New Jersey Administrative Code
Title 11 - INSURANCE
Chapter 4 - ACTUARIAL SERVICES
Subchapter 28 - GROUP COORDINATION OF BENEFITS
Section 11:4-28.3 - Coordination permissive
Universal Citation: NJ Admin Code 11:4-28.3
Current through Register Vol. 56, No. 6, March 18, 2024
(a) The use of COB provisions in group contracts providing health care benefits shall be permissive; any plan may elect to be always "primary". Where COB is used, it shall be included in group contracts providing health care benefits subject to the following conditions:
1. If a group
contract includes a COB provision, it shall be consistent with the requirements
of this subchapter.
2. A plan that
does not include a COB provision shall not take the benefits of another plan
into account in determining its benefits.
(b) Group coverage that is designed to supplement a part of a basic package of benefits may provide that the supplementary coverage shall be excess to any other parts of a plan provided by the same contract holder.
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