioner of Insurance, after consultation with the State Commissioner of Health, shall provide for a system of direct reimbursement to home health care providers for services rendered pursuant to this a…

17B:27-51.7. Regulations The State Commissioner of Insurance, after consultation with the State Commissioner of Health, is hereby empowered and directed to promulgate regulations necessary to effectuate the provisions of this act. L.1977, c. 99, s. 6.

17B:27-51.8. Policy provision for reimbursement of dental services; payment regardless of discipline of provider Notwithstanding any provision of a policy or contract of group health insurance hereafter delivered, issued for delivery, amended, renewed or ratified in this State wh…

17B:27-51.9. Application to policy or contract not limited to reimbursement of specific types of duly licensed health care professionals other than dentists The provisions of section 1 of this act shall also apply to any policy or contract of group health insurance already delive…

17B:27-52. Group life and health--package policies Any insurer authorized to write in this State group life and group health insurance may provide such coverages in one policy or in separate policies, or in supplements or riders to such policy or policies, with or without health …

17B:27-53. Group life and health--rate reductions and application of dividends; excess over employer's cost If a policy dividend is hereafter declared or a reduction in rate is hereafter made or continued under any group insurance policy heretofore or hereafter issued to an emplo…

17B:27-54 Application of provisions; definitions. 14. The provisions of sections 14 through 27 of P.L.1997, c.146 (C.17B:27-54 through C.17B:27-67) shall apply to group health insurance coverage that is not subject to the provisions of P.L.1992, c.161 and c.162 (C.17B:27A-2 et se…

17B:27-60. Written certification of creditable coverage under COBRA 20. a. A health insurer which offers a group health plan shall provide a written certification of creditable coverage at the time an individual ceases coverage or otherwise becomes covered under a COBRA continuat…

17B:27-61. Affiliation period imposed by HMO 21. A health maintenance organization which offers a group health plan and which does not impose a preexisting condition exclusion, may impose an affiliation period if the period is applied uniformly without regard to any health status…

17B:27-62. Permission to enroll for group coverage 22. A health insurer which offers a group health plan shall permit an employee or dependent who is eligible, but not enrolled, for coverage under the terms of the plan, to enroll for coverage if: a. the employee or dependent was …

17B:27-63. Dependent special enrollment period 23. If a group health plan makes coverage available with respect to a dependent of an individual who is a participant under the plan or has satisfied any waiting period and is eligible to be enrolled, and the dependent becomes a depe…

17B:27-64. Rules for eligibility, health status-related factors prohibited 24. A health insurer which offers a group health plan may not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of the plan based on health statu…

17B:27-65. Premiums, contributions regulated 25. A health insurer which offers a group health plan may not require an individual, as a condition of enrollment or continued enrollment under the plan, to pay a premium or contribution which is greater than the premium or contributio…

17B:27-66. Renewal of coverage; exceptions 26. A health insurer which offers health insurance coverage in connection with a group health plan shall renew the coverage under the plan at the option of the policy holder, except that: a. A health insurer may discontinue the coverage …

17B:27-67. Modification of coverage 27. At the time of coverage renewal, a health insurer may modify the health insurance coverage for a product offered to a group health plan. L.1997,c.146,s.27.

17B:27-68 Conditions for issuance, delivery of group life insurance. 1. Except as provided in section 2 of this act, no policy of group life insurance shall be delivered or issued for delivery in this State unless it meets one of the descriptions in subsections a. through h. of t…

17B:27-69 Conditions for issuance, delivery of group life insurance to groups not included in C.17B:27-68. 2. a. Group life insurance offered to a resident of this State under a group life insurance policy issued to a group other than one described in section 1 of this act shall …

17B:27-70 Written notice to prospective insureds of noncompliance with C.17B:27-68; definitions. 3. a. With respect to a program of insurance which, if issued on a group basis, does not meet the requirements of section 1 of this act, the insurer shall cause to be distributed to p…

17B:27-71 Extension to dependents of group life insurance policy. 4. Except for a policy issued under subsection b. of section 1 of this act, a group life insurance policy may be extended to insure the employees or members against loss due to the death of their spouses, domestic …

17B:27-72 Required provisions for delivery, issuance of group life insurance policy. 5. a. No policy of group life insurance shall be delivered or issued for delivery in this State unless it contains in substance the following provisions, or provisions which in the opinion of the…

17B:27-73 Issuance, delivery of individual policy of life insurance. 6. If an individual insured under a group insurance policy hereafter delivered or issued for delivery in this State becomes entitled under the terms of the policy to have an individual policy of life insurance i…

17B:27-74 Filing of form required for delivery, issuance of group life insurance. 7. a. No group life insurance policy, or application, if a written application is required and is to be made a part of the policy, certificate, printed rider or endorsement for use with the policy, …

17B:27-75 Payment of benefits. 8. a. Notwithstanding any policy provision to the contrary, benefits under a group life insurance policy subject to this act shall become payable by reason of the death of the insured within 60 days after the receipt of due proof of death and, at th…