New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 24 - HEALTH MAINTENANCE ORGANIZATIONS
Subchapter 5 - HEALTH CARE SERVICES
Section 11:24-5.5 - Health promotion programs

Universal Citation: NJ Admin Code 11:24-5.5

Current through Register Vol. 56, No. 24, December 18, 2024

(a) In accordance with N.J.S.A. 26:2J-4.6, and rules promulgated pursuant thereto, including N.J.A.C. 11:22-2, HMOs shall provide a health promotion program.

(b) An HMO shall not be required to provide health wellness promotion program services to members in values exceeding the dollar amounts established by the Commissioner as published as a public notice periodically in the New Jersey Register.

(c) The Commissioner, in consultation with the Department of the Treasury, shall adjust the threshold amounts in (b) above annually in direct proportion to the increase or decrease in the consumer price index for all urban consumers in the New York City and Philadelphia areas as reported by the United States Department of Labor. The adjustment shall become effective on July 1 of the year in which it is reported, or such other date as may be set forth in the public notice published in the New Jersey Register.

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