reglab/housing_qa huggingface dataset:
NJ Rev Stat § 17B:27A-19.33 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-19.33 - Small employer health benefits plan to cover adolescent depression screenings.

17B:27A-19.33 Small employer health benefits plan to cover adolescent depression screenings.  7. A small employer 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.162 (C.17B:27A-17 et seq.), 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 health benefits plan, except that the carrier 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 health benefits plans in which the carrier has reserved the right to change the premium. L.2021, c.73, s.7.
NJ Rev Stat § 17B:27A-20 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-20 - Coinsurance, deductibles applicable

17B:27A-20. Coinsurance, deductibles applicable  4. Plans required to be offered under this act may be subject to coinsurance and deductibles, which may vary by selected portions of the coverage, except that no deductible applicable to any portion of the coverage shall exceed $250 for an individual or family unit during any benefit year, and no coinsurance applicable to any portion of the coverage shall exceed $500 for an individual or family unit during any benefit year, unless provided by the board pursuant to section 17 of P.L.1992, c.162 (C.17B:27A-33).  L.1992,c.162,s.4; 1993,c.162,s.3.
NJ Rev Stat § 17B:27A-21 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-21 - Standard coordination of benefits provisions applicable

17B:27A-21. Standard coordination of benefits provisions applicable  5. Coverage provided pursuant to this act shall be subject to standard coordination of benefits provisions for all persons covered under the policy or contract. Notwithstanding the provision of any other law to the contrary, the health benefits plan with the lowest actuarial value provided under this act shall not extend to any injury for which coverage is available or applicable pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4), and that health benefits plan shall not be used as a substitute for any insurance required to be maintained pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4). L.1992,c.162,s.5.
NJ Rev Stat § 17B:27A-21.1 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-21.1 - Eligibility for enrollment in small employer health benefits plan

17B:27A-21.1 Eligibility for enrollment in small employer health benefits plan  5. Notwithstanding any other provision of law to the contrary, a carrier shall not consider a person's eligibility for medical assistance pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), or the equivalent statute in another state, when determining the person's eligibility for enrollment in, or the provision of benefits under, a small employer health benefits plan delivered, issued or executed in this State. L.1995,c.291,s.5.
NJ Rev Stat § 17B:27A-22 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-22 - Preexisting condition provisions.

17B:27A-22 Preexisting condition provisions.  6. a. No health benefits plan subject to this act shall include any provision excluding coverage for a preexisting condition regardless of the cause of the condition. b. (Deleted by amendment, P.L.2019, c.353) c. (Deleted by amendment, P.L.2019, c.353) L.1992, c.162, s.6; amended 1995, c.298, s.2; 1997, c.146, s.9; 2017, c.361, s.10; 2019, c.353, s.5.
NJ Rev Stat § 17B:27A-24 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-24 - Reasonable specified minimum participation.

17B:27A-24 Reasonable specified minimum participation.  8. Any small employer carrier may require a reasonable specified minimum participation of eligible employees, which shall not exceed 75%, or reasonable minimum employer contributions in determining whether to accept a small group pursuant to this act. The standards so established by the carrier shall be first approved by the board and shall be applied uniformly to all small groups, except that in no event shall a carrier require an employer to contribute more than 10% to the annual cost of the policy or contract, or an amount as otherwise provided by the board, and any minimum participation standards established by the carrier shall be reasonable. In establishing the percentage of employee participation, a one-to-one credit shall be given for each employee covered by a spouse's health benefits coverage, Medicare, Medicaid, NJ FamilyCare or another group health benefits plan. In calculating an employer's participation, the carrier shall include all insured employees, regardless of whether the employees chose an indemnity plan or a health maintenance organization, or a combination thereof. L.1992,c.162,s.8; amended 1993, c.162, s.10; 1994, c.11, s.3; 1995, c.298, s.3; 2001, c.346; 2005, c.166.
NJ Rev Stat § 17B:27A-25.1 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.1 - Findings, declarations relative to small employer health benefits purchasing alliances

