This act shall be known and may be cited as the "New Jersey State Health Benefits Program Act." N.J.S. § 52:14-17.25 L.1961, c.49, p.509, s.1; amended by L.1964, c.125, s.2, eff. 7/1/1964; L.1972, c.75, s.1.
a. For each active covered State employee and for the eligible dependents the employee may have enrolled at the employee's option, the State, from funds appropriated therefor, shall pay its share of the premium or periodic charges for the benefits provided under the contract purchased by the commission pursuant to subsection a. of section 4 of P.L. 1961, c.49 (C.52:14-17.28). An employee may, on an optional basis, enroll the employee's dependents for coverage under the contract subject to such regulations
a. A group health insurance policy which provides hospital or medical expense benefits for groups with more than 50 persons, which includes pregnancy-related benefits, shall not be delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act unless the policy provides coverage for persons covered under the policy for medically necessary expenses incurred in the diagnosis
(a) Any member of the SHBP who disagrees with the decision of the carrier and has exhausted all appeals within the plan, as well as any external review required by the PPACA, if applicable, may request that the matter be considered by the Commission. Requests for consideration must be directed to the Secretary of the Commission within one year of the plan's final adverse benefit determination, and must contain the reason for the disagreement and all available supporting documentation. Appeals shall
(a) The State Health Benefits Commission shall meet, as necessary, at the call of the Chairperson or the Secretary provided that the required public notice has been given, pursuant to the provisions of the Open Public Meetings Act, 10:4-13. (b) Any three members of the Commission, at least two of whom are ex-officio members, shall constitute a quorum for the purpose of conducting the business of the Commission. Each member shall be entitled to one vote and a majority of all votes of the entire Commission
The Commission adopts by reference all of the policy provisions contained in the contracts between the health, prescription drug and dental plans and the Commission, as well as any subsequent amendments thereto, to the exclusion of all other possible coverages. The plans handbook supplements the master contracts and contains the specific provisions for services to be covered and those which are excluded. N.J. Admin. Code § 17:9-2.14 R.1981 d.138, effective 6/4/1981. See: 13 N.J.R. 110(b), 13 N.J