New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 24A - HEALTH CARE QUALITY ACT APPLICATION TO INSURANCE COMPANIES, HEALTH SERVICE CORPORATIONS, HOSPITAL SERVICE CORPORATIONS, AND MEDICAL SERVICE CORPORATIONS
Subchapter 2 - PROVISIONS APPLICABLE TO ALL CARRIERS
Section 11:24A-2.5 - Other rights of covered persons
Universal Citation: NJ Admin Code 11:24A-2.5
Current through Register Vol. 56, No. 6, March 18, 2024
(a) Every carrier shall establish and implement written policies and procedures regarding the rights of covered persons and the implementation of these rights.
(b) Carriers' policies and procedures shall address at least the following:
1. The right
of covered persons to receive all of the disclosures set forth at
11:24A-2.3;
2. The right of covered person to have access
to services, and payment of appropriate benefits therefor, when medically
necessary, including availability of care 24 hours a day, seven days a week for
urgent or emergency conditions, if covered;
3. The right of covered persons to be treated
with courtesy, consideration, and with respect to the covered person's dignity
and need for privacy; and
4. The
right of covered persons to obtain information regarding the carrier's policies
and procedures concerning (b)1 through 3 above.
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