reglab/housing_qa huggingface dataset:
NJ Rev Stat § 17B:27-46.1rr (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1rr - Group health insurance policy to provide coverage for standard fertility preservation services.

17B:27-46.1rr Group health insurance policy to provide coverage for standard fertility preservation services.  4. a. A group health insurance policy which provides hospital or medical expense benefits for groups with more than 50 persons and is delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for standard fertility preservation services when a medically necessary treatment may directly or indirectly cause iatrogenic infertility. For the purposes of this section:  "Iatrogenic infertility" means an impairment of fertility caused by surgery, radiation, chemotherapy, or other medical treatment affecting reproductive organs or processes. "May directly or indirectly cause" means a medical treatment with a likely side effect of iatrogenic infertility as established by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or as defined by the New Jersey Department of Health. "Standard fertility preservation services" means procedures consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine, the American Society of Clinical Oncology, or as defined by the New Jersey Department of Health. "Standard fertility preservation services" shall not include the storage of sperm or oocytes. The benefits shall be provided to the same extent as for any other medical condition under the policy. The same copayments, deductibles, and benefit limits shall apply to the provision of standard fertility preservation services pursuant to this section as those applied to other medical or surgical benefits under the policy. b. An insurer providing coverage under this section shall not determine the provision of standard fertility preservation services based on an insured's expected length of life, present or predicted disability, degree of medical dependency, perceived quality of life, or other health conditions, or based on personal characteristics, including age, sex, sexual orientation, marital status, or gender identity. c. This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium. L.2019, c.306, s.4.
NJ Rev Stat § 17B:27-46.1tt (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1tt - Group health insurer policy to cover preventive services.

17B:27-46.1tt Group health insurer policy to cover preventive services.  5. a. A group health insurer policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage, without requiring any cost sharing, for the following preventive services: (1) evidence-based items or services that have in effect a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force; (2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention;  (3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration; and (4) with respect to women, any additional preventive care and screenings not described in paragraph (1) as provided for in the comprehensive guidelines supported by the Health Resources and Services Administration. b. (1) Except as provided in paragraph (2) of this subsection, nothing in this section shall: (a) require a policy which has a network of providers to provide benefits for items or services described in subsection a. of this section that are delivered by an out-of-network provider; or (b) preclude a policy which has a network of providers from imposing cost-sharing requirements for items or services described in subsection a. of this section that are delivered by an out-of-network provider. (2) If a policy does not have in its network a provider who can provide an item or service described in subsection a. of this section, the policy shall cover the item or service when performed by an out-of-network provider, and shall not impose cost sharing with respect to that item or service. c. (1) A policy shall provide coverage for an item or service described in subsection a. of this section for plan years that begin on or after the date that is one year after the date the recommendation or guideline is issued. (2) (a) Except as provided in subparagraph (b) of this paragraph, a policy that is required to provide coverage for an item or service described in subsection a. of this section on the first day of a plan year shall provide coverage for that item or service through the last day of the plan year.  (b) The commissioner may remove a coverage requirement for an item or service during a plan year if the recommendation or guideline changes or is no longer described in subsection a. of this section. d. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2019, c.360, s.5.
NJ Rev Stat § 17B:27-46.1uu (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1uu - Group health insurance policy to provide certain coverage for prescription drugs.

17B:27-46.1uu Group health insurance policy to provide certain coverage for prescription drugs.  5. a. Notwithstanding any other provision of law to the contrary, an insurer that offers a group health insurance policy that provides benefits for expenses incurred in the purchase of prescription drugs and is delivered, issued, executed, or renewed in this State, shall ensure that the insurer offers at least two plans in the large group market pursuant to N.J.S.17B:27-26 et seq. b. The provisions of the section shall apply to all policies in which the insurer has reserved the right to change the premium. L.2019, c.471, s.5.
NJ Rev Stat § 17B:27-46.1vv (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1vv - Group health insurance policy to cover adolescent depression screenings.

