Chapter 22 - HEALTH BENEFIT PLANS

  1. Subchapter 1 - PROMPT PAYMENT OF CLAIMS (§ 11:22-1.1 to 11:22-1.16)
  2. Subchapter 2 - HEALTH WELLNESS PROMOTION PLANS (§ 11:22-2.1 to 11:22-2.4)
  3. Subchapter 3 - ELECTRONIC RECEIPT AND TRANSMISSION OF HEALTH CARE CLAIMS (§ 11:22-3.1 to 11:22-3.11)
  4. Subchapter 4 - ORGANIZED DELIVERY SYSTEMS (§ 11:22-4.1 to 11:22-4.14)
  5. Subchapter 5 - MINIMUM STANDARDS FOR HEALTH BENEFIT PLANS, PRESCRIPTION DRUG PLANS AND DENTAL PLANS (§ 11:22-5.1 to 11:22-5.11)
  6. Subchapter 6 - EXCLUSIONS AND PREAUTHORIZATION REQUIREMENTS (§ 11:22-6.1 to 11:22-6.5)
  7. Subchapter 7 - CARRIER/PROVIDER JOINT NEGOTIATION AGREEMENTS (§ 11:22-7.1 to 11:22-7.3)
  8. Subchapter 8 - HEALTH INSURANCE IDENTIFICATION CARDS (§ 11:22-8.1 to 11:22-8.6)
  9. Subchapter 9 - MATERNITY INSTALLMENT PAYMENTS (§ 11:22-9.1 to 11:22-9.6)

Notes

CHAPTER SOURCE AND EFFECTIVE DATE:
R.2019 d.032, effective March 20, 2019.
See: 50 N.J.R. 2209(a), 51 N.J.R. 501(b).
CHAPTER HISTORICAL NOTE:
Chapter 22, Health Benefit Plans, was adopted as R.2000 d.452, effective November 6, 2000. See: 32 N.J.R. 2860(a), 32 N.J.R. 4014(a).
Subchapter 1, Prompt Payment of Claims, was adopted as new rules by R.2001 d.13, effective January 2, 2001. See: 32 N.J.R. 1985(a), 33 N.J.R. 105(a).
Subchapter 3, Electronic Receipt and Transmission of Health Care Claims, was adopted as new rules by R.2001 d.364, effective October 1, 2001. See: 33 N.J.R. 750(a), 33 N.J.R. 3461(a).
Subchapter 4, Organized Delivery Systems, was adopted as new rules by R.2002 d.336, effective October 21, 2002. See: 34 N.J.R. 20(a), 34 N.J.R. 3607(a).
Subchapter 5, Minimum Standards for Network-Based Health Benefit Plans, was adopted as new rules by R.2003 d.419, effective November 3, 2003. See: 34 N.J.R. 3485(a), 35 N.J.R. 5116(a).
Subchapter 6, Exclusions and Preauthorization Requirements, was adopted as new rules by R.2004 d.80, effective February 17, 2004. See: 35 N.J.R. 2396(a), 36 N.J.R. 958(a).
Subchapter 7, Carrier/Provider Joint Negotiation Agreements, was adopted as new rules by R.2004 d.295, effective August 2, 2004. See: 35 N.J.R. 5036(a), 36 N.J.R. 3553(a).
Chapter 22, Health Benefit Plans, was readopted by R.2006 d.199, effective April 26, 2006. See: 37 N.J.R. 3779(a), 38 N.J.R. 2499(b).
Subchapter 8, Health Insurance Identification Cards, was adopted as new rules by R.2009 d.333, effective November 2, 2009 (operative July 1, 2010). See: 40 N.J.R. 6527(a), 41 N.J.R. 4117(b).
Subchapter 5, Minimum Standards for Network-Based Health Benefit Plans, was renamed Minimum Standards for Health Benefit Plans, Prescription Drug Plans and Dental Plans by R.2009 d.265, effective September 8, 2009 (operative September 8, 2010). See: 40 N.J.R. 6915(a), 41 N.J.R. 3302(b).
In accordance with N.J.S.A. 52:14B-5.1b, Chapter 22, Health Benefit Plans, was scheduled to expire on April 26, 2013. See: 43 N.J.R. 1203(a).
Subchapter 9, Maternity Installment Payments, was adopted as new rules by R.2011 d.190, effective July 5, 2011. See: 43 N.J.R. 146(a), 43 N.J.R. 1533(a).
Chapter 22, Health Benefit Plans, was readopted as R.2011 d.256, effective September 21, 2011. See: 43 N.J.R. 1236(a), 43 N.J.R. 2668(b).
Chapter 22, Health Benefit Plans, was readopted as R.2019 d.032, effective March 20, 2019. As a part of R.2019 d.032, Subchapter 5, Minimum Standards for Health Benefit Plans, Prescription Drug Plans and Dental Plans, was renamed Minimum Standards for Health Benefits Plans, Prescription Drug Plans, and Dental Plans, effective April 15, 2019. See: Source and Effective Date. See, also, section annotations.

CHAPTER AUTHORITY:

N.J.S.A. 17:1-8.1, 17:1-15.e, 17:48H-32, 17B:27B-25, 17B:30-13.1, 17B:30-23 et seq., 17B:30-55, 17B:30-56, and 26:1A-36.11 and 36.12.