Current through Register Vol. 56, No. 6, March
18, 2024
(a) No insurer
shall deliver or issue for delivery in this State any form unless the form has
been approved by the Commissioner pursuant to the procedures set forth in this
subchapter, except for those forms eligible for submission to the Commissioner
pursuant to the file and use system described in this subchapter at
11:4-40.9 and 40.10 or
specifically exempt from compliance with this subchapter.
(b) An insurer seeking approval of a form
shall transmit a complete form filing to the Department, which shall include
the items set forth below:
1. A properly
completed Initial Submission Data Form as set forth on the Department's website
at:
www.state.nj.us/dobi/division_insurance/pdfs/lhfmsub.pdf;
2. A specimen copy of the form;
3. A cover letter, which shall include the
following:
i. The insurer's
identity;
ii. The form number(s) of
the form(s) being submitted. If several forms are being submitted, the form
numbers may be included as an attachment to the cover letter;
iii. A general description of the nature of
the form(s), including, but not limited to, the specific market and issue
ages;
iv. The identity of one
individual authorized as the insurer's contact person for the form(s) being
filed;
v. A statement as to whether
the form was previously submitted to the Department, including the date and
status of any such submission;
vi.
For rider forms or endorsements, an explanation of the manner in which the
rider or endorsement affects the mortality basis or premiums for the base
policy; and
vii. The contents of
the cover letter in (b)3i through vi above shall be included in the Filing
Description Field within SERFF or as a separate line entry attached to the
Supporting Documentation tab;
4. A certification signed by a responsible
officer of the insurer that the forms comply with all laws, rules, bulletins
and published guidelines applicable to the particular type of form. The
certification may be included in the text of the cover letter described in (b)3
above if the cover letter is signed by a responsible officer of the
insurer;
5. A readability
certification if required pursuant to N.J.S.A. 17B:17-21d;
6. An actuarial memorandum which complies
with the requirements of any applicable statutes, rules or published
guidelines, and premium rates if required by this subchapter or other law or
rule, for the particular type of form being submitted;
7. Any additional items required to be
submitted for forms as specifically set forth at other sections of this
subchapter;
8. Where the form
submitted is a rider, endorsement, insert page or supplemental form, a listing
of the policy form number(s) and approval date(s) of the policy form(s) with
which the form submitted is to be used and a specimen copy of an approved
policy form; and
9. All forms and
attachments should be in a PDF format.
(c) The Department shall, within 25 days of
the date of an initial filing, return an incomplete filing to the insurer with
a notice indicating that the filing is being returned with no action by the
Department, and that time for the Department's substantive review for approval
of the form and/or rate filing has not commenced.
(d) A form/rate filing shall be deemed
approved upon the expiration of 60 days following submission of the filing to
the Commissioner unless the Department approves or disapproves the filing in
writing within that 60-day period. If approval is deemed, the insurer shall
notify the Department in writing prior to use of its intent to use the form.
1. The Department's written disapproval of a
filing shall include the specific reasons for the disapproval, which shall be
limited to only the standards set forth in this subchapter at
11:4-40.3, and in any laws, rules,
bulletins or published guidelines applicable to the particular type of form
being disapproved.
2. A form filing
which is disapproved by the Department prior to the expiration of the 60-day
disapproval period shall be deemed withdrawn at the expiration of the 60-day
period following notice of disapproval unless the insurer resubmits the
disapproved form filing within the 60-day period pursuant to the procedures set
forth in (e) below.
(e)
An insurer may resubmit a form filing which has been disapproved by the
Commissioner pursuant to (d) above. The resubmission shall include the items
set forth below:
1. A cover letter submitted
as a separate line entry attached to the Supporting Documentation tab, which
shall include the Department's submission number and shall indicate all changes
made and/or comments which address the Department's previous objections. The
cover letter shall also indicate any changed form number(s) and/or the form
number(s) of any new form(s) included;
2. The revised form(s) or page(s) only, if
practicable, of the disapproved form(s). One copy shall be marked to show the
changes from the prior submission, and one copy shall be unmarked. The marked
copy shall be underlined such that the changes will be discernable when
printed. The resubmission shall also include a marked copy of any revised
support material (for example, an actuarial memorandum);
3. A certification signed by a responsible
officer of the insurer that the resubmission is the same as the original form
filing, with the exception of the item(s) identified as modified or new;
and
4. The resubmission shall
completely respond to all the objections raised in the Department's disapproval
of the initial or previous submission; otherwise, the Department shall return
the resubmission as incomplete.
(f) A complete form filing resubmission shall
be deemed approved upon the expiration of 30 days following resubmission of the
filing to the Commissioner unless the Department approves or disapproves the
resubmission in writing within that 30-day period. If approval is deemed, the
insurer shall notify the Department in writing prior to use of its intent to
use the form.
1. The Department's written
disapproval of a form filing resubmission shall include the specific reasons
for disapproval of the resubmission, which shall be limited to only the
objections specifically stated in the Department's initial disapproval of the
form filing except to the extent that the resubmission contains new provisions
not included in the initially disapproved form filing or any changes or
modifications to any substantive provisions of the form filing.
(g) If the Department issues a
written disapproval of a resubmitted form filing prior to the expiration of the
30-day disapproval period, the filing shall be deemed withdrawn at the
expiration of the 30-day period following disapproval unless the insurer
resubmits a disapproved form filing within the 30-day period pursuant to the
procedures set forth in this subsection.
