reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 9 - MEDICAL MALPRACTICE LIABILITY INSURANCE PURCHASING ALLIANCES › Section 11:27-9.3 - Filing requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Within 30 days of formation, a medical malpractice liability insurance purchasing alliance shall file the following with the Commissioner:
1. A certification by a senior officer or other authorized representative of the purchasing alliance, which shall include:
i. The name of the purchasing alliance;
ii. The members of the purchasing alliance;
iii. The names of the board of directors, chairman, treasurer and secretary of the purchasing alliance;
iv. The New Jersey mailing address at which communications for the purchasing alliance are to be received;
v. The eligibility requirements for membership in the purchasing alliance; and
vi. The fees charged to members of the purchasing alliance;
vii. The identity of the insurer who is providing the medical malpractice liability insurance;
viii. A description of how coverage will be issued (that is, through individual policies or through a master policy with individual certificates of insurance); and
ix. The procedure and method by which return premium is calculated if a member discontinues coverage prior to policy termination;
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 9 - MEDICAL MALPRACTICE LIABILITY INSURANCE PURCHASING ALLIANCES › Section 11:27-9.4 - By-laws of the purchasing alliance

Current through Register Vol. 56, No. 14, July 15, 2024
The purchasing alliance shall adopt by-laws, which shall comply with the requirements of P.L. 2004, c. 17, §14c, and otherwise comply with the provisions of P.L. 2004, c. 17 and this subchapter.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 9 - MEDICAL MALPRACTICE LIABILITY INSURANCE PURCHASING ALLIANCES › Section 11:27-9.5 - Termination of membership in a purchasing alliance

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A physician or physician group practice may discontinue purchasing coverage as a member of a purchasing alliance at any time.
(b) A purchasing alliance may include a requirement in its bylaws or joint contract that members provide no more than 30 days notice of discontinuance to the alliance.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 9 - MEDICAL MALPRACTICE LIABILITY INSURANCE PURCHASING ALLIANCES › Section 11:27-9.6 - Prohibited practices

