N.J. Admin. Code § 11:24-17.2 - General requirements
(a) The HMO
shall provide a written contract to the contractholder and an evidence of
coverage to each subscriber , which evidence of coverage may be incorporated
into the member handbook required pursuant to
N.J.A.C.
11:24-9.1.
1. The contract, evidence of coverage and
member handbook shall conform to the Life and Health Insurance Policy
Simplification Act,
N.J.S.A.
17B:17-17 et seq. as demonstrated by the
submission of a readability certification with a Flesch score for each
form.
(b) All documents
required to be delivered or issued for delivery in accordance with (a) above
shall be delivered or issued for delivery no later than 30 days following the
date of enrollment of the group, or notice to the HMO of enrollment of a
subscriber within the group.
(c) No
plan document shall be delivered or issued for delivery unless the form thereof
has been filed with the Department , and approved, or deemed approved, by the
Department .
Notes
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