N.J. Admin. Code § 11:4-28.1

Current through Register Vol. 56, No. 17, September 3, 2024

Section 11:4-28.1 - Purpose and scope

(a) The purpose of this subchapter is to:

1. Discourage overinsurance and avoid duplication of benefits by permitting a reduction of benefits when a person is covered by more than one plan providing benefits or services for medical, dental, or other care or treatment;

2. Avoid claims payment delays and misunderstandings that result from the use of inconsistent or incompatible nonduplication provisions; and

3. Establish uniformity in the order in which plans pay their claims, and provide the authority for the orderly transfer of information needed to pay claims promptly.

(b) This subchapter applies to group contracts providing health care benefits which are issued, amended, delivered or renewed in New Jersey by insurers transacting the business of health insurance, health service corporations, hospital service corporations, medical service corporations, dental service corporations, dental plan organizations, health maintenance organizations and all similar organizations.

N.J. Admin. Code § 11:4-28.1

Amended by R.2002 d.106, effective 4/1/2002 (operative January 1, 2003).
See: 33 New Jersey Register 2578(a), 34 New Jersey Register 1440(a).
Rewrote (b).