Current through Register Vol. 56, No. 6, March
18, 2024
(a) A carrier
seeking to withdraw an optional benefit rider to a standard SEH plan that has
been filed with the Commissioner and/or the Board pursuant to N.J.S.A.
17B:27A-19i(1) shall first obtain the Commissioner's approval by complying with
all of the requirements of this subchapter.
(b) A carrier seeking to withdraw an optional
benefit rider shall prior to withdrawal of the optional benefit rider submit a
written application to the Commissioner as follows:
1. The written application shall include the
following:
i. The name of the
carrier;
ii. The name, address,
telephone number and fax number of the carrier's representative responsible for
the application to withdraw the optional benefit rider;
iii. The reason(s) the carrier is withdrawing
the optional benefit rider;
iv. The
number of inforce plans affected by the withdrawal;
v. A copy of the nonrenewal notice the
carrier shall provide to policyholders or contractholders as described in (c)
below;
vi. A copy of the nonrenewal
notice the carrier shall provide to producers as described in (d) below;
and
vii. A copy of the optional
benefit rider the carrier is withdrawing, along with evidence of approval of
the rider by the Department or acknowledgment of the rider by the SEH
Board.
2. The completed
application shall be sent to the following address:
New Jersey Department of Banking and Insurance
Life and Health Division
20 West State Street
PO Box 325
Trenton, NJ 08625-0325
3. The Department shall review the completed
application for compliance with the requirements of this section, and shall
provide the carrier within 30 days of receipt with written notice of any
deficiencies in the application or with an acknowledgment that the application
is complete and in compliance with the requirements of this section.
4. The carrier shall return to the Department
an amended application correcting any deficiencies within 30 days of receipt of
the Department's deficiency notice.
5. The carrier shall cease issuing the
optional benefit rider no later than 60 days after the date that acknowledgment
of a complete application to withdraw the optional benefit rider is received.
(c) In addition to
meeting all of the other requirements of this subchapter, a carrier seeking to
withdraw an optional benefit rider shall provide written notice of nonrenewal
of the optional benefit rider to the policyholder or contractholder as follows:
1. An initial notice of nonrenewal shall be
provided at least 90 days prior to the anniversary date of the optional benefit
rider, and shall include the following:
i. A
statement that the carrier has elected to nonrenew the optional benefit rider
pursuant to the authority of this subchapter;
ii. A statement that the optional benefit
rider shall be nonrenewed on the anniversary date of the rider;
iii. A statement that the carrier shall offer
the policyholder the option to purchase any other optional benefit riders that
the carrier offers in the small employer market;
iv. A statement that the policyholder or
contractholder may contact his or her producer, if any, for additional
information regarding the optional benefit rider withdrawal;
v. The name, address and telephone number of
the employee or agent of the carrier who may be contacted for assistance and
information regarding the optional benefit rider withdrawal; and
vi. A statement that in choosing to nonrenew
the optional benefit rider and offering all other health insurance the carrier
offers in the small employer market, the carrier is acting uniformly without
regard to the claims experience of the policyholder or contractholder or to any
health status-related factors relating to any participants or beneficiaries
covered or new participants or beneficiaries who may become eligible for
coverage.
2. In addition
to the nonrenewal notice described in (c)1 above, a subsequent notice of
nonrenewal shall be included with each monthly premium bill or premium notice
issued prior to the date of nonrenewal. If no monthly premium statement is
issued, a subsequent notice of nonrenewal shall be provided at least 30 days
prior to nonrenewal. The notice shall contain at least the information set
forth at (c)1ii and v above.
(d) In addition to meeting all of the other
requirements of this subchapter, a carrier seeking to withdraw an optional
benefit rider shall provide at least 90 days prior to the anniversary date of
the optional benefit rider, a written notice of nonrenewal to the producer of
record, if any, for each policy or contract, as follows:
1. The nonrenewal notice to the producer
shall include the following:
i. A statement
that the carrier has elected to nonrenew the optional benefit rider pursuant to
the authority of this subchapter;
ii. The date the optional benefit rider shall
be nonrenewed;
iii. A statement
that the carrier will offer the policyholder or contractholder the option to
purchase all other optional benefit riders that the carrier offers in the small
employer market; and
iv. The name,
address and telephone number of the employee or agent of the carrier who may be
contacted for assistance and information regarding the optional benefit rider
withdrawal.