17B:27-46.1vv Group health insurance policy to cover adolescent depression screenings.  5. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to chapter 27 of Title 17B of the New Jersey Statutes, or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, shall provide coverage for expenses incurred in screening adolescents between the ages of 12 and 18 for major depressive disorder, so long as screening for major depressive disorder in adolescents continues to receive a rating of "A" or "B" from the United States Preventative Services Task Force. Coverage shall not be denied solely on the basis that the screening is provided in conjunction with any other health care evaluation, treatment, or service. The benefits shall be provided to the same extent as for any other condition under the policy, except that the insurer shall not impose on covered persons receiving these services any form of cost sharing, including, but not limited to, copayments, deductibles, or coinsurance. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2021, c.73, s.5.
NJ Rev Stat § 17B:27-46.2 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.2 - Second surgical opinions; definitions

17B:27-46.2. Second surgical opinions; definitions  As used in this act: a. "Elective surgical procedure" means any nonemergency surgical procedure which may be scheduled at the convenience of the patient or the surgeon without jeopardizing the patient's life or causing serious impairment to the patient's bodily functions. b. "Second surgical opinion" means an opinion of an eligible physician based on that physician's examination of a person for the purpose of evaluating the medical advisability of that person undergoing an elective surgical procedure. The examination must be performed after another physician licensed to practice medicine and surgery has proposed to perform such surgical procedure on the person but prior to the performance of such surgical procedure. c. "Eligible physician" means a physician licensed to practice medicine and surgery who holds the rank of Diplomate of an American Board (M.D.) or Certified Specialist (D.O.) in the surgical or medical specialty for which surgery is proposed. L.1979, c. 329, s. 1.
NJ Rev Stat § 17B:27-46.3 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.3 - Group insurance policies; provision of program on request

17B:27-46.3. Group insurance policies; provision of program on request  Any insurer issuing a group insurance policy in accordance with chapter 27 of Title 17B of the New Jersey Statutes which provides coverage of surgical operations performed on a person while confined in a hospital as an inpatient shall make available, and if requested by the group policyholder, provide a second surgical opinion program for elective surgical procedures which would require inpatient admission to a hospital for persons insured under the group policy for such surgical coverage. L.1979, c. 329, s. 2.
NJ Rev Stat § 17B:27-46.4 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.4 - Payment for second surgical opinion services

17B:27-46.4. Payment for second surgical opinion services  A second surgical opinion program shall provide for payment for the second surgical opinion services of an eligible physician and for essential laboratory and X-ray services incidental thereto, either as a benefit under the group policy or, at the insurer's option, by a separate arrangement with the group policyholder. The program may be limited to eligible physicians who have agreed to participate in the insurer's second surgical opinion program. If the benefits are provided by the group insurance policy, the amount shall be reasonably related to amounts payable under the group policy for covered surgical procedures. L.1979, c. 329, s. 3.
NJ Rev Stat § 17B:27-46.5 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.5 - Third surgical opinion

17B:27-46.5. Third surgical opinion  If a second surgical opinion does not confirm that a proposed elective surgical procedure is medically advisable, the program must cover a third surgical opinion in the same manner as the second opinion. L.1979, c. 329, s. 4.
NJ Rev Stat § 17B:27-46.6 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.6 - Reduction of benefits where no second opinion obtained

17B:27-46.6. Reduction of benefits where no second opinion obtained  Where a second surgical opinion program is operative in connection with surgical coverage under a group insurance policy, and provides second and third surgical opinion services at no cost to the insured or patient, the group policy may, as an incentive to encourage utilization of the program when elective surgery is proposed, provide reduced benefits for the surgeon's charges for such elective surgery if it is performed without first obtaining a second or third opinion confirming that the proposed elective surgery was advisable. L.1979, c. 329, s. 5.
NJ Rev Stat § 17B:27-46.7 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.7 - Permissible benefit exclusions

17B:27-46.7. Permissible benefit exclusions  A second surgical opinion program may exclude benefits while the patient is confined in a hospital as an inpatient, any surgical procedure not covered by the group insurance policy, and surgical procedures in the following categories: cosmetic surgery, dental surgery, and podiatric surgery.  L. 1979, c. 329, s. 6. Amended by L. 1985, c. 277, s. 1.
NJ Rev Stat § 17B:27-46.8 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.8 - Payment for opinion services of physician

17B:27-46.8. Payment for opinion services of physician  If a physician who furnishes a second or third surgical opinion also performs the surgical procedure, the second surgical opinion program need not provide payment for the second or third opinion services of that physician. L.1979, c. 329, s. 7.
NJ Rev Stat § 17B:27-46.9 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.9 - Application of act

