New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 21 - SMALL EMPLOYER HEALTH BENEFITS PROGRAM
Subchapter 16 - WITHDRAWALS FROM THE SMALL EMPLOYER HEALTH BENEFITS PLANS MARKET AND WITHDRAWALS OF PLANS, PLAN OPTIONS AND COPAYMENT/ DEDUCTIBLE OPTIONS
Section 11:21-16.2 - Definitions

Universal Citation: NJ Admin Code 11:21-16.2
Current through Register Vol. 56, No. 18, September 16, 2024

Words and terms, when used in this subchapter, shall have the meanings set forth in the Act or at 11:21-1.2 unless defined below or unless the context clearly indicates otherwise:

"Affiliate" or "affiliated company" means a carrier that directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, the carrier that initiates a withdrawal.

"Cease doing business" for purposes of these rules means withdraw or withdrawal.

"Market withdrawal" means the nonrenewal on the anniversary date of all inforce nonstandard health benefits plans or small employer health benefits plans, or both as appropriate, issued to small employers without offering replacement with a small employer health benefits plan (or a nonstandard health benefits plan, if offered through an association, multiple employer arrangement or out-of-State trust that continues to market its nonstandard health benefits plans pursuant to 17B:27A-17 et seq.), except where such action is taken pursuant to N.J.S.A. 17B:27A-23a, c, d, f, h and i or is approved by the Commissioner in accordance with N.J.A.C. 11:21-11.

"Nonstandard health benefits plan" means a health benefits plan policy or contract form under which policies, contracts or certificates were issued on or before December 31, 1993 to small employers or to one or more employees of a small employer by virtue of the employment arrangement.

"Plan option withdrawal" means a carrier's cessation of the issuance of a standard health benefits plan option and the nonrenewal on the anniversary date of all inforce standard small employer health benefits plans issued with that option.

"Plan withdrawal" means a carrier's cessation of the issuance of a standard health benefits plan and the nonrenewal on the anniversary date of all inforce small employer health benefits plans of that plan type.

"State" means the State of New Jersey.

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.