17B:27A-25.1. Findings, declarations relative to small employer health benefits purchasing alliances  1. The Legislature finds and declares that: a. Small employers, that is, employers that employ between two and 50 employees, have traditionally been at an economic disadvantage with respect to the purchase and provision of health benefits for their employees because certain administrative and premium rate savings that are available to larger employers are not available to them by virtue of their size; b. Providing for the establishment of purchasing alliances comprised of groups of small employers would enable small employers to take advantage of the economies of scale in the delivery of health benefits currently available to large employer groups; and c. Working within the framework of the Small Employer Health Benefits Program established by P.L.1992, c.162 (C.17B:27A-17 et seq.), small employer purchasing alliances, with the voluntary participation of insurance carriers, would have access to the standard health benefits plans developed under that law at a reduced premium, along with the protections afforded under that law, including: guaranteed access to health benefits coverage for their employees; guaranteed renewability of health plans regardless of the health status of employees or their dependents; and prohibitions against the use of certain rating factors such as health status, prior claims history or occupation. L.2001,c.225,s.1.
NJ Rev Stat § 17B:27A-25.2 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.2 - Definitions relative to small employer benefits purchasing alliances

17B:27A-25.2. Definitions relative to small employer benefits purchasing alliances  2. As used in this act: "Board" means a small employer purchasing alliance board of directors provided for in section 4 of this act. "Carrier" means a small employer carrier as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17). "Commissioner" means the Commissioner of Banking and Insurance. "Dependent" means the same as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17). "Eligible employee" means the same as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17). "Eligible group of small employers" means a group of small employers which: (1) are engaged in the same or similar type of trade or business; (2) are members of a common trade association, professional association, or other association; or (3) are located in a common geographic area. "Health benefits plan" means a small employer health benefits plan approved by the commissioner pursuant to section 17 of P.L.1992, c.162 (C.17B:27A-33). "Health status-related factor" means the same as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17). "Member" means a small employer who is a member of a purchasing alliance as provided for in section 3 of this act. "Small Employer Purchasing Alliance," "purchasing alliance" or "alliance" means a small employer purchasing alliance as established pursuant to section 3 of this act. "Small employer" means the same as defined in section 1 of P.L.1992, c.162 (C.17B:27A-17). L.2001,c.225,s.2.
NJ Rev Stat § 17B:27A-25.3 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.3 - Small Employer Purchasing Alliance, formation

17B:27A-25.3. Small Employer Purchasing Alliance, formation  3. Any eligible group of small employers may join together, by means of a joint contract under the procedures established by this act, to form a "Small Employer Purchasing Alliance" for the purpose of negotiating a reduced premium for its members purchasing a small employer health benefits plan or plans for their eligible employees and the employees' dependents. The joint contract shall be executed by all members of the purchasing alliance. L.2001,c.225,s.3.
NJ Rev Stat § 17B:27A-25.4 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.4 - Board of directors

17B:27A-25.4. Board of directors  4. The purchasing alliance, which may be a corporation, shall be governed by a board of directors, elected by the members of the purchasing alliance. No person may serve as an officer or director of an alliance who has a prior record of administrative, civil or criminal violations within the financial services industry. The directors shall serve for terms of three years, and shall serve until their successors are elected and qualified. The directors shall serve without compensation, except for reimbursement for actual expenses. L.2001,c.225,s.4.
NJ Rev Stat § 17B:27A-25.5 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.5 - Bylaws, contents

17B:27A-25.5. Bylaws, contents  5. The board shall adopt by-laws for the operation of the purchasing alliance, which shall be effective upon ratification by a two-thirds majority of the members. The by-laws shall include, but not be limited to: a. The establishment of procedures for the organization and administration of the alliance. b. Procedures for the qualifications and admission of the members of the alliance. The bases for denial of membership shall include, but not be limited to: (1) Performance of an act or practice that constitutes fraud or intentional misrepresentation of material fact; (2) Previous denial of membership in the alliance; or (3) Previous expulsion from the alliance. c. Procedures for the withdrawal of members from the alliance. d. Procedures for the expulsion of members from the alliance. The bases for expulsion shall include, but not be limited to: (1) Failure to pay membership or other fees required by the purchasing alliance; (2) Failure to pay premiums in accordance with the terms of the health benefits plan or the terms of the joint contract; or (3) Performance of an act or practice that constitutes fraud or intentional misrepresentation of material fact. e. Procedures for the termination of the alliance. L.2001,c.225,s.5.
NJ Rev Stat § 17B:27A-25.6 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.6 - Further authority of alliance

