N.J. Admin. Code Tit. 11, ch. 21 - SMALL EMPLOYER HEALTH BENEFITS PROGRAM
- Subchapter 1 - GENERAL PROVISIONS (§ 11:21-1.1 to 11:21-1.6)
- Subchapter 2 - NEW JERSEY SMALL EMPLOYER HEALTH BENEFITS PROGRAM PLAN OF OPERATION (§ 11:21-2.1 to 11:21-2.17)
- Subchapter 3 - STANDARD BENEFIT PLANS AND RIDERS (§ 11:21-3.1 to 11:21-3.2)
- Subchapter 3A - RESERVED
- Subchapter 4 - POLICY FORMS (§ 11:21-4.1 to 11:21-4.4)
- Subchapter 5 - RESERVED, version 5
- Subchapter 6 - STANDARD EMPLOYER AND EMPLOYEE APPLICATION AND SMALL EMPLOYER CERTIFICATION FORMS (§ 11:21-6.1 to 11:21-6.4)
- Subchapter 7 - PROGRAM COMPLIANCE (§ 11:21-7.1 to 11:21-7.16)
- Subchapter 7A - LOSS RATIO REPORTS; DIVIDENDS AND CREDITS (§ 11:21-7A.1 to 11:21-7A.5)
- Subchapter 8 - RESERVED, version 2
- Subchapter 9 - INFORMATIONAL RATE FILING REQUIREMENTS PURSUANT TO THE SMALL EMPLOYER HEALTH BENEFITS PROGRAM (§ 11:21-9.1 to 11:21-9.8)
- Subchapter 10 - THE MARKET SHARE REPORT (§ 11:21-10.1 to 11:21-10.6)
- Subchapter 11 - THROUGH 14 (RESERVED)
- Subchapter 15 - RELIEF FROM OBLIGATIONS IMPOSED UNDER THE SMALL EMPLOYER HEALTH BENEFITS PROGRAM (§ 11:21-15.1 to 11:21-15.11)
- Subchapter 16 - WITHDRAWALS FROM THE SMALL EMPLOYER HEALTH BENEFITS PLANS MARKET AND WITHDRAWALS OF PLANS, PLAN OPTIONS AND COPAYMENT/ DEDUCTIBLE OPTIONS (§ 11:21-16.1 to 11:21-16.8)
- Subchapter 17 - FAIR MARKETING STANDARDS (§ 11:21-17.1 to 11:21-17.5)
- Subchapter 18 - PETITIONS FOR RULES (§ 11:21-18.1 to 11:21-18.3)
- Subchapter 19 - THROUGH 22 (RESERVED)
- Subchapter 23 - RULEMAKING; PUBLIC NOTICES; INTERESTED PARTIES MAILING LIST (§ 11:21-23.1 to 11:21-23.6)
- Appendix - APPENDIX (Exhibit A to KK)
Notes
Effective: September 11, 2023.
See: 55 N.J.R. 2201(a).
CHAPTER HISTORICAL NOTE:
Chapter 21,
Subchapter 14, Declaration and Approval of Reinsuring or Risk-Assuming
Subchapter 15, Relief From Obligations Imposed Under the
Subchapter 6, Standard Employer and
Subchapter 3A, Non-
Subchapter 9, Informational Rate Filing Requirements Pursuant to the
Subchapter 16, Withdrawals of
Subchapter 2, New Jersey
Subchapter 8,
Subchapter 11, Nonstandard
Subchapter 11, Nonstandard
Subchapter 19, SEH
Subchapter 7A, Loss Ratio Reports; Dividends and Credits, was adopted as R.1996 d.213, effective May 6, 1996. See: 28 N.J.R. 59(a), 28 N.J.R. 234(b), 28 N.J.R. 2388(a).
Subchapter 3A, Non-
Subchapter 13, Nonstandard Plans: Withdrawal of Plans, was adopted as R.1997 d.126, effective March 17, 1997. See: 28 N.J.R. 4364(a), 29 N.J.R. 887(b).