17B:27-46.9. Application of act  This act shall apply to all contracts in which the insurer has reserved the right to change the premium. L.1979, c. 329, s. 8.
NJ Rev Stat § 17B:27-47 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-47 - Group health or blanket insurance--provisions as favorable; policies issued outside State

17B:27-47. Group health or blanket insurance--provisions as favorable; policies issued outside State  No policy of group health or blanket insurance, and no certificate thereunder shall be delivered or issued for delivery in this State if such policy or certificate contains any provision inconsistent with any of the provisions of this chapter, except that such policy may contain any provision which in the opinion of the commissioner is as favorable to policyholders or certificate holders as the provision herein required, and except that such policy issued by any insurer of this State for delivery outside of this State may contain any provision not consistent with the provisions of this chapter; provided, such policy conforms to the laws of the State or country in which it is delivered. L.1971, c. 144, s. 17B:27-47.
NJ Rev Stat § 17B:27-48 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-48 - Exceptions in same type as benefits

17B:27-48. Exceptions in same type as benefits  Exceptions in the policy shall be printed in the policy and in the certificate with the same prominence as the benefits to which they apply. L.1971, c. 144, s. 17B:27-48.
NJ Rev Stat § 17B:27-49 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-49 - Filing of forms

17B:27-49. Filing of forms  17B:27-49. a. No group health insurance policy, or blanket insurance policy, or application, if a written application is required and is to be made a part of the policy, certificate, printed rider or endorsement for use with the policy, shall be delivered or issued for delivery in this State unless the form has been filed with the commissioner in accordance with the provisions of section 16 of P.L.1995, c.73 (C.17B:25-18.2).  b. (Deleted by amendment, P.L.1995, c.73.) c. If a form is disapproved for filing by the commissioner during the 60-day period, it may not be delivered or issued for delivery unless it is resubmitted and approved in accordance with the provisions of subsections b., c., and d. of section 16 of P.L.1995, c.73 (C.17B:25-18.2). Such disapproval shall be subject to review in accordance with the procedure described in the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and any rules adopted thereunder. Any such form which is filed by the commissioner or deemed filed may be so delivered or issued for delivery until such time as any subsequent withdrawal of the filing by the commissioner, following an opportunity for a hearing held in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) and any rules adopted thereunder, becomes final in accordance therewith  d. (Deleted by amendment, P.L.1995, c.73.) e. (Deleted by amendment, P.L.1995, c.73.) f. This section shall not apply to documents which relate only to the manner of distribution of benefits or to the reservation of rights and benefits under such policies and which are used at the request of the individual insured or policyholder.  g. The disapproval by the commissioner of any such form may be on the ground that such form contains provisions which are unjust, unfair, inequitable, misleading, contrary to law or to the public policy of this State.  L.1971, c.144; amended 1995,c.73,s.21.
NJ Rev Stat § 17B:27-50.1 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-50.1 - Severability

17B:27-50.1. Severability  If any section, subsection, paragraph, sentence, clause, phrase or word contained in this act shall be declared invalid for any reason whatsoever, such invalidity shall not effect the remaining portions of this act which shall remain in full force and effect, and, to this end, the provisions of this act are hereby declared to be severable. L.1973, c. 340, s. 2, eff. Dec. 27, 1973.
NJ Rev Stat § 17B:27-51 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51 - Reimbursement for optometric service

17B:27-51. Reimbursement for optometric service  Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a policy or contract provides for reimbursement for any optometric service which is within the lawful scope of practice of a duly licensed optometrist, a person covered under such group health policy or contract shall be entitled to reimbursement for such service, whether the said service is performed by a physician or duly licensed optometrist. L.1971, c. 144, s. 17B:27-51.
NJ Rev Stat § 17B:27-51.1 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.1 - Reimbursement for service of chiropractor

17B:27-51.1. Reimbursement for service of chiropractor  Notwithstanding any provision of a policy or contract of group health insurance, hereafter delivered or issued for delivery in this State, whenever such a policy or contract provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed chiropractor, a person covered under such group health policy or contract or the chiropractor rendering such service shall be entitled to reimbursement for such service when the said service is performed by a chiropractor. The foregoing provision shall be liberally construed in favor of reimbursement of chiropractors. L.1975, c. 125, s. 1, eff. June 5, 1975.
NJ Rev Stat § 17B:27-51.1a (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.1a - Group health insurance benefits for certain nursing services