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A purchasing alliance shall not:
1. Assume risk for the cost or provision of medical malpractice liability insurance;
2. Exclude a member who agrees to pay fees for membership and the premium for medical malpractice liability insurance coverage, and who abides by the bylaws of the alliance;
3. Engage in any trade practice or activity prohibited pursuant to 17:29B-1 et seq.;
4. Represent more than 35 percent of the physicians in any one county if the population density of the county is greater than 1,000 per square mile based on the latest census data;
5. Where (a)4 above does not apply, represent more than 35 percent of the physicians in any one of the following three regions:
i. Region I, which consists of the following three digit zip codes in New Jersey: 080, 081, 082, 083 and 084;
ii. Region II, which consists of the following three-digit zip codes in New Jersey: 077, 078, 079, 085, 086, 087, 088 and 089; and
iii. Region III, which consists of the following three digit zip codes in New Jersey: 070, 071, 072, 073, 074, 075 and 076; or
6. Require a member to purchase medical malpractice liability insurance only through the alliance.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 9 - MEDICAL MALPRACTICE LIABILITY INSURANCE PURCHASING ALLIANCES › Section 11:27-9.7 - Violations and penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with any of the requirements of this subchapter shall be a violation of P.L. 2004, c. 17. The purchasing alliance in violation shall be subject to all penalties provided by applicable law including, but not limited to, an order directing that the purchasing alliance cease and desist from further operations until such time as all violations are abated.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 10 - STRUCTURED SETTLEMENTS AND FURNISHING OF BONDS › Section 11:27-10.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
The purpose of this subchapter is to establish the requirements that the judgment debtor or the judgment debtor's insurer shall follow in order to post a bond or security pursuant to a structured payment agreement authorized by 17:30D-27.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 10 - STRUCTURED SETTLEMENTS AND FURNISHING OF BONDS › Section 11:27-10.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Annuity" means an annuity issued by an insurer licensed or authorized to do business in this State, which is a qualified assignment under section 130 of the Federal Internal Revenue Code of 1986, 26 U.S.C. §
										130.
"Commissioner" means the Commissioner of the Department of Banking and Insurance of the State of New Jersey, or his or her designee as may be permitted by law.
"Department" means the Department of Banking and Insurance of the State of New Jersey.
"Insurer" means any person or persons, corporation, partnership or company authorized by the laws of this State to transact the business of insurance in this State; except that it shall not include agencies, authorities or instrumentalities of the United States, its possessions and territories, the Commonwealth of Puerto Rico, the District of Columbia or a state or political subdivision of a state.
"Judgment creditor" means a claimant who is the recipient of an award for economic or non-economic damages, or both, that is the result of an action filed against a health care provider for medical malpractice, which award is subject to the provisions of 17:30D-27.
"Judgment debtor" means a health care provider who, as a defendant in an action brought for medical malpractice, is required to pay the claimant an award that is subject to the provisions of N.J.S.A. 17:20D-27.
"Non-economic damages" means damages for physical and emotional pain, suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of enjoyment of life, loss of society and companionship, loss of consortium, hedonic damages, injury to reputation, and all other nonpecuniary losses of any kind or nature.
"Structured payment agreement" means an agreement made to settle a claim or lawsuit or respond to a judgment in an action brought for medical malpractice by an injured person whereby a series of periodic payments, rather than a lump sum payment, is made over time to a claimant, in accordance with the needs of the claimant or the claimant's family, either through the purchase of an annuity or the establishment of a trust fund, or by another means approved by the court.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 10 - STRUCTURED SETTLEMENTS AND FURNISHING OF BONDS › Section 11:27-10.3 - Structured settlement bond/security requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Pursuant to 17:30D-27, the judgment debtor or the judgment debtor's insurer shall post a bond or security or, with the written consent of the judgment creditor, assign, as set forth in (b) below, its periodic payment obligations to an insurer authorized to write insurance business in New Jersey, in order to assure full payment of non-economic damages awarded in excess of $ 1 million, or as otherwise agreed to by the parties in a medical malpractice matter. The bond or other security requirements are specified below:
1. A bond shall not be deemed adequate unless it is written by a company that is authorized to do business in this State and is rated A-, or better, by A.M. Best Company or maintains a comparable rating with Standards & Poor's, Moody's Investors Services or Fitch Ratings. A "comparable rating," means a rating of at least A- from Standards & Poor's, at least A3 from Moody's Investors Services, or at least A- from Fitch Ratings.
i. No bond may be cancelled or be subject to cancellation unless at least 60 days advance written notice is filed with the court and the claimant.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to establish reporting requirements regarding reinsurance agreements and loss reserves established by insurers that are writing medical malpractice liability insurance in this State.
(b) Except as set forth in this subchapter, this subchapter shall apply to insurers that are writing medical malpractice liability insurance in this State. This subchapter shall not apply to any insurer that has less than $ 1,000,000 of direct written premiums in medical malpractice liability insurance on a countrywide basis as of December 31 immediately preceding, or an insurer that has less than $ 1,000,000 of direct written premiums in medical malpractice liability insurance in this State as of December 31 immediately preceding and that do not write coverage for physicians or surgeons for the relevant period.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The words and terms, as used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Department" means the New Jersey Department of Banking and Insurance.
"Insurer" means an entity authorized pursuant to 17:17-1 et seq. or admitted pursuant to 17:32-1 et seq. that is writing medical malpractice liability insurance in this State.
"NAIC" means the National Association of Insurance Commissioners.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.3 - Reinsurance agreements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No later than the earlier of 60 days after the effective date of or 30 days after the execution of a new, renewal of or amendment to any ceded reinsurance contract covering medical malpractice liability insurance, whether such agreement covers medical malpractice liability as a single line or in combination with other lines, an insurer shall file with the Department:
1. A copy of the complete ceded reinsurance agreement, including all amendments thereto; and
2. The reinsurance attestation maintained in accordance with the instructions to the NAIC annual statement, required pursuant to 17:23-1.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.4 - Actuarial reports