Pursuant to Executive Order No. 66(1978), Subchapters 1 through 7, 8, 10, 17, 18, and Appendix Exhibits A through KK of Chapter 21,
Subchapter 20, Withdrawals of Standard SEH Plan Optional Benefit Riders, was adopted as R.1999 d.156, effective May 17, 1999. See: 31 N.J.R. 109(a), 31 N.J.R. 1357(a).
Subchapters 1, 2, 3, 4, 5, 6, 7, 8, 10, 17, 18, 23 and Appendix Exhibits H, N, O, T, CC, DD, and KK were readopted as R.2004 d.107, effective February 19, 2004. Subchapters 7A, 9, 11, 13, 15, 16, 19 and Appendix Exhibits BB, FF, and GG, were readopted as R.2004 d.108, effective February 19, 2004. As part of R.2004, d.107, Subchapter 5, Standard Claim Form, was repealed effective March 15, 2004. See: 35 N.J.R. 5011(a), 36 N.J.R. 1594(a); 35 N.J.R. 4438(a), 36 N.J.R. 1605(a).
Subchapter 20, Withdrawals of Standard SEH Plan Optional Benefit Riders, was readopted as R.2004 d.149, effective March 18, 2004. See: 36 N.J.R. 145(a), 36 N.J.R. 1942(a).
Subchapter 3A, Non-Standard Health Benefits Plans, expired on
Chapter 21,
Chapter 21,
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 21,
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 21,
Chapter 21,
Chapter 21,
Chapter 21,
CHAPTER AUTHORITY:
N.J.S.A. 17:1-8.1, 17:1-15.e, and 17B:27A-17 et seq.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
- Subchapter 1 - GENERAL PROVISIONS (§ 11:21-1.1 to 11:21-1.6)
- Subchapter 2 - NEW JERSEY SMALL EMPLOYER HEALTH BENEFITS PROGRAM PLAN OF OPERATION (§ 11:21-2.1 to 11:21-2.17)
- Subchapter 3 - STANDARD BENEFIT PLANS AND RIDERS (§ 11:21-3.1 to 11:21-3.2)
- Subchapter 3A - RESERVED
- Subchapter 4 - POLICY FORMS (§ 11:21-4.1 to 11:21-4.4)
- Subchapter 5 - RESERVED, version 5
- Subchapter 6 - STANDARD EMPLOYER AND EMPLOYEE APPLICATION AND SMALL EMPLOYER CERTIFICATION FORMS (§ 11:21-6.1 to 11:21-6.4)
- Subchapter 7 - PROGRAM COMPLIANCE (§ 11:21-7.1 to 11:21-7.16)
- Subchapter 7A - LOSS RATIO REPORTS; DIVIDENDS AND CREDITS (§ 11:21-7A.1 to 11:21-7A.5)
- Subchapter 8 - RESERVED, version 2
- Subchapter 9 - INFORMATIONAL RATE FILING REQUIREMENTS PURSUANT TO THE SMALL EMPLOYER HEALTH BENEFITS PROGRAM (§ 11:21-9.1 to 11:21-9.8)
- Subchapter 10 - THE MARKET SHARE REPORT (§ 11:21-10.1 to 11:21-10.6)
- Subchapter 11 - NONSTANDARD HEALTH BENEFITS PLANS FILINGS WITH THE COMMISSIONER: REQUIREMENTS FOR MAINTAINING NONSTANDARD PLANS (§ 11:21-11.1 to 11:21-11.11)
- Subchapter 12 - RESERVED
- Subchapter 13 - NONSTANDARD PLANS: WITHDRAWAL OF PLANS (§ 11:21-13.1 to 11:21-13.7)
- Subchapter 14 - RESERVED
- Subchapter 15 - RELIEF FROM OBLIGATIONS IMPOSED UNDER THE SMALL EMPLOYER HEALTH BENEFITS PROGRAM (§ 11:21-15.1 to 11:21-15.11)
- Subchapter 16 - WITHDRAWALS FROM THE SMALL EMPLOYER HEALTH BENEFITS PLANS MARKET AND WITHDRAWALS OF PLANS, PLAN OPTIONS AND COPAYMENT/ DEDUCTIBLE OPTIONS (§ 11:21-16.1 to 11:21-16.8)
