Current through Register Vol. 54, No. 7, April 4, 2022
A carrier may
amend a nonstandard health benefits plan that has been approved or deemed
approved by the Commissioner by submitting for approval the amendment together
with a new, completed Checklist and Certification set forth in Part 5 of
Exhibit BB of the Appendix to this chapter.
1. Each such filing shall comply with
N.J.A.C. 11:4-40, except that only one copy of the form(s) need be
2. The carrier shall
submit a separate Checklist and Certification for each nonstandard health
benefits plan form being amended, clearly identifying the nonstandard health
benefits plan form, and the date(s) previous certification(s) made in
compliance with this subchapter were filed.
3. The carrier shall certify on the Checklist
and Certification, for each plan being amended that the amendment to the
nonstandard health benefits plan does not reduce the actuarial value or the
benefits coverage of the nonstandard health benefits plan below the benefits
coverage of Plan A and the actuarial value of the standard health benefits plan
with the lowest actuarial value of the standard health benefits plans created
by the Board.
4. The carrier
simultaneously shall submit an explanation of the manner in which the amendment
to the nonstandard health benefits plan affects the premiums for the health
benefits plan, in accordance with N.J.A.C. 11:21-8.
Notwithstanding (a) above, a carrier
shall not amend a nonstandard health benefits plan for six months following the
date that the first contract or policy under the nonstandard health benefits
plan becomes effective with that carrier if the carrier agreed to add the
nonstandard health benefits plan to its portfolio at the request of a small
employer pursuant to N.J.S.A. 17B:27A-19j(12) and