Current through Register Vol. 56, No. 14, July 15, 2024
(a) An insurer transacting medical malpractice liability insurance shall file with the Department by no later than March 15 of each year a copy of the actuarial opinion summary and, by no later than June 1 of each year, a copy of the actuarial report that are maintained pursuant to the instructions to the NAIC annual statement filed pursuant to 17:23-1. The actuarial report shall include the actuarial estimate and/or range for the reserves recommended to be established by the insurer.
(b) Insurers shall file with the actuarial report required pursuant to (a) above a detailed justification supporting the management decision for the level of reserves selected, signed by the chief executive officer and chief financial officer of the insurer. In addition, the written justification shall include a justification for the selection by the management of the insurer of applicable loss sensitive items, which shall include, but not be limited to, the following:
1. Death, disability and retirement (DDR) reserves booked as part of unearned premiums;
2. Other extended reporting endorsement reserves booked as part of unearned premiums;
3. Statutory reserves;
4. Technical reserves;
5. Retroactive reinsurance reserves (assumed and/or ceded);
6. Other reserves reported as write-in lines on Page 3 (Liabilities) on the NAIC annual statement;
7. Accrual/return for direct commissions;
8. Accrual/return for ceded and/or assumed commissions; and
9. Accrual/return for interest on reinsurance funds held.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.5 - Confidentiality

Current through Register Vol. 56, No. 14, July 15, 2024
All of the documents and information filed pursuant to this subchapter shall be confidential and shall not be deemed a public record for purposes of the Open Public Records Act, 47:1A-1 et seq.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 11 - REPORTING REQUIREMENTS › Section 11:27-11.6 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter shall result in the imposition of penalties pursuant to law, including, but not limited to, penalties set forth in 17:33-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 12 - CORPORATE GOVERNANCE › Section 11:27-12.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth minimum requirements for the independence of the board of directors and the committees of the board of directors of an insurer that is writing medical malpractice liability insurance in this State.
(b) This subchapter shall apply to all insurers that are writing medical malpractice liability insurance in this State pursuant to 17:17-1 et seq. and 17:32-1 et seq., as applicable.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 12 - CORPORATE GOVERNANCE › Section 11:27-12.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as used in this subchapter, shall have the following meaning, unless the context clearly indicates otherwise.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Control," "controlling" or "controlled by" are as defined in N.J.S.A. 17:27A-1c.
"Department" means the New Jersey Department of Banking and Insurance.
"Insurer" means an entity authorized pursuant to 17:17-1 et seq. or admitted pursuant to 17:32-1 et seq. that is writing medical malpractice liability insurance in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 12 - CORPORATE GOVERNANCE › Section 11:27-12.3 - Board of directors

Current through Register Vol. 56, No. 14, July 15, 2024
Not less than one-third of the directors of an insurer, and not less than one-third of the members of each committee of the board of directors of any insurer, shall be persons who are not officers or employees of that insurer or of any entity controlling, controlled by, or under common control with, that insurer and who are not beneficial owners of a controlling interest in the voting securities of that insurer or any such entity. At least one such person shall be included in any quorum for the transaction of business at any meeting of the board of directors or any committee thereof.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 12 - CORPORATE GOVERNANCE › Section 11:27-12.4 - Independent board member committees

