New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM
Subchapter 6 - INDIVIDUAL HEALTH BENEFITS CARRIERS INFORMATIONAL RATE FILING REQUIREMENTS
Section 11:20-6.4 - Informational rate filing procedures
Current through Register Vol. 56, No. 6, March 18, 2024
(a) A member shall file one copy of the informational rate filing with the Department pursuant to 11:20-6.3(a) or (b) at the following address: New Jersey Dept. of Banking and Insurance
Life & Health Actuarial: IHC Rate Filings
PO Box 325
20 West State Street
Trenton, NJ 08625
(b) If the Commissioner determines that an informational filing filed pursuant to 11:20-6.3(a) or (b) is incomplete but in substantial compliance with 17B:27A-2 et seq., the Commissioner shall provide written notice to the member specifying those portions of the filing which are deficient and the information required to be submitted or resubmitted by the member.
(c) Within 30 days of receipt of a written notice as referenced in (b) above, the member shall provide the Department with the information required to complete the filing. Failure to provide this information may result in the imposition of penalties specified in 17B:27A-43 and/or revision of rates to the last filed rate.
(d) If the Commissioner determines that a filing is incomplete and not in substantial compliance, that the rates are inadequate, or that the rates are unfairly discriminatory, the Commissioner shall provide written notice to the member specifying the information required to be submitted, and specifying in addition the basis for the finding that the filing is not in substantial compliance, or, if applicable, that the rates are inadequate or unfairly discriminatory. The rate filing shall not become effective until the Commissioner has confirmed in writing that the basis for disapproval is cured.
(e) Upon the issuance of a notice as set forth in (d) above, the member shall submit any additional information required to make the filing complete in accordance with (c) above. A carrier may appeal the Commissioner's determination that the filing is not in substantial compliance or that the rates are inadequate or unfairly discriminatory and request a hearing within 20 days of receipt of the written notice set forth in (d) above.
