Title 17B, Title 17B: INSURANCE

17B:27A-61 Carrier seeking rate increase. 1. In addition to any other applicable laws or regulations, a carrier that seeks a rate increase as part of an informational filing for an individual or small employer health benefits plan shall comply with all of the provisions of this a…

17B:27A-62 Information to support, justify rate requests. 2. a. An informational rate filing by a carrier for an individual or small employer health benefits plan offered in this State shall contain information to support and justify rate requests. A rate increase shall be subjec…

17B:27A-63 Additional information requested by department. 3. a. If the department determines that a carrier's requested rate increase exceeds the 10 percent threshold for expanded rate review set forth in section 2 of this act, the department shall require the carrier to submit …

17B:27A-64 Disclosure of information. 4. a. Any information filed with the department pursuant to this act may be disclosed in accordance with P.L.1963, c.73 (C.47:1A-1 et seq.), except that confidential information shall not be disclosed by the department to any person other tha…

17B:27A-65 Definitions relative to certain assessments. 1. As used in this act: "Commissioner" means the Commissioner of Banking and Insurance. "Entity subject to this act" or "entity" means an insurance company, health service corporation, hospital service corporation, medical s…

17B:27A-66 Filing of net written premiums. 2. a. An entity subject to this act shall annually file with the commissioner its net written premiums for the preceding year, no later than April 1 of each year. b. The commissioner shall calculate and issue to the entity a certified as…

17B:27A-67 "Health Insurance Affordability Fund." 3. a. There is established in the Department of the Treasury a nonlapsing revolving fund to be known as the "Health Insurance Affordability Fund." This fund shall be the repository for all monies collected pursuant to this act. As…

17B:27A-7 Approval of policy and contract forms, benefit levels. 6. The commissioner shall approve the policy and contract forms and benefit levels to be made available by all carriers for the health benefits plans required to be issued pursuant to section 3 of P.L.1992, c.161 (C…

17B:27A-7.1. Coverage for birth and natal care; individual health policy 5. a. Every policy that provides maternity benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or approved for issuance or renewal in this S…

17B:27A-7.10 Individual health benefits plan, mammogram examination benefits. 7. a. Every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or approved for issuance or renewal in this St…

17B:27A-7.11 Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances. 14. Notwithstanding the provisions of subsection e. of section 6 of P.L.1992, c.161 (C.17B:27A-7) regarding deductibles for a high deductible health plan, a health benef…

17B:27A-7.12 Individual health benefits plan, coverage for contraceptives. 7. a. An individual health benefits plan required pursuant to section 3 of P.L.1992, c.161 (C.17B:27A-4) shall provide coverage for expenses incurred in the purchase of prescription female contraceptives, …

17B:27A-7.13 Individual health benefits plans to provide benefits for orthotic and prosthetic appliances. 6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.199…

17B:27A-7.14 Individual health benefits plan to provide coverage for hearing aids, cochlear implant for covered persons. 7. a. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursua…

17B:27A-7.15 Individual health benefits plan to provide installment payments to obstetrical provider for maternity services. 6. a. Every individual health benefits plan that provides benefits for maternity services, and that is delivered, issued, executed or renewed in this State…

17B:27A-7.16 Individual health benefits plan to provide benefits for treatment of autism or other developmental disability. 6. Notwithstanding any other provision of law to the contrary, an individual health benefits plan that provides hospital and medical expense benefits and is…

17B:27A-7.17 Individual health benefits plan to provide coverage for oral anticancer medication. 6. a. An individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), on or after the effective dat…

17B:27A-7.18 Individual health benefits plan to provide coverage for sickle cell anemia. 7. Every individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27…

17B:27A-7.19 Individual health benefits plan to provide coverage for prescription eye drops. 6. a. An individual health benefits plan which provides hospital or medical expense benefits that include coverage for prescription eye drops under a contract delivered, issued, executed …