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The board of directors of an insurer shall establish one or more independent board member committees. Such committees shall be comprised of at least two members and shall be comprised solely of directors who are not officers or employees of the insurer or of any entity controlling, controlled by, or under common control with, the insurer and who are not beneficial owners of a controlling interest in the voting securities of the insurer or any such entity. Such committees shall meet not less than quarterly. Such committees shall be responsible for recommending the selection of independent certified public accountants and reviewing the insurer's financial condition, the scope and results of any independent audit or review, and any internal audit.
1. The requirements imposed by (a) above and by 11:27-12.3 shall not apply to an insurer that is a direct subsidiary of an entity that satisfies the requirements set forth therein.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 12 - CORPORATE GOVERNANCE › Section 11:27-12.5 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter shall result in the imposition of penalties as authorized by law, including, but not limited to, the penalties authorized by 17:33-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 13 - MEDICAL MALPRACTICE LIABILITY INSURERS - BIANNUAL REPORTING OF RATE MODIFIERS › Section 11:27-13.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to provide for the biannual reporting of information related to rate modifiers used by medical malpractice liability insurers writing physicians and surgeons coverage in this State.
(b) This subchapter shall apply to all insurers authorized to transact medical malpractice liability insurance and writing physicians and surgeons coverage in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 13 - MEDICAL MALPRACTICE LIABILITY INSURERS - BIANNUAL REPORTING OF RATE MODIFIERS › Section 11:27-13.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Department" means the New Jersey Department of Banking and Insurance.
"Insurer" means an insurer authorized to transact medical malpractice liability insurance in this State, and that is writing physicians and surgeons coverage in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 13 - MEDICAL MALPRACTICE LIABILITY INSURERS - BIANNUAL REPORTING OF RATE MODIFIERS › Section 11:27-13.3 - Biannual reporting requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All insurers shall file with the Department biannually the information set forth in Exhibit 1 in the Appendix to this subchapter, incorporated herein by reference, no later than August 1 and February 1 of each year, for the immediately preceding six month periods of January 1 through June 30 and July 1 through December 31, respectively, as applicable.
(b) With the exception of information otherwise filed pursuant to N.J.S.A. 17:29AA-1 et seq., information filed pursuant to this subchapter shall be deemed proprietary and therefore kept confidential pursuant to N.J.S.A. 17:23-24f, and shall not be considered a public record pursuant to the Open Public Records Act, 47:1A-1 et seq.
(c) The information filed pursuant to this subchapter shall be filed either electronically and sent to reports@dobi.nj.gov, or on a CD-ROM sent to:
Office of Property and Casualty
New Jersey Department of Banking and Insurance
20 West State St.
PO Box 325
Trenton, NJ 08625-0325.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 13 - MEDICAL MALPRACTICE LIABILITY INSURERS - BIANNUAL REPORTING OF RATE MODIFIERS › Section 11:27-13.4 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter shall result in the imposition of penalties as authorized by law, including, but not limited to, penalties authorized pursuant to 17:33-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This subchapter sets forth:
1. The procedures by which the Commissioner shall establish the designated range of annual rate change that may become effective 30 days after filing pursuant to N.J.S.A. 17:29AA-5.1;
2. The filing requirements for changes in rates for medical malpractice liability insurance; and
3. The procedures for the review of medical malpractice liability insurance rates subject to prior approval.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Department" means the New Jersey Department of Banking and Insurance.
"Insurer" means an insurer authorized or admitted to transact medical malpractice liability insurance in this State.
"NAIC" means the National Association of Insurance Commissioners.
"Prospective loss cost" means that portion of a rate that does not include provisions for expenses (other than loss adjustment expenses) or profit, and are based on historical aggregate losses and loss adjustment expenses adjusted through development to their ultimate value and projected through trending to a future point in time.
"Rate" means the unit charge by which the measure of exposure or the amount of insurance specified in a policy of insurance or covered thereunder is multiplied to determine the premium. The unit charge may be expressed as a single number or as a prospective loss cost and an adjustment to account for the treatment of expenses, profit and variations in loss experience.
"Rate change" means a change to any part of a rating system that results in a change to an insured's premium that is not accompanied by a corresponding change in coverage.
"Rating organization" means every person or persons, corporation, partnership, company, society or association engaged in the business of rate-making for two or more insurers.
"Rating system" means every schedule, class, classification, rule, guide, standard, manual, table or rating plan by whatever name described containing the rates and rules used by any insurer in determining or ascertaining a rate.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.3 - Designation of range of annual rate change limitation

