Current through Register Vol. 54, No. 7, April 4, 2022
of the employer's completed "Request for Information Form" and "Statement of
Insurance Coverage," the Premium Support Program will initiate a two step
review of the employer plan to determine if the plan meets the Division's plan
participation requirements, as follows:
Step I: The employer-sponsored plan shall be compared, benefit-by-benefit, to
the NJ FamilyCare Plan 'D' service package, to determine whether the
employer-sponsored plan's services are the same services the employee would be
eligible for under NJ FamilyCare.
i. If the
employer is a large employer, both the specific services and the extent of
coverage of the services shall be at least equal to the services in the NJ
FamilyCare Plan D service package.
ii. If the employer is a small employer, the
specific services shall be identical to the services in the NJ FamilyCare Plan
D service package; however, the extent of coverage of the services need not be
the same as the extent of coverage in the NJ FamilyCare Plan D service package.
For small employer health plan information, refer to N.J.A.C. 11:21.
Step II: The employer plan will
be evaluated for cost effectiveness, in accordance with
N.J. Admin. Code §
The following state regulations pages link to this page.
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