N.J. Admin. Code § 11:21-11.8 - Agreement by a carrier to add a nonstandard health benefits plan to its portfolio

(a) A carrier may agree to add a nonstandard health benefits plan not currently being offered by the carrier to its portfolio of small employer health benefits plans at the request of either an association, multiple employer arrangement, trust or a single small employer if that nonstandard health benefits plan has been renewed by the current carrier in accordance with this subchapter and upon the new carrier filing the nonstandard health benefits plan with the Commissioner in accordance with N.J.A.C. 11:4-40 and submission of a completed Checklist and Certification as set forth in Part 5 of Exhibit BB of the Appendix to this chapter.

(b) The filing carrier simultaneously shall comply with N.J.A.C. 11:21-11.6, with initial date of marketing of the nonstandard health benefits plan specified in writing by the filing carrier, which date shall be no later than the effective date of the filing carrier's obligations pursuant to any contract transferred to the filing carrier under the nonstandard health benefits plan.

(c) Upon written request by the Department, the carrier currently marketing the nonstandard health benefits plan shall submit to the Department in writing for each nonstandard health benefits plan form being accepted by a filing carrier the current carrier's identification of the nonstandard health benefits plan form, and the date(s) the current carrier's checklists and certification(s) with appropriate statements made in compliance with this subchapter for the nonstandard health benefits plan form(s) were filed by the Department (including amendments thereto, if any).

(d) If the filing carrier is accepting the nonstandard health benefits plan upon the request of an association, trust or multiple employer arrangement, the filing carrier may amend the nonstandard health benefits plan form to be effective simultaneously with the effective date of the filing carrier's obligations pursuant to any contract transferred to the filing carrier under the nonstandard health benefits plan, subject to the filing carrier filing an amendment made in accordance with N.J.A.C. 11:21-11.7.

(e) If the filing carrier agrees to add a nonstandard health benefits plan to its portfolio at the request of a small employer, the filing carrier shall not amend the nonstandard health benefits plan for six months following the date that the filing carrier's obligations pursuant to the contract issued to the small employer under the nonstandard health benefits plan becomes effective.

1. Any amendment made subsequently shall be made by the filing carrier in accordance with N.J.A.C. 11:21-11.7.

(f) A filing carrier shall not make a request to withdraw a nonstandard health benefits plan that it adds to its portfolio of small employer health benefits plans for at least one 12 month period following the date that the filing carrier's obligations pursuant to contracts issued under the nonstandard health benefits plan first become effective.

Notes

N.J. Admin. Code § 11:21-11.8