Statutes, codes, and regulations
New Jersey Administrative Code
Title 11 - INSURANCEChapter 24 - HEALTH MAINTENANCE ORGANIZATIONS
Subchapter 13 - LICENSING OF REPRESENTATIVES AND ADVERTISING
Section 11:24-13.5 - Trade and claims practices and coordination of benefits

N.J. Admin. Code § 11:24-13.5

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Current through Register Vol. 56, No. 24, December 18, 2024
Section 11:24-13.5 - Trade and claims practices and coordination of benefits
(a) HMOs shall be subject to all of the provisions of the Trade Practice Act, N.J.S.A. 17B:30-1 et seq., any amendments thereto, and all rules promulgated thereunder, except to the extent that HMOs have been specifically excluded by reference from a provision of the applicable statutes or rules.
(b) HMOs that elect to coordinate their benefits with those of other benefits or coverages available to members may do so subject to compliance with N.J.A.C. 11:4-28, Coordination of Benefits. HMOs that do not comply with N.J.A.C. 11:4-28 shall provide primary coverage to all members.

N.J. Admin. Code § 11:24-13.5