17B:27-51.1a. Group health insurance benefits for certain nursing services  2. a. Notwithstanding any provision of a policy of group health insurance, whenever such a policy provides for reimbursement for any service which is within the lawful scope of practice of a duly registered professional nurse who is not being paid a salary by a health care provider for the services so performed, a person covered under that group health insurance policy or the registered professional nurse rendering the service shall be entitled to reimbursement for the service.  b. This act shall exclude salaried services which are already reimbursed and shall not be construed to affect or impair hospital procedures for billing in-hospital nursing care. The practice of nursing shall be deemed to be within the provisions of chapter 27 of Title 17B of the New Jersey Statutes and duly registered professional nurses shall have those privileges and benefits in the scope of their practice as are afforded thereunder to licensed physicians and surgeons in the scope of their practice.  c. This section shall apply to any group health insurance policy: (1) delivered or issued for delivery in this State on or after the effective date of this act; or (2) under which the insurer reserves the right to change the premium.  L.1992,c.128,s.2.
NJ Rev Stat § 17B:27-51.2 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.2 - Legislative findings and declarations

17B:27-51.2. Legislative findings and declarations  The Legislature hereby finds and declares that the high cost of hospital care necessitates the establishment of alternative means of caring for patients who need some professional health care, but who do not need to remain hospitalized. Home health care, therefore, is a necessary and desirable means of providing professional services to patients, consistent with the following objectives: a. Rehabilitation of the patient in order to assist in the development of independent living capabilities; b. Rehabilitation of the patient in order to attain reduction of physical or mental disability. L.1977, c. 99, s. 1.
NJ Rev Stat § 17B:27-51.3 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.3 - Definitions

17B:27-51.3. Definitions  As used in this act: a. "Home health care" means those nursing and other home health care services rendered to a person in his place of residence, under the following conditions: (1) On a part-time and intermittent basis, except when full-time or 24-hour services are needed on a short-term basis; (2) If continuing hospitalization would otherwise have been required if home health care were not provided; (3) Pursuant to a physician's order and under a plan of care established by the responsible physician in collaboration with a home health care provider, which plan shall be periodically reviewed and approved by said physician. All care plans shall be established within 14 days following the commencement of home health care. b. "Home health care services" means any of the following services necessary for achievement of the care plan set forth for the patient: (1) Nursing care; (2) Physical therapy; (3) Occupational therapy; (4) Medical social work; (5) Nutrition services; (6) Speech therapy; (7) Home health aide services; (8) Medical appliances and equipment, drugs and medications, laboratory services and special meals, to the extent such items and services would have been covered under the policy if the covered person had been in a hospital; (9) Any diagnostic or therapeutic service, including surgical services, performed in a hospital outpatient department, a doctor's office or any other licensed health care facility, provided such service would have been covered under the policy if performed as inpatient hospital services. c. "Home health care provider" means a home health care agency which is certified to participate as a home health agency under Title XVIII of the Social Security Act or a proprietary agency licensed by the Commissioner of Health. At such time as home health agency licensure standards are promulgated pursuant to c. 136 and 138, P.L.1971, home health care providers shall be licensed agencies. L.1977, c. 99, s. 2.
NJ Rev Stat § 17B:27-51.4 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.4 - Home health care; requirement for coverage

17B:27-51.4. Home health care; requirement for coverage  Notwithstanding any provision of a policy of group health insurance, hereafter delivered or issued for delivery in this State, whenever such policy provides coverage for inpatient hospital care or skilled nursing facility care, it shall also provide coverage for home health care. L.1977, c. 99, s. 3.
NJ Rev Stat § 17B:27-51.5 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-51.5 - Benefits

17B:27-51.5. Benefits  Every policy shall provide benefits required by section 3 without a separate deductible or coinsurance provision for the home health care benefit. For the purpose of determining the benefits for home health care, each visit by a member of a home health care team shall be considered as one home health care visit. The policy may contain a limitation on the number of home health care visits, but no policy may provide for less than 60 home health care visits in any calendar year or in any continuous period of 12 months. L.1977, c. 99, s. 4.