17B:27A-25.6. Further authority of alliance  6. In addition to the powers authorized under this act, a purchasing alliance shall have the authority to: a. Set reasonable fees for membership in the alliance that will finance reasonable and necessary costs incurred in administering the purchasing alliance; b. Negotiate premium rates with carriers on behalf of the members of the alliance; and c. Contract with third parties for any services necessary to carry out the powers and duties authorized or required pursuant to this act. L.2001,c.225,s.6.
NJ Rev Stat § 17B:27A-25.7 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.7 - Restrictions on alliances

17B:27A-25.7 Restrictions on alliances  7. A purchasing alliance established pursuant to the provisions of this act shall not: a. Purchase health care services, assume risk for the cost or provision of health care services or otherwise contract with health care providers for the provision of health care services to eligible employees or their dependents; b. Exclude a small employer, eligible employee or dependent from membership in the purchasing alliance who agrees to pay fees for membership and the premium for health benefits coverage and who abides by the by-laws and rules of the purchasing alliance; c. Engage in any act or practice that results in the selection of member small employers or eligible employees based on any health status-related factor; or d. Engage in any trade practice or activity prohibited pursuant to chapter 30 of Title 17B of the New Jersey Statutes. L.2001,c.225,s.7.
NJ Rev Stat § 17B:27A-25.8 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.8 - Certificate from alliance to commissioner

17B:27A-25.8. Certificate from alliance to commissioner  8. a. Within 30 days after its organization, the purchasing alliance board shall file with the commissioner a certificate which shall list the members of the alliance, the names of the board of directors and the chairman, treasurer, and secretary of the purchasing alliance, and the address at which communications for the purchasing alliance are to be received, a copy of the certificate of incorporation of the purchasing alliance, if any, and a copy of the joint contract executed by all of the members. Any change in the information required by the provisions of this section shall be filed with the commissioner within 30 days of the change. b. If the commissioner determines that the premium reduction, permitted pursuant to subsection k. of section 9 of P.L.1992, c.162 (C.17B:27A-25) and filed by a carrier in the informational filing required pursuant to subsection f. of that section, results in rates that are excessive, inadequate or unfairly discriminatory, the commissioner may disapprove or deny the premium reduction. If, after notice and a hearing pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14b-1 et seq.), a carrier or purchasing alliance is found by the commissioner to be in violation of any provision of this act, the commissioner may disapprove or deny the premium reduction permitted pursuant to subsection k. of section 9 of P.L.1992, c.162 (C.17B:27A-25). L.2001,c.225,s.8.
NJ Rev Stat § 17B:27A-25.9 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-25.9 - Rules, regulations

17B:27A-25.9. Rules, regulations  10. The commissioner shall promulgate rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) necessary to effectuate the provisions of this act. L.2001, c.225, s.10.
NJ Rev Stat § 17B:27A-26 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-26 - Health maintenance organization coverage; exceptions

17B:27A-26. Health maintenance organization coverage; exceptions  10. a. No health maintenance organization shall be required to offer coverage or accept applications pursuant to section 3 of this act to a small employer if the small employer does not have eligible individuals who live, work, or reside in the service area for such plan, or if the health maintenance organization reasonably anticipates and demonstrates to the satisfaction of the commissioner that it will not have the capacity in its network of providers within the service area to deliver service adequately to the members of such groups because of its obligations to existing group contract holders and enrollees. Upon denying health insurance coverage in any service area as a result of insufficient network capacity in accordance with this subsection, the health maintenance organization shall not offer coverage in the small employer market within such service area for a period of at least 180 days after the date the coverage is denied. b. No small employer carrier shall be required to offer coverage or accept applications pursuant to this act for any period of time in which the commissioner determines that the requiring of the issuing of policies or contracts pursuant to this act would place the carrier in a financially impaired position. c. A health maintenance organization which complies with the basic health benefits, underwriting and rating standards established by the federal government pursuant to subchapter XI of Pub.L.93-222 (42.U.S.C. s.300e et seq.), and which also provides the comprehensive health benefit plans coverage required by subsection f. of section 3 of P.L.1992, c.162 (C.17B:27A-19), shall be deemed in compliance with this act. L.1992,c.162,s.10; amended 1993, c.162, s.11; 1997, c.146, s.12.
NJ Rev Stat § 17B:27A-28 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-28 - New Jersey Small Employer Health Benefits Program created

