N.J. Admin. Code § 11:4-56.11

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

Section 11:4-56.11 - Notification to the Department by carriers of contracts with MEAs

(a) A carrier shall notify the Department by December 31 of each year of all health insurance contracts, health maintenance organization contracts, stop-loss contracts and administrative services only (ASO) contracts it issued, renewed, or had in force at any time during the 12-month period ending on September 30 of that calendar year, that covered a multiple employer arrangement (MEA) with employees and dependents in New Jersey.

(b) Such notice shall include:

1. The name and address of each MEA with whom the carrier contracted;

2. The state in which the health insurance contract, health maintenance organization contract, stop-loss contract or ASO contract was issued to the MEA;

i. If the issue state was New Jersey, the unique identifying form number of the health insurance contract, health maintenance organization contract or stop-loss contract issued to the MEA, and the date such form was approved by the Department;

3. The names and addresses of all employers covered by the MEA with employees or dependents in New Jersey and, for each such employer, the number of employees eligible for coverage; and

4. A copy of the health insurance contract, health maintenance organization contract, stop-loss contract or ASO contract between the carrier and the MEA in force at any time during the calendar year.

(c) Such notice shall be addressed to:

MEA Notice, Life and Health Section

Department of Banking and Insurance

PO Box 325

Trenton, New Jersey 08625-0325

N.J. Admin. Code § 11:4-56.11