Title 17B, Title 17B: INSURANCE

17B:27-46.1w. Coverage for hemophilia services by group health insurers 4. Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed or renewed on or after the effective date of P.L.2000, c…

17B:27-46.1ww Group health insurance policy, coverage, epinephrine auto-injector device. 14. A group health insurance policy providing hospital or medical expense benefits that is delivered, issued, executed, or renewed in this State pursuant to Chapter 27 of Title 17B of the New…

17B:27-46.1x Group health insurance policy to provide coverage for treatment of infertility. 4. a. A group health insurance policy which provides hospital or medical expense benefits for groups with more than 50 persons, which includes pregnancy-related benefits, shall not be del…

17B:27-46.1xx Group health insurance policy, coverage, prescription asthma inhaler. 15. A group health insurance policy providing hospital or medical expense benefits that is delivered, issued, executed, or renewed in this State pursuant to Chapter 27 of Title 17B of the New Jers…

17B:27-46.1y Group policy to provide coverage for colorectal cancer screening. 5. a. Every group policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 et seq., or approved for issuance or …

17B:27-46.1yy Biomarker precision medical testing coverage, group health insurance policies. 5. a. Each group health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to chapter 27 of Title 17…

17B:27-46.1z Group health insurer prescription drug plans to cover certain infant formulas. 4. A group health insurer which provides hospital or medical expense benefits for expenses incurred in the purchase of prescription drugs under a policy that is delivered, issued, executed…

17B:27-46.1zz Group health insurance policy, HIV preexposure prophylaxis, HIV postexposure prophylaxis. 7. a. (1) Except as provided in paragraph (2) of this subsection, no group health insurance policy providing hospital or medical expense benefits shall be delivered, issued, ex…

17B:27-46.2. Second surgical opinions; definitions As used in this act: a. "Elective surgical procedure" means any nonemergency surgical procedure which may be scheduled at the convenience of the patient or the surgeon without jeopardizing the patient's life or causing serious im…

17B:27-46.3. Group insurance policies; provision of program on request Any insurer issuing a group insurance policy in accordance with chapter 27 of Title 17B of the New Jersey Statutes which provides coverage of surgical operations performed on a person while confined in a hospi…

17B:27-46.4. Payment for second surgical opinion services A second surgical opinion program shall provide for payment for the second surgical opinion services of an eligible physician and for essential laboratory and X-ray services incidental thereto, either as a benefit under th…

17B:27-46.5. Third surgical opinion If a second surgical opinion does not confirm that a proposed elective surgical procedure is medically advisable, the program must cover a third surgical opinion in the same manner as the second opinion. L.1979, c. 329, s. 4.

17B:27-46.6. Reduction of benefits where no second opinion obtained Where a second surgical opinion program is operative in connection with surgical coverage under a group insurance policy, and provides second and third surgical opinion services at no cost to the insured or patie…

17B:27-46.7. Permissible benefit exclusions A second surgical opinion program may exclude benefits while the patient is confined in a hospital as an inpatient, any surgical procedure not covered by the group insurance policy, and surgical procedures in the following categories: c…

17B:27-46.8. Payment for opinion services of physician If a physician who furnishes a second or third surgical opinion also performs the surgical procedure, the second surgical opinion program need not provide payment for the second or third opinion services of that physician. L.…

17B:27-46.9. Application of act This act shall apply to all contracts in which the insurer has reserved the right to change the premium. L.1979, c. 329, s. 8.

17B:27-47. Group health or blanket insurance--provisions as favorable; policies issued outside State No policy of group health or blanket insurance, and no certificate thereunder shall be delivered or issued for delivery in this State if such policy or certificate contains any pr…

17B:27-48. Exceptions in same type as benefits Exceptions in the policy shall be printed in the policy and in the certificate with the same prominence as the benefits to which they apply. L.1971, c. 144, s. 17B:27-48.

17B:27-49. Filing of forms 17B:27-49. a. No group health insurance policy, or blanket 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, shall be deliver…

17B:27-50. Reimbursement for service of physician or practicing psychologist a. Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a policy or contract provides for reimbursement…

17B:27-50.1. Severability If any section, subsection, paragraph, sentence, clause, phrase or word contained in this act shall be declared invalid for any reason whatsoever, such invalidity shall not effect the remaining portions of this act which shall remain in full force and ef…

17B:27-51. Reimbursement for optometric service Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a policy or contract provides for reimbursement for any optometric service whic…

17B:27-51.1. Reimbursement for service of chiropractor Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a policy or contract provides for reimbursement for any service which is…

17B:27-51.10. Renewal date; policy with reservation of right to change premium For the purposes of this act, a policy or contract in which the company has reserved the right to change the premium shall be considered renewed as of the date on which the premium is changed or is sub…

17B:27-51.10a. Alternative dental coverage; original coverage restricted to limited number of providers Each employer or other organization which employs or has 25 or more employees or members during the full preceding calendar year which contributes to a group health insurance c…

17B:27-51.10b. Employer contribution An employer or other organization shall be required to pay or contribute towards the provision of alternative coverage an amount equal to the premium or cost which it pays or contributes to the group health insurance contract for dental servic…

17B:27-51.10c. Rules and regulations Within 120 days of the effective date of this act, the Commissioner of the Department of Insurance shall promulgate rules and regulations necessary to effectuate the purpose of this act, including procedures for notice to covered persons, empl…

17B:27-51.11. Definitions As used in this act: a. "Group policy" means a group health insurance policy issued by an insurer pursuant to Title 17B of the New Jersey Statutes. b. "Insurer" means the entity issuing a group policy or an individual policy or converted policy. c. "Insu…

17B:27-51.12. Total disability of employee or member; continuation under group policy; conditions A group policy delivered or issued for delivery in this State which insures employees or members and their dependents for hospital, surgical or major medical insurance on an expense …

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 …