New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 23A - MEDICARE SUPPLEMENT-UNDER 50 COVERAGE
Section 11:4-23A.10 - Assessments
Current through Register Vol. 56, No. 18, September 16, 2024
(a) Every insurer and HMO providing health benefits plans or health maintenance organization subscriber contracts in this State shall be liable for an assessment to pay its equitable share of any net loss incurred by the Under 50 Plan in the previous calendar year, unless the insurer or HMO has received an exemption or deferment from the Commissioner.
(b) The assessment of each insurer and HMO described in (a) above shall be in the proportion that its net earned premium bears to the net earned premium of all insurers and HMOs, except that no insurer or HMO shall be liable for an assessment amount greater than 35 percent of the total net loss incurred by the Under 50 Plan in any calendar year.
(c) Assessment amounts for insurers or HMOs granted a deferment or exemption, or that portion of assessment that exceeds the 35 percent limit noted in (b) above, shall be reapportioned to other insurers and HMOs based on their respective adjusted market share.
(d) Assessments shall be due and payable upon receipt by the insurer or HMO of the invoice for the assessment. Any assessment, or portion of an assessment, not paid within 30 days of the date of the invoice shall be subject to interest of 1.5 percent of the assessment amount not timely paid per month, accruing from the date of the invoice of the assessment.
