N.J. Admin. Code § 11:22-8.3

Current through Register Vol. 56, No. 9, May 6, 2024

Section 11:22-8.3 - Requirement to issue identification cards

(a) Each carrier or third party administrator shall issue, or cause to be issued, an identification card to the primary insured covered by a health benefit plan. Additional cards may be issued to other persons included under the primary insured's coverage. The carrier or third party administrator may contract with an administrator, agent, contractor or other vendor to issue the cards; however, the carrier or other provider shall remain responsible for the proper issuance of the cards and for their compliance with this subchapter.

(b) The following information shall appear on all health benefit plan identification cards:

1. The name of the carrier issuing the health benefit plan or the name of the third party administrator administering the health benefit plan;

2. An indication of whether the plan is insured or self funded;

3. The insured's name;

4. The insured's identification number, the contract number and the policy or group number, if applicable;

5. The name of the primary care provider for each covered person where selection of a primary care provider is required;

6. A phone number or electronic address for authorization and admission certifications, if required; and

7. In-network cost sharing information, including amounts applicable to primary care provider visits, specialist visits, emergency room visits and hospital stays.

(c) The identification card must present the information in a readily identifiable manner.

N.J. Admin. Code § 11:22-8.3