N.J. Admin. Code § 11:24-17.2

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:24-17.2 - General requirements

(a) The HMO shall provide a written contract to the contractholder and an evidence of coverage to each subscriber, which evidence of coverage may be incorporated into the member handbook required pursuant to N.J.A.C. 11:24-9.1.

1. The contract, evidence of coverage and member handbook shall conform to the Life and Health Insurance Policy Simplification Act, N.J.S.A. 17B:17-17 et seq. as demonstrated by the submission of a readability certification with a Flesch score for each form.

(b) All documents required to be delivered or issued for delivery in accordance with (a) above shall be delivered or issued for delivery no later than 30 days following the date of enrollment of the group, or notice to the HMO of enrollment of a subscriber within the group.

(c) No plan document shall be delivered or issued for delivery unless the form thereof has been filed with the Department, and approved, or deemed approved, by the Department.

N.J. Admin. Code § 11:24-17.2