reglab/housing_qa huggingface dataset:
NJ Rev Stat § 17B:27A-7.6 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.6 - Coverage for hemophilia services by individual health policy

17B:27A-7.6. Coverage for hemophilia services by individual health policy  6. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on or after the effective date of P.L.2000, c.121 (C.26:2S-10.1 et al.) unless the policy or contract meets the requirements of sections 1 and 2 of P.L.2000, c.121 (C.26:2S-10.1 and C.26:2S-10.2) and the regulations adopted thereto. The provisions of this section shall apply to all policies or contracts in which the carrier has reserved the right to change the premium. L.2000,c.121,s.6.
NJ Rev Stat § 17B:27A-7.7 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.7 - Individual health benefits plan to provide coverage for colorectal cancer screening.

17B:27A-7.7 Individual health benefits plan to provide coverage for colorectal cancer screening.  6. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age 50 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person. As used in this section, "high risk for colorectal cancer" means a person has: a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps; b. chronic inflammatory bowel disease; or c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer. The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan. The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium. L.2001,c.295,s.6.
NJ Rev Stat § 17B:27A-7.8 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.8 - Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services.

17B:27A-7.8 Policy, contract issued under C.17B:27A-2 et seq. required to cover certain out-of-network services.  6. Notwithstanding the provisions of P.L.1992, c.161 (C.17B:27A-2 et seq.) to the contrary, no policy or contract shall be delivered, issued, executed or renewed on or after the effective date of this act unless the policy or contract meets the requirements of P.L.2001, c.367 (C.26:2S-6.1 et al.). The provisions of this section shall apply to all policies or contracts in which the carrier has reserved the right to change the premium. L.2001,c.367,s.6.
NJ Rev Stat § 17B:27A-7.9 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.9 - Individual health benefits plan to offer coverage for domestic partner.

17B:27A-7.9 Individual health benefits plan to offer coverage for domestic partner.  53. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State on or after the effective date of P.L.2003, c.246 (C.26:8A-1 et al.), under which dependent coverage is available, shall offer dependent coverage to a covered person for a covered person's domestic partner. For the purposes of this section, "domestic partner" means a domestic partner as defined in section 3 of P.L.2003, c.246 (C.26:8A-3). The provisions of this section shall apply to all policies or contracts in which the carrier has reserved the right to change the premium. L.2003,c.246,s.53.
NJ Rev Stat § 17B:27A-7.10 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.10 - Individual health benefits plan, mammogram examination benefits.

17B:27A-7.10 Individual health benefits plan, mammogram examination benefits.  7. a. Every individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in conducting: (1) one baseline mammogram examination for women who are 40 years of age; a mammogram examination every year for women age 40 and over; and, in the case of a woman who is under 40 years of age and has a family history of breast cancer or other breast cancer risk factors, a mammogram examination at such age and intervals as deemed medically necessary by the woman's health care provider; and (2) an ultrasound evaluation, a magnetic resonance imaging scan, a three-dimensional mammography, or other additional testing of an entire breast or breasts, after a baseline mammogram examination, if the mammogram demonstrates extremely dense breast tissue, if the mammogram is abnormal within any degree of breast density including not dense, moderately dense, heterogeneously dense, or extremely dense breast tissue, or if the patient has additional risk factors for breast cancer including but not limited to family history of breast cancer, prior personal history of breast cancer, positive genetic testing, extremely dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology, or other indications as determined by the patient's health care provider. The coverage required under this paragraph may be subject to utilization review, including periodic review, by the carrier of the medical necessity of the additional screening and diagnostic testing. b. The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.  c. The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium. L.2004, c.86, s.7; amended 2013, c.196, s.6.
NJ Rev Stat § 17B:27A-7.11 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.11 - Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances.

17B:27A-7.11 Individual health benefits plan, high deductible, deductible inapplicable, certain circumstances.  14. Notwithstanding the provisions of subsection e. of section 6 of P.L.1992, c.161 (C.17B:27A-7) regarding deductibles for a high deductible health plan, a health benefits plan offered pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.) on or after the effective date of P.L.2005, c.248 (C.17:48E-35.27 et al.), that qualifies as a high deductible health plan for which qualified medical expenses are paid using a health savings account established pursuant to section 223 of the federal Internal Revenue Code of 1986 (26 U.S.C.s.223), shall not apply a deductible for any benefits for which a deductible is not applicable pursuant to any law enacted after the effective date of P.L.2005, c.248 (C.17:48E-35.27 et al.). This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium. L.2005,c.248,s.14.
NJ Rev Stat § 17B:27A-7.13 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.13 - Individual health benefits plans to provide benefits for orthotic and prosthetic appliances.