17B:27A-28. New Jersey Small Employer Health Benefits Program created  12. There is created a nonprofit entity to be known as the New Jersey Small Employer Health Benefits Program. All carriers issuing health benefits plan policies and contracts in this State shall be members of this program. The program shall be administered by the board of directors established pursuant to section 13 of P.L.1992, c.162 (C.17B:27A-29).  L.1992,c.162,s.12; 1993,c.162,s.6.
NJ Rev Stat § 17B:27A-29.1 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-29.1 - Immunity from liability for board

17B:27A-29.1 Immunity from liability for board  11. A member of the board and an employee of the board shall not be liable in an action for damages to any person for any action taken or recommendation made by him within the scope of his functions as a member or employee, if the action or recommendation was taken or made without malice. The members of the board shall be indemnified and their defense of any action provided for in the same manner and to the same extent as employees of the State under the "New Jersey Tort Claims Act," P.L.1972, c.45 (C.59:1-1 et seq.) on account of acts or omissions in the scope of their employment. L.1995,c.298,s.11.
NJ Rev Stat § 17B:27A-29.2 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-29.2 - Rules, regulations for voluntary risk pooling arrangement

17B:27A-29.2 Rules, regulations for voluntary risk pooling arrangement  12. The board may, if necessary, adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.) to establish a voluntary risk pooling arrangement for program members. If the board determines that such an arrangement is necessary, it shall submit the proposed rules and regulations to the Legislature for review on a day that the Legislature is in session and to the commissioner for his approval. If the Legislature does not take action in 30 days to amend or otherwise change the rules and regulations, the rules and regulations shall be effective upon approval by the commissioner or upon such later date as the board determines. L.1995,c.298,s.12.
NJ Rev Stat § 17B:27A-30 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-30 - Submission of plan of operation

17B:27A-30. Submission of plan of operation  14. Within 90 days after the election of the initial board, the board shall submit to the commissioner a plan of operation which shall establish the administration of the program pursuant to the provisions of this act. The plan of operation and any subsequent amendments thereto shall be submitted to the commissioner who shall, after notice and hearing, approve the plan if he finds that it is reasonable and equitable and sufficiently carries out the provisions of this act. The plan of operation shall become effective after the commissioner has approved it in writing. The plan or any subsequent amendments thereto shall be deemed approved if not expressly disapproved by the commissioner in writing within 90 days of receipt by the commissioner.  L.1992,c.162,s.14.
NJ Rev Stat § 17B:27A-31 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-31 - Contents of plan of operation

17B:27A-31. Contents of plan of operation  15. The plan of operation shall constitute a public record and shall include, but not be limited to, the following: a. A method of handling and accounting for assets and moneys of the program and an annual fiscal reporting to the commissioner; b. A means of providing for the filling of vacancies on the board, subject to the approval of the commissioner; and c. (Deleted by amendment, P.L.1993, c.162).  d. (Deleted by amendment, P.L.1995, c.298). e. (Deleted by amendment, P.L.1995, c.298). f. (Deleted by amendment, P.L.1995, c.298). g. Any additional matters which are appropriate to effectuate the provisions of this act. L.1992,c.162,s.15; amended 1993,c.162,s.7; 1994,c.11,s.5; 1995,c.298,s.7.
NJ Rev Stat § 17B:27A-32 (2021)
2021 New Jersey Revised Statutes|Title 17B - Insurance|Section 17B:27A-32 - Authority of board

17B:27A-32. Authority of board  16. The board shall have the authority to: a. Enter into contracts as are necessary or proper to carry out the provisions and purposes of this act; b. Sue or be sued, including taking any legal actions as may be necessary for recovery of any assessments due to the program or to avoid paying any improper claims; c. Establish rules, conditions, and procedures pertaining to the assessment of members by the program; d. Assess members in accordance with the provisions of this act, including such interim assessments as may be reasonable and necessary for organizational and reasonable operating expenses. Such interim assessments shall be credited as offsets against any regular assessments due following the close of the fiscal year; e. Appoint from among its members appropriate legal, actuarial, and other committees as necessary to provide technical assistance in the operation of the program, policy and other contract design, and any other function within the authority of the program; and f. Contract for an independent actuary or any other professional services the board deems necessary to carry out its duties under P.L.1992, c.162 (C.17B:27A-17 et seq.). L.1992,c.162,s.16; amended 1993,c.162,s.19; 1995,c.298,s.8.