New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 23A - MEDICARE SUPPLEMENT-UNDER 50 COVERAGE
Section 11:4-23A.9 - Equitable sharing of losses and audit
Current through Register Vol. 56, No. 6, March 18, 2024
(a) Net losses of the Under 50 Plan shall be apportioned among insurers and HMOs as set forth in the plan of operation of the Under 50 Plan.
(b) Assessments for net losses of the Under 50 Plan may be determined or apportioned, and may include calculations based upon the information provided pursuant to 11:4-23A.8, but the contracting carrier shall not be reimbursed for its total reported net losses until the conclusion of an audit of the losses reported by the contracting carrier and its related operations, conducted in accordance with the Under 50 Plan of operation. The contracting carrier may be paid for a portion of its reported net losses prior to the completion of the audit, as provided in the Under 50 Plan plan of operation. The cost of such audit shall be paid as an administrative expense of the Under 50 Plan.