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Commissioner shall designate the range of annual rate change pursuant to N.J.S.A. 17:29AA-5.1 as set forth in this section.
1. If the Commissioner finds that either of the following conditions exist, then the range of annual rate change shall be plus or minus five percent for that category, subcategory, specialty or subspecialty:
i. There is a significant restriction on the availability and affordability of medical malpractice liability insurance for a category, subcategory, specialty or subspecialty of health care provider, and there is no significant negative impact to the capitalization and reserve requirements necessary to ensure the solvency of insurers; or
ii. There are significant limitations on access to care by the citizens of this State to a category, subcategory, specialty or subspecialty of health care provider, and there is no significant negative impact to the capitalization and reserve requirements necessary to ensure the solvency of insurers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.4 - Commissioner's findings

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Commissioner's findings as provided in N.J.A.C. 11:27-14.3 shall be made no less frequently than once every three years as follows:
1. The Department shall issue a public notice setting forth the Commissioner's proposed findings in accordance with N.J.A.C. 11:27-14.3 pursuant to data at the time of issuance not earlier than 60 days prior to the effective date thereof. The public notice shall be disseminated to those interested parties on the Department's distribution list utilized pursuant to N.J.A.C. 1:30-5.2(a)6, and shall be posted on the Department's web site:
www.dobi.nj.gov
. In addition, the public notice shall be published in the New Jersey Register. The public notice shall provide that interested parties shall have 30 days from the date of its posting on the Department's web site to provide written comments or additional data for the Commissioner's determination under N.J.A.C. 11:27-14.3.
2. After giving due consideration to any comments and data received, the Commissioner shall thereafter issue an Order prescribing each designated range of annual rate change and the categories of providers whose medical malpractice liability insurance rate changes shall be subject to each range pursuant to the standards set forth in N.J.A.C. 11:27-14.3. The Order shall be disseminated to those interested parties on the Department's distribution list utilized pursuant to 1:30-5.2(a)6, and to all persons who submitted written comments on the public notice referenced in (a)1 above, and shall also be posted on the Department's web site:
www.njdobi.org
. In addition, the Order shall be published in the New Jersey Register. The Order shall constitute a final agency decision.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.5 - Filing procedures

Current through Register Vol. 56, No. 14, July 15, 2024
Any medical malpractice liability insurance rate changes, unless such are required to be filed for prior approval pursuant to this subchapter, shall be filed with the Department no later than 30 days prior to the implementation thereof, and thereafter may be implemented unless disapproved by the Department within the 30-day period.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.6 - Rate filing requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Any insurer or rating organization seeking to change or modify its rating system for medical malpractice liability insurance shall provide the following information in support of its application:
1. A narrative overview that sets forth the contents of the filing, and explains the reasons and procedures used to develop the proposed rating system; and
2. Data regarding New Jersey premium, exposures, losses or loss costs, loss adjustment expenses, underwriting expenses and profit provisions as necessary to support the proposed rating system. Filers shall provide all underlying calculations, including any judgments made.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.7 - Procedures for review and action on filings requiring prior approval

Current through Register Vol. 56, No. 14, July 15, 2024
(a) In computing any period of time fixed by this subchapter, the day of the act or event from which the designated period begins to run is not to be included. The last day of the period so computed is to be included, unless it is on a Saturday, Sunday or legal holiday, in which event the period runs until the end of the next day which is neither a Saturday, Sunday nor legal holiday.
(b) Provisions of this subchapter that establish time limits may be relaxed or modified by the Commissioner for good cause shown.
(c) A determination by the Department that a filing requiring prior approval is complete relates solely to the presence in the filing of the items required by 11:27-14.6 and shall not be considered a finding regarding the accuracy or reasonableness of the information or calculations.
(d) The time period for the Department's review of a prior approval filing shall commence the day after the filing is received.
(e) The Department shall advise the filer if the filing is incomplete not later than 15 days after receipt of the filing.
1. The filing shall be deemed to be complete if the filer is not notified that the filing is incomplete within the 15-day period.
2. Notice to the filer that the filing has been found to be incomplete shall specify the missing item(s) or information.
3. The Department may disapprove an incomplete filing as a nonconforming filing. Any resubmission of the filing after the deficiency has been cured shall be considered initial receipt.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.8 - Changes to rating system with no impact on premium

