N.J. Admin. Code § 11:21-20.3 - Withdrawal of optional benefit riders

Current through Register Vol. 54, No. 7, April 4, 2022

(a) A carrier seeking to withdraw an optional benefit rider to a standard SEH plan that has been filed with the Commissioner and/or the Board pursuant to N.J.S.A. 17B:27A-19i(1) shall first obtain the Commissioner's approval by complying with all of the requirements of this subchapter.
(b) A carrier seeking to withdraw an optional benefit rider shall prior to withdrawal of the optional benefit rider submit a written application to the Commissioner as follows:
1. The written application shall include the following:
i. The name of the carrier;
ii. The name, address, telephone number and fax number of the carrier's representative responsible for the application to withdraw the optional benefit rider;
iii. The reason(s) the carrier is withdrawing the optional benefit rider;
iv. The number of inforce plans affected by the withdrawal;
v. A copy of the nonrenewal notice the carrier shall provide to policyholders or contractholders as described in (c) below;
vi. A copy of the nonrenewal notice the carrier shall provide to producers as described in (d) below; and
vii. A copy of the optional benefit rider the carrier is withdrawing, along with evidence of approval of the rider by the Department or acknowledgment of the rider by the SEH Board.
2. The completed application shall be sent to the following address:

New Jersey Department of Banking and Insurance

Life and Health Division

20 West State Street

PO Box 325

Trenton, NJ 08625-0325

3. The Department shall review the completed application for compliance with the requirements of this section, and shall provide the carrier within 30 days of receipt with written notice of any deficiencies in the application or with an acknowledgment that the application is complete and in compliance with the requirements of this section.
4. The carrier shall return to the Department an amended application correcting any deficiencies within 30 days of receipt of the Department's deficiency notice.
5. The carrier shall cease issuing the optional benefit rider no later than 60 days after the date that acknowledgment of a complete application to withdraw the optional benefit rider is received.
(c) In addition to meeting all of the other requirements of this subchapter, a carrier seeking to withdraw an optional benefit rider shall provide written notice of nonrenewal of the optional benefit rider to the policyholder or contractholder as follows:
1. An initial notice of nonrenewal shall be provided at least 90 days prior to the anniversary date of the optional benefit rider, and shall include the following:
i. A statement that the carrier has elected to nonrenew the optional benefit rider pursuant to the authority of this subchapter;
ii. A statement that the optional benefit rider shall be nonrenewed on the anniversary date of the rider;
iii. A statement that the carrier shall offer the policyholder the option to purchase any other optional benefit riders that the carrier offers in the small employer market;
iv. A statement that the policyholder or contractholder may contact his or her producer, if any, for additional information regarding the optional benefit rider withdrawal;
v. The name, address and telephone number of the employee or agent of the carrier who may be contacted for assistance and information regarding the optional benefit rider withdrawal; and
vi. A statement that in choosing to nonrenew the optional benefit rider and offering all other health insurance the carrier offers in the small employer market, the carrier is acting uniformly without regard to the claims experience of the policyholder or contractholder or to any health status-related factors relating to any participants or beneficiaries covered or new participants or beneficiaries who may become eligible for coverage.
2. In addition to the nonrenewal notice described in (c)1 above, a subsequent notice of nonrenewal shall be included with each monthly premium bill or premium notice issued prior to the date of nonrenewal. If no monthly premium statement is issued, a subsequent notice of nonrenewal shall be provided at least 30 days prior to nonrenewal. The notice shall contain at least the information set forth at (c)1ii and v above.
(d) In addition to meeting all of the other requirements of this subchapter, a carrier seeking to withdraw an optional benefit rider shall provide at least 90 days prior to the anniversary date of the optional benefit rider, a written notice of nonrenewal to the producer of record, if any, for each policy or contract, as follows:
1. The nonrenewal notice to the producer shall include the following:
i. A statement that the carrier has elected to nonrenew the optional benefit rider pursuant to the authority of this subchapter;
ii. The date the optional benefit rider shall be nonrenewed;
iii. A statement that the carrier will offer the policyholder or contractholder the option to purchase all other optional benefit riders that the carrier offers in the small employer market; and
iv. The name, address and telephone number of the employee or agent of the carrier who may be contacted for assistance and information regarding the optional benefit rider withdrawal.

Notes

N.J. Admin. Code § 11:21-20.3

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