17B:27A-7.13 Individual health benefits plans to provide benefits for orthotic and prosthetic appliances.  6. a. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et al.), 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 benefits to any person covered thereunder for expenses incurred in obtaining an orthotic or prosthetic appliance from any licensed orthotist or prosthetist, or any certified pedorthist, as determined medically necessary by the covered person's physician. As used in this section, "orthotic appliance," "prosthetic appliance," "licensed orthotist" and "licensed prosthetist" have the meaning assigned to them in section 3 of P.L.1991, c.512 (C.45:12B-3) and "certified pedorthist" has the meaning assigned to it in subsection j. of section 18 of P.L.1991, c.512 (C.45:12B-18). b. On and after the effective date of this act, an individual health benefits plan shall reimburse for orthotic and prosthetic appliances at the same rate as reimbursement for such appliances under the federal Medicare reimbursement schedule. c. The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan. d. The provisions of this section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium. L.2007, c.345, s.6.
NJ Rev Stat § 17B:27A-7.14 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.14 - Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger.

17B:27A-7.14 Individual health benefits plan to provide coverage for hearing aids for certain persons aged 15 or younger.  7. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et al.), on or after the effective date of this act, shall provide coverage for medically necessary expenses incurred in the purchase of a hearing aid for a covered person 15 years of age or younger, as provided in this section. A health benefits plan shall provide coverage that includes the purchase of a hearing aid for each ear, when medically necessary and as prescribed or recommended by a licensed physician or audiologist. A carrier may limit the benefit provided in this section to $1,000 per hearing aid for each hearing-impaired ear every 24 months. A covered person may choose a hearing aid that is priced higher than the benefit payable under this section and may pay the difference between the price of the hearing aid and the benefit payable under this section, without financial or contractual penalty to the provider of the hearing aid. The benefits shall be provided to the same extent as for any other condition under the health benefits plan. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium. L.2008, c.126, s.7.
NJ Rev Stat § 17B:27A-7.15 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.15 - Individual health benefits plan to provide installment payments to obstetrical provider for maternity services.

17B:27A-7.15 Individual health benefits plan to provide installment payments to obstetrical provider for maternity services.  6. a. Every individual health benefits plan that provides benefits for maternity services, and that 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 for reimbursement in installments to an obstetrical provider licensed in New Jersey for maternity services rendered during the term of a covered person's pregnancy.  b. For the purposes of this section, "obstetrical provider licensed in New Jersey" means:  (1) an obstetrician/gynecologist licensed by the State Board of Medical Examiners; or  (2) a midwife licensed by the State Board of Medical Examiners as a certified midwife or a certified nurse midwife. c. This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium. L.2009, c.113, s.6.
NJ Rev Stat § 17B:27A-7.17 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.17 - Individual health benefits plan to provide coverage for oral anticancer medication.

17B:27A-7.17 Individual health benefits plan to provide coverage for oral anticancer medication.  6. a. An individual health benefits plan that is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), on or after the effective date of this act, shall provide coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells on a basis no less favorable than the plan provides for intravenously administered or injected anticancer medications.  b. Pursuant to subsection a. of this section, coverage for expenses for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medications. c. An individual health benefits plan shall not achieve compliance with the provisions of this section by imposing an increase in patient cost sharing, including any copayment, deductible or coinsurance, for anticancer medications, whether intravenously administered or injected or orally administered, that are covered under the plan as of the effective date of this act. d. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium. L.2011, c.188, s.6.
NJ Rev Stat § 17B:27A-7.18 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.18 - Individual health benefits plan to provide coverage for sickle cell anemia.

17B:27A-7.18 Individual health benefits plan to provide coverage for sickle cell anemia.  7. Every individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State, on or after the effective date of this act, shall provide coverage for medical expenses incurred by a covered person for the treatment of sickle cell anemia and, if the plan provides benefits for expenses incurred in the purchase of outpatient prescription drugs, then the plan shall provide coverage for prescription drug expenses incurred by a covered person for the treatment of sickle cell anemia. The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan. This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium. L.2011, c.210, s.7.
NJ Rev Stat § 17B:27A-7.19 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.19 - Individual health benefits plan to provide coverage for prescription eye drops.

