N.J. Admin. Code § 11:2-12.12

Current through Register Vol. 56, No. 23, December 2, 2024

Section 11:2-12.12 - Cancellation and nonrenewal

(a) The failure of an employer, association, organization or other group to remit premiums when due for any reason (including but not limited to interruption or termination of employment or membership) shall not be regarded as "nonpayment of premium" by any employee or member insured under any such plan providing for remittance of premium by such employer, association, organization or other group, unless such insured shall have been given written notice of such failure to remit and shall not himself have paid such premium by the later of ten days after such notice or the due date of such premium remittance under the mass marketing plan.

(b) Any insurer which delivers in this State to any employer, association or organization a contract of insurance pursuant to the application or request of such employer, association or organization, acting for an insured other than itself, shall be deemed to have authorized such employer, association or organization to receive on its behalf payment of any premium which is due on such contract at the time of its issuance or delivery. Moneys collected for premiums for a mass marketing plan shall be kept in a separate account for the benefit of insured employees or members.

(c) Unless otherwise covered by statute, regulation or policy, all mass marketing plans shall provide those insured under such plan with an opportunity to purchase individual equivalent coverage in the same insurer upon termination of employment or membership or upon the discontinuance of the mass marketing plan. The insured employee or member may maintain his policy in force upon payment of the premium applicable to the class of risk to which he belongs on an individual basis. The option to maintain the insurance in force shall be exercised within 30 days following the date of termination.

(d) Any notice of cancellation or nonrenewal of any policy of an employee or member insured under a mass marketing plan shall be accompanied by a notice to the employee or member that, at his request, the insurer will afford the employee or member, and the employer, association, organization or other group a reasonable opportunity to consult with the insurer and to present facts in opposition to cancellation or nonrenewal.

N.J. Admin. Code § 11:2-12.12