Current through Register Vol. 56, No. 14, July 15, 2024
Any change to an insurer's or rating organization's rating system that has no impact on premiums charged (for example, a company introduces a new limit and factor with no impact on premium) shall be filed with the Department for review no later than 30 days prior to the implementation thereof. Such change thereafter may be implemented unless disapproved by the Department within the 30-day period.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 27 - MEDICAL MALPRACTICE LIABILITY INSURANCE › Subchapter 14 - CHANGES TO MEDICAL MALPRACTICE LIABILITY INSURANCE RATES › Section 11:27-14.9 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with this subchapter may result in the imposition of penalties as authorized by law, including, but not limited to, those penalties authorized pursuant to 17:33-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth the admission procedures and financial reporting requirements which are necessary to implement 17:47B-1 et seq.
(b) This subchapter shall apply to all captive insurance companies licensed under 17:47B-1 et seq.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, as used in this subchapter, shall have the following meanings, unless the context indicates otherwise.
"Alien captive insurance company" means an insurance company formed to write insurance business for its parents and affiliates and licensed pursuant to the laws of a jurisdiction other than this State which imposes statutory or regulatory standards in a form acceptable to the Commissioner on companies transacting the business of insurance in that jurisdiction.
"Association captive insurance company" means a company that insures risks of the member organizations of the association and their affiliated companies.
"Branch captive insurance company" means an alien captive insurance company licensed by the Commissioner to transact the business of insurance in this State through a business unit with a principal place of business in this State.
"Captive" or "captive insurance company" means any pure captive insurance company, association captive insurance company, sponsored captive insurance company or industrial insured captive insurance company formed or licensed pursuant to 17:47B-1 et seq. For the purposes of this subchapter, a branch captive insurance company shall be a pure captive insurance company with respect to operations in the State, unless otherwise permitted by the Commissioner.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Department" means the New Jersey Department of Banking and Insurance.
"Industrial insured captive insurance company" means a company that insures risks of the industrial insureds that comprise the industrial insured group, and their affiliated companies.
"Pure captive insurance company" means a company that insures risks of its parent and affiliated companies or controlled unaffiliated businesses.
"Sponsored captive insurance company" means a captive insurance company:
1. In which the minimum capital and surplus required by applicable law is provided by one or more sponsors;
2. That is formed or licensed under 17:47B-1 et seq.;
3. That insures the risks of separate participants through the contract; and
4. That segregates each participant's liability through one or more protected cells.
"Work papers" include, but are not necessarily limited to, schedules, analyses, reconciliations, abstracts, memoranda, narratives, flow charts, copies of company records or other documents prepared or obtained by the accountant and his or her employees in the conduct of their examination of the company.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.3 - Captive formation; general admission requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A captive that intends to be formed and licensed to do business in any of the lines of insurance authorized by 17:47B-1 et seq., shall submit the following to the Department, as applicable:
1. A captive application for admission (form can be found on the Department's website at
http://www.state.nj.us/dobi/division_insurance/captive/app_formation.htm
). The application requests the name of the proposed captive, the type of captive, the parent, the directors, capital and surplus information and the names and addresses of professional service providers;
2. The appropriate costs for license application review as set forth in 11:28-1.5;
3. An irrevocable letter of credit (a sample of which can be found on the Department's website at the address indicated above);
4. A detailed business plan (form outline can be found on the Department's website at the address indicated above);
5. Biographical affidavits (form can be found on the Department's website at the above address) - one for each incorporator, officer, and director of a corporate applicant or each manager and member owning a 10 percent or greater interest in a L.L.C. applicant;
6. Designee to receive Department documents (form can be found on the Department's website at the above address);
7. Designee for Receipt of Service of Process in accordance with N.J.S.A. 17:47B-2b.(4) (which form can be found on the Department's website at the above address);
8. Bylaws;
9. Articles of incorporation or the equivalent for non-corporate forms of business;
10. Pro forma financial projections (five-year expected and five-year adverse);
11. Actuarial feasibility study;
12. Statement of benefit to New Jersey;
13. Minimum capital and surplus guidelines;
14. As required pursuant to 17:47B-1 et seq.:
i. A statement under oath of its president and secretary showing its financial condition;
ii. A description of coverage limits and rates together with any additional information as the Commissioner may reasonably require. In the event of any subsequent material change in an item in the description, the captive insurance company shall submit to the Commissioner for approval an appropriate revision and shall not offer any additional lines of insurance until a revision of the description is approved by the Commissioner. The captive shall notify the Department of any proposed material change not later than 30 days prior to the effective date of the adoption of any such change; and
iii. Documents evidencing the following:
(1) The amount and liquidity of its assets relative to the risks to be assumed;
(2) The adequacy of the expertise, experience and character of the person who will manage it;
(3) The overall soundness of its plan of operation; and
(4) The adequacy of the loss prevention programs of its insureds (only applicable to property casualty); and
15. Statement of net worth.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.4 - Redomestication of captive insurance companies

