New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 23 - THIRD-PARTY ADMINISTRATORS
Subchapter 3 - THIRD PARTY ADMINISTRATORS
Section 11:23-3.2 - Access to certain information by the Commissioner

Universal Citation: NJ Admin Code 11:23-3.2

Current through Register Vol. 56, No. 6, March 18, 2024

(a) The Commissioner shall have access to all books and records of a third party administrator for the purposes of examination, audit and inspection, the reasonable expense of which shall be paid to the Department by the third party administrator. Any trade secrets, proprietary information, information which if disclosed would give an advantage to competitors or bidders and the identities and addresses of enrollees contained in the books and records shall be kept confidential, except that the Commissioner may use the information in any proceeding instituted against the administrator or benefits payer.

(b) The benefits payer shall own the records generated by the administrator pertaining to the benefits payer, except that the administrator shall retain the right to continuing access to such books and records to permit the administrator to fulfill all of its contractual obligations to the benefits payer and its obligations to the Department.

(c) In the event that an agreement between an administrator and a benefits payer is canceled, the administrator may, with the written agreement of the benefits payer, transfer all records to a new administrator instead of retaining them for five years.

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