N.J. Admin. Code § 11:21-4.4 - Compliance and variability rider
(a) Notwithstanding
the requirements of
N.J.A.C.
11:21-4.1, members may incorporate regulatory
changes required to be made to the standard policy forms, standard HMO and HMO
POS contracts, certificates, and evidences of coverage for Plans B, C, D, E,
HMO, and HMO POS through the use of the Compliance and Variability Rider as set
forth as Exhibit DD of the Appendix, incorporated herein by reference, subject
to the following:
1. If expressly permitted
by the Board , the Compliance and Variability Rider may be issued by Members to
incorporate changes to the standard policy forms Plans B-E, HMO, and HMO POS
contracts, certificates, or evidences of coverage. Nothing contained herein
shall prevent a Member from issuing a standard policy form Plans B-E, HMO, or
HMO POS contract, certificate, or evidence of coverage which has incorporated
Board -promulgated changes.
(b) Notwithstanding the requirements of
N.J.A.C.
11:21-4.1, members may make any changes to
the standard policy forms, standard HMO and HMO POS contracts, certificates,
and evidences of coverage for Plans B, C, D, E, HMO, and HMO POS consistent
with the variability as explained in Exhibit K to this Appendix through the use
of the Compliance and Variability Rider as set forth as Exhibit DD of the
Appendix.
(c) Members may use the
Compliance and Variability Rider only as permitted by (a) and (b) above. In no
event shall the Compliance and Variability Rider be used in lieu of optional
benefit riders which riders are subject to filing requirements set forth in
N.J.A.C.
11:21-3.2.
Notes
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