17B:27A-7.2. Coverage for minimum inpatient care following mastectomy by individual health benefits plan 6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992…

17B:27A-7.20 Individual health benefits plan, coverage for synchronization of prescribed medications. 7. a. Every individual health benefits plan delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or re…

17B:27A-7.21 Individual health benefits plan to provide benefits for treatment of substance use disorder. 6. a. An individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issua…

17B:27A-7.22 Individual health benefits plan to provide coverage regardless of gender identity, expression. 6. a. Notwithstanding any other law or regulation to the contrary, an individual health benefits plan that provides hospital and medical expense benefits and is delivered, …

17B:27A-7.23 Individual health benefits plan to cover digital tomosynthesis of the breast. 6. a. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:2…

17B:27A-7.24 Individual health benefits plan to provide coverage for donated human breast milk. 6. a. An individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issuance or ren…

17B:27A-7.25 Individual health benefits plan to provide coverage for breastfeeding support. 6. a. An individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issuance or renewal…

17B:27A-7.26 Individual health benefits plan to meet essential health benefits requirements. 1. a. An individual health benefits plan subject to P.L.1992, c.161 (C.17B:27A-2 et seq.) shall provide coverage under every plan delivered, issued, executed or renewed in this State, on …

17B:27A-7.27 Individual health benefits plan to cover preventive services. 6. a. An individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State, or approved for issuance or renewal in this State b…

17B:27A-7.28 Individual health benefits plan to provide coverage for certain prescription drugs. 6. a. Notwithstanding any other provision of law to the contrary, a carrier that offers an individual health benefits plan that provides benefits for expenses incurred in the purchase…

17B:27A-7.29 Individual health benefits plan to cover adolescent depression screenings. 6. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 …

17B:27A-7.3 Applicability of Health Care Quality Act 24. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on or after the effective date of this act unless the policy or …

17B:27A-7.30 Individual health benefits plan to cover newborn home nurse visitation. 10. a. Every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or approved for issuance or renewal in…

17B:27A-7.31 Individual health benefits plan, coverage, insulin for diabetes treatment. 19. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2…

17B:27A-7.32 Individual health benefits plan, coverage, epinephrine auto-injector device. 20. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A…

17B:27A-7.33 Individual health benefits plan, coverage, prescription asthma inhaler. 21. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et…

17B:27A-7.34 Biomarker precision medical testing coverage, individual health benefits plans. 6. a. Each individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.1…

17B:27A-7.35 Individual health benefits plan, HIV preexposure prophylaxis, HIV postexposure prophylaxis. 8. a. (1) Except as provided in paragraph (2) of this subsection, every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant …

17B:27A-7.36 Benefits provided under individual health benefits plans. 7. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or…

17B:27A-7.4 Coverage for treatment of inherited metabolic diseases by individual health benefits plan. 6. No individual health benefits plan subject to the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) shall be delivered, issued, executed or renewed in this State, or approv…

17B:27A-7.5 Individual health benefits plan to provide coverage for mental health conditions, substance use disorders; collaborative care model. 6. a. (1) Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed o…

17B:27A-7.6. Coverage for hemophilia services by individual health policy 6. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on or after the effective date of P.L.2000, …

17B:27A-7.7 Individual health benefits plan to provide coverage for colorectal cancer screening. 6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 …

17B:27A-7.8 Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services. 6. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on or…

17B:27A-7.9 Individual health benefits plan to offer coverage for domestic partner. 53. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et…

17B:27A-8. Offering of certain coverage not required 7. a. A health maintenance organization shall not be required to offer coverage to or accept an applicant pursuant to this act if: (1) the eligible individual does not live, reside, or work within the health maintenance organiz…

17B:27A-9 Determination of rates. 8. a. (Deleted by amendment, P.L.2008, c.38). b. The board shall make application on behalf of all carriers for any other subsidies, discounts, or funds that may be provided for under State or federal law or regulation. A carrier may include subs…