N.J. Admin. Code § 11:4-55.3

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

Section 11:4-55.3 - Time limits

(a) A carrier, multiple employer welfare arrangement, or health benefits provider shall provide each primary insured a new pharmacy identification card within 60 days of a health benefits plan becoming effective.

(b) A card shall be issued to the primary insured within 60 days of the primary insured initially becoming eligible for coverage under an existing health benefits plan (for example, new employee).

(c) A carrier, multiple employer welfare arrangement, or other health benefits provider shall provide each primary insured a new pharmacy identification card within a reasonable time, not to exceed 180 days, after a change in the insured's coverage that changes the information required to be on the card, if the issuance of a new card is required for proper claims adjustment. However, the carrier, multiple employer welfare arrangement, or other health benefits provider shall not be required to issue a new card reflecting changes in information more than once in a calendar year.

N.J. Admin. Code § 11:4-55.3