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All captive insurance companies redomesticating to New Jersey shall file the following documentation with the Department:
1. A captive application for admission (form can be found on the Department's website at
http://www.state.nj.us/dobi/division_insurance/captive/app_redomestication.htm
). The application requests the name of the proposed captive, the type of captive, the parent, the directors, capital and surplus information and the names and addresses of professional service providers;
2. A detailed business plan (form outline can be found on the Department's website at the above address);
3. Biographical affidavits (form can be found on the Department's website at the address above) - one for each incorporator, officer, and director of a redomesticating corporate captive, or each manager and member owning a 10 percent or greater interest in a L.L.C. applying to redomesticate as a captive;
4. Designee to receive Department documents (which form can be found on the Department's website at the above address);
5. Designee for Receipt of Service of Process in accordance with N.J.S.A. 17:47B-2b.(4) (form can be found on the Department's website at the above address);
6. Current examination reports;
7. A year-end financial statement and any subsequently issued quarterly statements;
8. The last audited financial statement;
9. The appropriate cost as set forth in 11:28-1.5;
10. A statement of good standing and letter from domicile stating that there are no open issues; and
11. The Commissioner may, in lieu of any of the documents listed in (a)1 through 10 above, request alternative and additional documentation, on the basis of which the Department may determine that the applicant has demonstrated that it sufficiently meets the financial requirements necessary for admission in this State as a captive insurance company.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.5 - Costs of license application and renewal reviews

