reglab/housing_qa huggingface dataset:
NJ Rev Stat § 17B:27-46.1w (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1w - Coverage for hemophilia services by group health insurers

17B:27-46.1w. Coverage for hemophilia services by group health insurers  4. Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy 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 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 in which the insurer has reserved the right to change the premium. L.2000,c.121,s.4.
NJ Rev Stat § 17B:27-46.1y (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1y - Group policy to provide coverage for colorectal cancer screening.

17B:27-46.1y Group policy to provide coverage for colorectal cancer screening.  5. Every group policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 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 benefits to any named insured or other 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 policy. The provisions of this section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium. L.2001,c.295,s.5.
NJ Rev Stat § 17B:27-46.1z (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1z - Group health insurer prescription drug plans to cover certain infant formulas.

17B:27-46.1z Group health insurer prescription drug plans to cover certain infant formulas.  4. A group health insurer which provides hospital or medical expense benefits for expenses incurred in the purchase of prescription drugs under a policy 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 benefits under the policy for expenses incurred in the purchase of specialized non-standard infant formulas, when the covered infant's physician has diagnosed the infant as having multiple food protein intolerance and has determined such formula to be medically necessary, and when the covered infant has not been responsive to trials of standard non-cow milk-based formulas, including soybean and goat milk. The coverage may be subject to utilization review, including periodic review, of the continued medical necessity of the specialized infant formula. The benefits shall be provided to the same extent as for any other prescribed items under the policy. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2001,c.361,s.4.
NJ Rev Stat § 17B:27-46.1aa (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1aa - Policy issued under Chapter 27 of Title 17B required to cover certain out-of-network services.

17B:27-46.1aa Policy issued under Chapter 27 of Title 17B required to cover certain out-of-network services.  4. Notwithstanding the provisions of chapter 27 of Title 17B of the New Jersey Statutes to the contrary, no policy shall be delivered, issued, executed or renewed on or after the effective date of this act unless the policy 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 in which the insurer has reserved the right to change the premium. L.2001,c.367,s.4.
NJ Rev Stat § 17B:27-46.1bb (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1bb - Group health insurer to offer coverage for domestic partner.

17B:27-46.1bb Group health insurer to offer coverage for domestic partner.  51. A group health insurer that provides hospital or medical expense benefits under a policy 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 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). This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2003,c.246,s.51.
NJ Rev Stat § 17B:27-46.1cc (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1cc - Group health insurance policy, high deductible, coverage for preventive care.

17B:27-46.1cc Group health insurance policy, high deductible, coverage for preventive care.  8. No group health insurance policy providing hospital or medical expense benefits for groups with more than 50 persons, 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 be 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 P.L.2005, c.248 (C.17:48E-35.27 et al.), unless the policy provides benefits to any named insured or other person covered thereunder for expenses incurred in connection with any medically necessary benefits provided in-network which represent preventive care as permitted by that federal law. The benefits provided pursuant to this section shall be provided to the same extent as for any other medical condition under the policy, except that a deductible shall not be applied for benefits provided pursuant to this section. This section shall apply to all group health insurance policies in which the health insurer has reserved the right to change the premium. L.2005,c.248,s.8.
NJ Rev Stat § 17B:27-46.1dd (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1dd - Group health insurance policy, high deductible, deductible inapplicable, certain circumstances.

17B:27-46.1dd Group health insurance policy, high deductible, deductible inapplicable, certain circumstances.  9. Notwithstanding the provisions of section 3 of P.L.1995, c.316 (C.17B:27-46.1l) regarding deductibles for a high deductible health plan, a group health insurance policy providing hospital or medical expense benefits for groups with more than 50 persons, 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), 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 P.L.2005, c.248 (C.17:48E-35.27 et al.), 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 group health insurance policies in which the health insurer has reserved the right to change the premium. L.2005,c.248,s.9.
NJ Rev Stat § 17B:27-46.1ff (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1ff - Group health insurance policies to provide benefits for orthotic and prosthetic appliances.

17B:27-46.1ff Group health insurance policies to provide benefits for orthotic and prosthetic appliances.  5. a. Every group health insurance policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 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 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, a group health insurance policy 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 policy. d. The provisions of this section shall apply to all group health insurance policies in which the insurer has reserved the right to change the premium. L.2007, c.345, s.5.
NJ Rev Stat § 17B:27-46.1gg (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1gg - Group health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.

17B:27-46.1gg Group health insurance policy to provide coverage for hearing aids for certain persons aged 15 or younger.  6. 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 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 policy 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. An insurer 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 policy. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2008, c.126, s.6.
NJ Rev Stat § 17B:27-46.1hh (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1hh - Group health insurance policy to provide installment payments to obstetrical provider for maternity services.

17B:27-46.1hh Group health insurance policy to provide installment payments to obstetrical provider for maternity services.  5. a. Every group health insurance policy 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 group health insurance policies in which the insurer has reserved the right to change the premium. L.2009, c.113, s.5.
NJ Rev Stat § 17B:27-46.1jj (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1jj - Group health insurance policy to provide coverage for oral anticancer medications.

17B:27-46.1jj Group health insurance policy to provide coverage for oral anticancer medications.  5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to N.J.S.17B:27-26 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 for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells on a basis no less favorable than the policy 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. A group health insurance policy 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 policy as of the effective date of this act. d. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2011, c.188, s.5.
NJ Rev Stat § 17B:27-46.1kk (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1kk - Group health insurance policy to provide coverage for sickle cell anemia.

17B:27-46.1kk Group health insurance policy to provide coverage for sickle cell anemia.  4. Every 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 medical expenses incurred by a covered person for the treatment of sickle cell anemia and, if the policy provides benefits for expenses incurred in the purchase of outpatient prescription drugs, then the policy 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 policy. This section shall apply to those policies in which the insurer has reserved the right to change the premium. L.2011, c.210, s.4.
NJ Rev Stat § 17B:27-46.1ll (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1ll - Group health insurer to provide coverage for prescription eye drops.

17B:27-46.1ll Group health insurer to provide coverage for prescription eye drops.  5. a. A group health insurer which provides hospital or medical expense benefits that include coverage for prescription eye drops, under a policy 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 insured or 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 policies in which the insurer has reserved the right to change the premium. L.2013, c.50, s.5.
NJ Rev Stat § 17B:27-46.1mm (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1mm - Group health insurance policy, contract, coverage for synchronization of prescribed medications.

17B:27-46.1mm Group health insurance policy, contract, coverage for synchronization of prescribed medications.  5. a. Every group health insurance policy or contract delivered, issued, executed or renewed in this State, 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 policies in which the insurer 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.5.
NJ Rev Stat § 17B:27-46.1pp (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1pp - Group health insurance policy to cover digital tomosynthesis of the breast.

17B:27-46.1pp Group health insurance policy to cover digital tomosynthesis of the breast.  5. a. A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 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 policy shall be applied.  c. This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium. L.2017, c.305, s.5.
NJ Rev Stat § 17B:27-46.1qq (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27-46.1qq - Group health insurance policy to provide coverage for donated human breast milk.

17B:27-46.1qq Group health insurance policy to provide coverage for donated human breast milk.  5. a. A group health insurance 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 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 policies in which the insurer has reserved the right to change the premium. c. Nothing in this section shall preclude the insurer 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 policy. e. If there is no supply of human breast milk that meets the requirements of paragraph (2) of subsection a. of this section, the insurer shall not be required to provide coverage of expenses pursuant to this section. L.2017, c.309, s.5.