17B:27A-7.19 Individual health benefits plan to provide coverage for prescription eye drops.  6. a. An individual health benefits plan which provides hospital or medical expense benefits that include coverage for prescription eye drops under a contract 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 expenses incurred for refills of prescription eye drops in accordance with the Guidance for Early Refill Edits of Topical Ophthalmic Products provided to Medicare Part D plan sponsors by the Centers for Medicare & Medicaid Services of the U.S. Department of Health and Human Services, provided that: (1) the prescribing health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed; and (2) the refill requested by the covered person does not exceed the number of additional quantities indicated on the original prescription by the prescribing health care practitioner. b. The provisions of this section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium. L.2013, c.50, s.6.
NJ Rev Stat § 17B:27A-7.20 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.20 - Individual health benefits plan, coverage for synchronization of prescribed medications.

17B:27A-7.20 Individual health benefits plan, coverage for synchronization of prescribed medications.  7. a. Every individual health benefits plan delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State on or after the effective date of this act, which provides benefits for pharmacy services, prescription drugs, or for participation in a prescription drug plan, shall, on at least one occasion per year for each covered person: (1) apply a prorated daily cost-sharing rate to prescriptions that are dispensed by a network pharmacy for less than a 30 days' supply if the prescriber or pharmacist indicates the fill or refill is in the best interest of the covered person or is for the purpose of synchronizing the covered person's chronic medications; (2) provide coverage for a drug prescribed for the treatment of a chronic illness dispensed in accordance with a plan among the covered person, the prescriber and the pharmacist to synchronize the refilling of multiple prescriptions for the covered person; and (3) determine dispensing fees based exclusively on the total number of prescriptions dispensed; dispensing fees shall not be prorated or based on the number of the days' supply of medication prescribed or dispensed.  b. This section shall apply to all health benefits plans in which the carrier has reserved the right to change the premium.  c. This section shall not apply to prescriptions for opioid analgesics. "Opioid analgesic" means a drug in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release form, and whether or not combined with other drug substances to form a single drug product or dosage form. L.2015, c.206, s.7.
NJ Rev Stat § 17B:27A-7.23 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.23 - Individual health benefits plan to cover digital tomosynthesis of the breast.

17B:27A-7.23 Individual health benefits plan to cover digital tomosynthesis of the breast.  6. a. An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), 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 conducting digital tomosynthesis to detect or screen for breast cancer in women 40 years of age and over; and for diagnostic purposes in women of any age. b. In the case of digital tomosynthesis conducted to detect or screen for breast cancer in women 40 years of age and over, no deductible, coinsurance or other cost sharing shall be applied; and in the case of digital tomosynthesis conducted for diagnostic purposes in women of any age, the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan shall be applied.  c. This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium. L.2017, c.305, s.6.
NJ Rev Stat § 17B:27A-7.24 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-7.24 - Individual health benefits plan to provide coverage for donated human breast milk.

17B:27A-7.24 Individual health benefits plan to provide coverage for donated human breast milk.  6. a. An individual health benefits plan 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 for expenses incurred in the provision of pasteurized donated human breast milk, which may include human milk fortifiers if indicated by the prescribing licensed medical practitioner, provided that: (1) the covered person is an infant under the age of six months; (2) the milk is obtained from a human milk bank that meets quality guidelines established by the Department of Health ; and (3) a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk in sufficient quantities or participate in breast feeding despite optimal lactation support; or (4) a licensed medical practitioner has issued an order for an infant who meets any of the following conditions:  (a) a body weight below healthy levels determined by the licensed medical practitioner; (b) a congenital or acquired condition that places the infant at a high risk for development of necrotizing enterocolitis; or  (c) a congenital or acquired condition that may benefit from the use of donor breast milk as determined by the Department of Health. b. The provisions of this section shall apply to those individual health benefits plans in which the carrier has reserved the right to change the premium. c. Nothing in this section shall preclude the carrier from performing utilization review, including periodic review of the medical necessity of a particular service. d. The benefits shall be provided to the same extent as for any other prescribed items under the plan. e. If there is no supply of human breast milk that meets the requirements of paragraph (2) of subsection a. of this section, the carrier shall not be required to provide coverage of expenses pursuant to this section. L.2017, c.309, s.6.