New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 21 - SMALL EMPLOYER HEALTH BENEFITS PROGRAM
Subchapter 15 - RELIEF FROM OBLIGATIONS IMPOSED UNDER THE SMALL EMPLOYER HEALTH BENEFITS PROGRAM
Section 11:21-15.7 - Hearings
Universal Citation: NJ Admin Code 11:21-15.7
Current through Register Vol. 56, No. 6, March 18, 2024
(a) If the Commissioner denies a member's request for relief made pursuant to this subchapter, or if the member objects to the terms of the relief granted, the member may request a hearing on the Commissioner's determination within seven days from the date of receipt of such determination as follows:
1. A request for a hearing shall be in
writing and shall include:
i. The name,
address, and daytime telephone number of a contact person familiar with the
matter;
ii. A copy of the
Commissioner's determination;
iii.
A statement requesting a hearing; and
iv. A concise statement describing the basis
for which the member believes that the Commissioner's findings of fact are
erroneous.
2. The
Commissioner may, after receipt of a properly completed request for a hearing,
provide for an informal conference between the member and such personnel of the
Department as the Commissioner may direct, to determine whether there are
material issues of fact in dispute.
3. The Commissioner shall, within 30 days of
a properly completed request for a hearing, determine whether the matter
constitutes a contested case, pursuant to the Administrative Procedure Act,
52:14B-1 et seq.
i. If the Commissioner finds that the matter
constitutes a contested case, the Commissioner shall transmit the matter to the
Office of Administrative Law for a hearing consistent with the Uniform
Administrative Procedure Rules, N.J.A.C. 1:1.
ii. In a matter which has been determined to
be a contested case, if the Commissioner finds that there are no good-faith
disputed issues of material facts and the matter may be decided on the
documents filed, the Commissioner may notify the applicant in writing as to the
final disposition of the matter.
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