N.J. Admin. Code § 11:15-3.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:15-3.5 - Bylaws and plan of risk management; filing requirements

(a) Each joint insurance fund shall file with the Department for approval by the Commissioners of Banking and Insurance and Community Affairs, as provided in 40A:10-41, its bylaws and plan of risk management and any subsequent amendments thereto. In addition, the initial filing shall contain and be accompanied by the information and documentation specified at N.J.A.C. 11:15-3.6, and such other information the Commissioner may request. All filings shall be in loose-leaf form inserted into standard two-ring or three-ring binders tabbed or otherwise indexed to correspond to the requirements set forth in N.J.A.C. 11:15-3.6. The loose-leaf sheets used shall be eight and one-half inches wide and 11 inches long and punched for two-ring and three-ring binders, as appropriate. The fund shall submit five copies of a filing in the format set forth in this section. All information shall be submitted completely and accurately.

1. All filings and accompanying documents shall be submitted to the Department and the Department of Community Affairs.

(b) All of the information and documentation set forth in 11:15-3.6 shall constitute the fund's bylaws and plan of risk management for purposes of 40A:10-41. In order to facilitate the filing and review process, the review of a filing shall be separated into two stages. The information set forth in 11:15-5.6(a) through (d) constitutes the initial stage. Within 90 days of the Commissioner's acceptance of the initial information filed, the fund shall complete the filing process by submitting the information set forth in 11:15-3.6 (e). Failure to file the required subsequent information within 90 days may result in the disapproval of the fund's filing. No joint insurance fund shall insure, contract or provide insurance coverage to its members until its bylaws and plan of risk management and other information required pursuant to 11:15-3.6 have been approved by the Commissioner and such approval becomes effective pursuant to (c) below.

(c) In order to provide a sufficient time for transition from the plan for the provision of health or term life benefits in effect immediately prior to joining the fund to the plan for the provision of such benefits through the fund, any approval of a fund's bylaws and plan of risk management shall take effect and become operative 60 days after the date of approval.

(d) No amendment to a fund's bylaws or plan of risk management, or change in the information or documentation required to accompany the filing of the fund's bylaws of plan of risk management as provided in (a) above, shall take effect until the amendment or change is approved by the Commissioner and the Commissioner of the Department of Community Affairs.

(e) The bylaws and plan of risk management and all information required to accompany the initial filing shall set forth an identifying number or code and the filing date on each page of the specific document filed. For example, each page of the bylaws shall set forth an identifying number or code; each page of the plan of risk management shall set forth a different identifying number or code; the sample resolution and trust agreement shall set forth a different identifying number or code; etc. Any amendment or supplemental form to any information previously filed shall contain the original identifying number or code, indicate that the document is an amendment or supplement to the information previously filed, and set forth the date of revision.

(f) In addition to the information set forth in 11:15-3.6, the fund shall provide a cover letter stating the name, telephone number(s) and telefax number(s) of two contact persons (one primary, one secondary) familiar with the filing to whom the Department may direct any questions; as well as the fund's official mailing address for the purpose of disseminating Department information, in accordance with N.J.A.C. 11:1-25.

(g) All information required to be submitted shall be sent to:

1. New Jersey Department of Banking and Insurance

Division of Life and Health

Attn. Municipal Health JIF Admissions

20 West State Street

PO 325

Trenton, NJ 08625-0325; and

2. New Jersey Department of Community Affairs

Division of Local Government Services

101 South Broad Street

PO 803

Trenton, New Jersey 08625-0803.

N.J. Admin. Code § 11:15-3.5

Amended by R.1996 d.535, effective 11/18/1996.
See: 28 New Jersey Register 4036(a), 28 New Jersey Register 4885(a).
Amended by R.1999 d.350, effective 10/18/1999.
See: 31 New Jersey Register 2125(b), 31 New Jersey Register 3091(a).
In (a), changed N.J.A.C. reference in the second sentence of the introductory paragraph.