New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM
Subchapter 18 - WITHDRAWALS OF CARRIERS FROM THE INDIVIDUAL MARKET AND THE WITHDRAWAL OF PLAN, PLAN OPTION, OR DEDUCTIBLE/COPAYMENT OPTION
Section 11:20-18.4 - Cessation of offer and issuance of individual plans

Universal Citation: NJ Admin Code 11:20-18.4

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

(a) No carrier with in force individual plans shall cease to offer and issue all of its individual plans to an eligible person unless the Commissioner has determined pursuant to N.J.S.A. 17B:27A-8b and N.J.A.C. 11:20-11 that the carrier does not have the financial resources necessary to underwrite additional coverage, and it has provided written notice to:

1. The IHC Board at least 30 days before it intends to cease offering and issuing individual plans. Upon receipt of such notice, the Board shall no longer distribute the carrier's filed rates in conjunction with the Individual Health Coverage Program Buyer's Guide; and

2. Its individual plan policyholders, in conjunction with each notice of an adjustment of rates provided to such policyholders following the date the carrier ceases to offer and issue such plans. The notice to policyholders shall state that:

i. The carrier intends to cease offering and issuing individual plans in New Jersey;

ii. The carrier will continue to renew the policyholder's health benefits plan at the policyholder's option; and

iii. The policyholder may obtain information about individual health benefits plans offered by other carriers by calling 1-800-838-0935 for a free Individual Health Coverage Program Buyer's Guide or may obtain information on the Department of Banking and Insurance website at: http://www.nj.gov/dobi/reform.htm.

(b) A carrier that notifies the Board under this section shall continue to renew all in force individual plans until it obtains the Department's approval for market withdrawal in accordance with N.J.A.C. 11:20-18.5.

(c) A carrier that has ceased offering and issuing individual plans pursuant to N.J.S.A. 17B:27A-8b and N.J.A.C. 11:20-11, but has not withdrawn from the market in accordance with N.J.A.C. 11:20-18.5, may resume offering and issuing standard individual health benefits plans to eligible persons after it has notified the Department and the Board, in writing, that it intends to resume offering individual plans. Upon receipt of such notice, the Board shall distribute the carrier's filed rates in conjunction with the Individual Health Coverage Program Buyer's Guide.

(d) A carrier with in force individual plans that has ceased to offer and issue all of its individual plans pursuant to this section shall nevertheless continue to comply with all other provisions of the law.

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