New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 2 - INSURANCE GROUP
Subchapter 39A - INCREASE IN CAPITAL AND SURPLUS REQUIREMENTS FOR HEALTH ORGANIZATIONS
Section 11:2-39A.1 - Purpose and scope

Universal Citation: NJ Admin Code 11:2-39A.1

Current through Register Vol. 56, No. 24, December 18, 2024

(a) The purpose of this subchapter is to provide a framework for the establishment of uniform risk-based capital and surplus requirements for all health organizations licensed pursuant to Titles 17 and 26 of the New Jersey Statutes, and to implement sections 11 through 45 of P.L. 2014, c. 81 (enacted December 26, 2014), which authorize the Commissioner to increase capital and surplus requirements for health organizations based upon the organization's business risks.

(b) Except as set forth in (c) below, this subchapter shall apply to all health organizations licensed in this State pursuant to Titles 17 and 26 of the New Jersey Statutes.

(c) This subchapter shall not apply:

1. To a domestic health organization that:
i. Writes direct business only in this State;

ii. Assumes no reinsurance in excess of five percent of direct premium written; and

iii. Writes direct annual premiums for comprehensive medical business of $ 2 million or less; or

2. To a dental plan organization, prepaid prescription services organization, or licensed organized delivery system that covers less than 2,000 lives.

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