New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 1 - NEW JERSEY INSOLVENT HEALTH MAINTENANCE ORGANIZATION ASSISTANCE ASSOCIATION
Section 11:4-1.5 - Application procedures and filing format

Universal Citation: NJ Admin Code 11:4-1.5

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

(a) Any member organization seeking relief shall submit such request to the Department as set forth in (f) below no later than 15 days following the due date of payment of the assessment.

(b) All requests shall be accompanied by a statement averring a need for relief from the obligation, including supporting documentation as set forth in 11:4-1.6, and shall specify the statutory and regulatory basis for such relief.

(c) Each request shall be in loose leaf form inserted into standard two-ring or three-ring binders tabbed or otherwise indexed to correspond to the exhibits set forth in 11:4-1.6. The loose leaf sheets used in the request shall be eight and one-half inches wide and 11 inches long and punched for two-ring or three-ring binders, as appropriate.

(d) All member organizations requesting relief pursuant to this subchapter shall submit five copies of each request in the format set forth in (c) above.

(e) If a request fails materially to comply with the filing format and information requirements set forth in 11:4-1.6 and this section, the Department shall notify the member organization that its request for relief is deficient and is denied on such grounds within 15 days of receipt of the request. The notice shall also set forth any information or other action required to cure the deficiency(s). If the member organization intends to pursue its request, the member organization shall submit the additional information specified or otherwise submit a filing in accordance with the format requirements specified in this section within 15 days of receipt of the Department's notice of deficiency. Failure to submit within 15 days the information necessary in the proper format to cure the deficiency shall result in the member organization's request being denied.

(f) All requests for relief or other information required pursuant to this subchapter shall be filed with the Department at the following address:

HMO Assistance Fund

Request for Relief

New Jersey Department of Banking and Insurance

Office of Financial Examinations

PO Box 325

Trenton, NJ 08625-0325

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