New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 22 - HEALTH BENEFIT PLANS
Subchapter 2 - HEALTH WELLNESS PROMOTION PLANS
Section 11:22-2.2 - Definitions

The following words and terms, when used in this subchapter, shall have the meanings as set forth below, unless the context clearly indicates otherwise:

"Act" means the Health Wellness Promotion Act, P.L. 1993, c.327, as amended by P.L. 1999, c. 339.

"Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation or health maintenance organization authorized to issue health benefits plans in this State.

"Department" means the Department of Banking and Insurance.

"Health benefits plan" means an individual or group contract issued by a carrier that provides hospital and medical expense benefits or services. Health benefits plan does not include the following types of policies or contracts: health benefit plans subject to 17B:27A-2 et seq. (Individual Health Coverage Program) or 17B:27A-17 et seq. (Small Employer Health Program); accident only, credit, disability, hospital confinement indemnity, long-term care, vision only, dental only, prescription only, CHAMPUS supplement, Medicare supplement, coverage for Medicare services pursuant to a contract with the United States government, coverage for Medicaid services pursuant to a contract with the State, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance or other liability-based medical payment insurance, or personal injury protection insurance issued pursuant to 39:6A-1 et seq.

"Health care provider" or "provider" means an individual or entity which, acting within the scope of its license or certification, provides a covered service or supply as defined by the health benefits plan. Health care provider includes, but is not limited to, the health professions specified in N.J.S.A. 17B:48E-12, 17B:27-50 and 17B:27-51.1a.

"Health wellness promotion program" means services or benefits for services rendered by a health care provider, which services or benefits are consistent with this subchapter, and any bulletins and public notices that may be issued in accordance with this subchapter as a supplement to this subchapter.

"Schedule" means the number of times a test, screen or other service must be covered or benefits provided therefor in a specified period.