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Commissioner may have the initial application reviewed by outside experts, with the costs of the review paid by the applicant. The applicant will be billed the actual costs for such a review, up to a maximum of $ 4,000. The outside review is of an advisory nature only and the Commissioner will make the determination regarding approval or disapproval of an application. The cost for the review/analysis of an initial application for licensure as a captive conducted by Department staff shall be based upon the number of hours devoted by Department staff to the review/analysis of the application and the salary levels of the staff members who perform or support those functions. Such salary levels will range from approximately $ 35.00 per hour for administrative/clerical support staff to approximately $ 100.00 per hour for senior professionals in the Captives Unit. In no event shall the cost for such a review exceed $ 4,000. The cost for a license renewal review shall be $ 300.00. Payments for these costs are non-refundable.
(b) All checks or money orders shall be made payable to: State of New Jersey - General Treasury.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.6 - Captive managers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No person shall act as a captive manager in this State unless they are registered with the Department as a captive manager. The Department shall maintain a list of registered captive managers in this State and shall post on its website a list of all registered captive managers who indicated on their application that their contact information may be published. Individuals seeking registration as a captive manager shall submit an application for captive manager and a Biographical Affidavit (forms can be found on the Department's website at
http://www.state.nj.us/dobi/division_insurance/captive/serviceproviders.html
) to the Department for approval. The application requests the name and address of the captive manager/firm, the date of formation and incorporation, and the names of any captives currently under management.
(b) Any person acting as a captive manager in this State shall have an office in New Jersey and shall maintain in this State the books and records of all licensed New Jersey captives being managed by that manager.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.7 - Reporting requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Pursuant to 17:47B-1 et seq., a captive insurance company doing business in this State shall annually submit to the Commissioner a report of their financial condition, verified by oath of two of the captive's executive officers, prior to March 1 of each year. An association captive shall file its report in the form required by 17:23-1 et seq.
(b) A captive insurance company that insures life and/or health insurance policies shall adhere to the following:
1. The captive insurance company shall use statutory accounting principles (that is, as documented in the National Association of Insurance Commissioners' Accounting Practices and Procedures Manual) and shall submit the annual report in the form of the annual statement approved by the National Association of Insurance Commissioners for life insurers. The captive shall submit to the Department for approval any requests for modification or supplement to the annual statement form.
2. If the captive desires to use generally accepted accounting principles including any and all modifications thereto, based upon the nature of the business insured and the captive parent's domestic regulator prior to filing a report, it shall request approval to do so from the Commissioner. With the Commissioner's approval, it shall submit an annual report which shall include the appropriate or necessary modifications or adaptations thereto.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.8 - Annual audit

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All captives shall be subject to an annual audit by an independent certified public accountant, registered with the Commissioner, and subject to N.J.S.A. 17:47B-6b, shall annually file an audited financial report describing the results of the said audit with the Commissioner on or before June 30 for the calendar year ending December 31 immediately preceding.
(b) The annual audit report shall be considered part of the company's annual report of financial condition, except with respect to the date by which it must be filed with the Commissioner.
(c) The annual audit report shall consist of the following:
1. An Opinion of Independent Certified Public Accountant, which shall:
i. Include financial statements which have been examined by an independent certified public accountant in accordance with generally accepted auditing standards as determined by the American Institute of Certified Public Accountants;
ii. Cover all years presented; and
iii. Be addressed to the captive on stationery of the accountant, bear the date and address of issuance and bear the original manual signature of the accountant;
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.9 - Designation of independent certified public accountant

Current through Register Vol. 56, No. 14, July 15, 2024
(a) After becoming subject to the provisions of this subchapter, captives shall, within 90 days, report to the Commissioner in writing, the name and address of the independent certified public accountant retained to conduct the annual audit set forth in this subchapter.
(b) No person or firm shall act as an independent certified public accountant for a captive insurer unless they are registered with the Department. The Department shall maintain a list of registered independent certified public accountants and shall post this list on its website. A person or firm seeking such registration who is not on the Department's list shall submit an application for Authorization as an Independent Certified Public Accountant for Captive Insurance Business and a Biographical Affidavit to the Department for approval. (Forms are available on the Department's website at
http://www.state.nj.us/dobi/division_insurance/captive/serviceproviders.html
.)
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 28 - CAPTIVE INSURANCE › Subchapter 1 - CAPTIVE INSURANCE › Section 11:28-1.10 - Notification of adverse financial condition

Current through Register Vol. 56, No. 14, July 15, 2024
A licensed captive shall require the independent certified public accountant to immediately notify in writing an officer and all members of the board of directors of the captive of any determination by the independent certified public accountant that the captive has materially misstated its financial condition in its report to the Commissioner. The captive shall furnish such notification to the Commissioner within five working days of receipt thereof.