- Subchapter 17 - FAIR MARKETING STANDARDS (§ 11:21-17.1 to 11:21-17.5)
- Subchapter 18 - PETITIONS FOR RULES (§ 11:21-18.1 to 11:21-18.3)
- Subchapter 19 - SEH PROGRAM PREMIUM COMPARISON SURVEY (§ 11:21-19.1 to 11:21-19.4)
- Subchapter 20 - WITHDRAWALS OF STANDARD SEH PLAN OPTIONAL BENEFIT RIDERS (§ 11:21-20.1 to 11:21-20.3)
- Subchapter 21 - SMALL EMPLOYER PURCHASING ALLIANCES (§ 11:21-21.1 to 11:21-21.6)
- Subchapter 22 - RESERVED, version 2
- Subchapter 23 - RULEMAKING; PUBLIC NOTICES; INTERESTED PARTIES MAILING LIST (§ 11:21-23.1 to 11:21-23.6)
- Appendix - APPENDIX (Exhibit A to KK)
Notes
Effective: September 11, 2023.
See: 55 N.J.R. 2201(a).
CHAPTER HISTORICAL NOTE:
Chapter 21,
Subchapter 14, Declaration and Approval of Reinsuring or Risk-Assuming
Subchapter 15, Relief From Obligations Imposed Under the
Subchapter 6, Standard Employer and
Subchapter 3A, Non-
Subchapter 9, Informational Rate Filing Requirements Pursuant to the
Subchapter 16, Withdrawals of
Subchapter 2, New Jersey
Subchapter 8,
Subchapter 11, Nonstandard
Subchapter 11, Nonstandard
Subchapter 19, SEH
Subchapter 7A, Loss Ratio Reports; Dividends and Credits, was adopted as R.1996 d.213, effective May 6, 1996. See: 28 N.J.R. 59(a), 28 N.J.R. 234(b), 28 N.J.R. 2388(a).
Subchapter 3A, Non-
Subchapter 13, Nonstandard Plans: Withdrawal of Plans, was adopted as R.1997 d.126, effective March 17, 1997. See: 28 N.J.R. 4364(a), 29 N.J.R. 887(b).
Pursuant to Executive Order No. 66(1978), Subchapters 1 through 7, 8, 10, 17, 18, and Appendix Exhibits A through KK of Chapter 21,
Subchapter 20, Withdrawals of Standard SEH Plan Optional Benefit Riders, was adopted as R.1999 d.156, effective May 17, 1999. See: 31 N.J.R. 109(a), 31 N.J.R. 1357(a).
Subchapters 1, 2, 3, 4, 5, 6, 7, 8, 10, 17, 18, 23 and Appendix Exhibits H, N, O, T, CC, DD, and KK were readopted as R.2004 d.107, effective February 19, 2004. Subchapters 7A, 9, 11, 13, 15, 16, 19 and Appendix Exhibits BB, FF, and GG, were readopted as R.2004 d.108, effective February 19, 2004. As part of R.2004, d.107, Subchapter 5, Standard Claim Form, was repealed effective March 15, 2004. See: 35 N.J.R. 5011(a), 36 N.J.R. 1594(a); 35 N.J.R. 4438(a), 36 N.J.R. 1605(a).
Subchapter 20, Withdrawals of Standard SEH Plan Optional Benefit Riders, was readopted as R.2004 d.149, effective March 18, 2004. See: 36 N.J.R. 145(a), 36 N.J.R. 1942(a).
Subchapter 3A, Non-Standard Health Benefits Plans, expired on
Chapter 21,
Chapter 21,
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 21,
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 21,
Chapter 21,
Chapter 21,
Chapter 21,
CHAPTER AUTHORITY:
N.J.S.A. 17:1-8.1, 17:1-15.e, and 17B:27A-17 et seq.