reglab/statecodes huggingface dataset:
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17D - INSURANCE PRODUCER STANDARDS OF CONDUCT: ADMINISTRATIVE PROCEDURES AND PENALTIES › Subchapter 2 - ADMINISTRATIVE PROCEDURES AND PENALTIES › Section 11:17D-2.4 - Schedules of fines for certain insurance producer licensing violations

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Department shall impose fines for certain insurance producer violations in accordance with the following schedule:
1. Failure to maintain on file with the Department a complete and accurate business or home address or to notify the Department of a change of business or home address within 30 calendar days as required by 11:17-2.7(f): $ 250.00, except where notification is delayed beyond 60 calendar days, including the aforesaid 30 days, in which case the violator is subject to the maximum penalty provided by law;
2. Failure to notify the Department of the opening of a branch office within 30 days or the closing of a branch office within 20 days as required by 11:17-2.8(c): $ 500.00;
3. Payment of a license or processing fee with a check later returned for insufficient funds or because the account is closed: $ 500.00;
4. Failure to obtain approval for the use of a business name from the Department prior to conducting business under that name as required by 11:17-2.7(c): $ 250.00;
5. Failure to notify the Department within 30 days of the addition or deletion of owners of more than 10 percent or officers, directors or partners as required by 11:17-2.1 1(c): $ 250.00;
6. Failure to maintain in at least one office with an address on file with the Department copies of all employment contracts and copies of all agency contracts in accordance with 11:17-2.9: $ 100.00 per contract; and
7. Upon demand by a licensed insurance producer, the failure by an employing insurance producer, insurer, or other custodian to return a license to the possession of the named insurance producer: $ 500.00.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17D - INSURANCE PRODUCER STANDARDS OF CONDUCT: ADMINISTRATIVE PROCEDURES AND PENALTIES › Subchapter 2 - ADMINISTRATIVE PROCEDURES AND PENALTIES › Section 11:17D-2.5 - Effect of suspension or revocation of producer license

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon service of any final order suspending or revoking an insurance producer license, the insurance producer shall immediately return to the Department for cancellation any license in his or her possession.
(b) Imposition of a period of suspension or of revocation shall sever any existing agency relationships with insurance companies, employment relationships with other insurance producers, and licensed officer or partner relationships with any licensed organization. In the event a license is later reinstated, those relationships shall be reestablished by refiling in accordance with 11:17-2.9.
(c) No other licensed individual or organization shall advertise, display or conduct any insurance business using the legal or business name of any person whose license has been revoked.
(d) No person whose insurance producer license has been suspended or revoked shall be entitled to any refund of license fees for the unexpired term of any license issued.
(e) No person whose license has been suspended or revoked may be a partner, officer, director or owner of a licensed business entity, or otherwise be employed in any capacity by an insurance producer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17D - INSURANCE PRODUCER STANDARDS OF CONDUCT: ADMINISTRATIVE PROCEDURES AND PENALTIES › Subchapter 2 - ADMINISTRATIVE PROCEDURES AND PENALTIES › Section 11:17D-2.6 - Reinstatement after suspension of insurance producer license

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Upon completion of any period of suspension and upon the completion of all conditions contained in the order suspending an insurance producer's license, a former licensee may reapply for an insurance producer license by submitting a properly completed application as required by 11:17-2.3.
(b) The applicant shall submit with the application a copy of the order of suspension and an executed affidavit that states:
1. That the period of suspension has been completed;
2. That all required conditions for reinstatement as described in the order of suspension have been met;
3. That documents confirming that all conditions have been met, such as receipts for fines or restitution, satisfactions of judgement, etc. are attached to the affidavit; and
4. That the applicant has complied with all restrictions imposed by the order of suspension.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17D - INSURANCE PRODUCER STANDARDS OF CONDUCT: ADMINISTRATIVE PROCEDURES AND PENALTIES › Subchapter 2 - ADMINISTRATIVE PROCEDURES AND PENALTIES › Section 11:17D-2.7 - Reinstatement after revocation of insurance producer license

Current through Register Vol. 56, No. 14, July 15, 2024
(a) A person whose license has been revoked may, after five years from the effective date of any order revoking an insurance producer license, apply for reinstatement of the license on the form of application used for initial insurance producer license applicants.
(b) The applicant shall demonstrate compliance with the professional qualification requirements of N.J.S.A. 17:22A-32a(3) and (5).
(c) The applicant shall include with the application an affidavit containing the following information concerning the applicant's activities since revocation:
1. An employment history;
2. A statement concerning the other business interests, if any, of the applicant;
3. The manner of disposition of the applicant insurance producer business upon revocation of his or her insurance producer license;
4. Whether restitution has been made as a result of the activities that led to revocation, including the names and addresses of the persons or entities to whom restitution was made and amounts of restitution made;
5. Whether the applicant currently holds any other business, professional or occupational licenses in this or any other state;
6. Whether the applicant, or any business in which he or she owns five percent or more, is or has been a party to any legal or administrative proceedings in this or any other state, and if so a statement concerning the nature of the proceedings, the parties and the result or current status; and
7. A written statement by the applicant describing the manner in which he or she has improved during the period of revocation his or her reputation, character, trustworthiness, competency and worthiness to be an insurance producer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17D - INSURANCE PRODUCER STANDARDS OF CONDUCT: ADMINISTRATIVE PROCEDURES AND PENALTIES › Subchapter 2 - ADMINISTRATIVE PROCEDURES AND PENALTIES › Section 11:17D-2.8 - Severability

Current through Register Vol. 56, No. 14, July 15, 2024
If any provision of this subchapter or the application thereof to any person or circumstance is for any reason held to be invalid, the remainder of the subchapter and the application of such provision to other persons or circumstances shall not be affected thereby.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this chapter is to implement 18 U.S.C. §
										1033, a Federal statute which provides that no person having been convicted of a felony involving dishonesty or breach of trust or an offense under 18 U.S.C. §
										1033 shall engage in the business of insurance without having first obtained the written consent of the Commissioner or his or her designee.
(b) This subchapter shall apply to any person employed in any capacity in the business of insurance.
(c) This subchapter applies to all insurers doing business in this State pursuant to Title 17, 17B, or 26 of the New Jersey Statutes, or any risk retention group or purchasing group operating pursuant to the "Liability Risk Retention Act of 1986," 15 U.S.C. §§
										3901 et seq., or other similar risk retention organization organized pursuant to State law.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.3 - Prohibited activities; requirement to obtain waiver; determination of appropriate state

Current through Register Vol. 56, No. 14, July 15, 2024
(a) No person having been convicted of a felony involving breach of trust or dishonesty or having been convicted under 18 U.S.C. §
										1033 shall be employed in the business of insurance in this State in any capacity without having first obtained a waiver from the Commissioner or his or her designee in accordance with the provisions of 18 U.S.C. §
										1033(e)(2) and this subchapter.
(b) No insurer, producer, or any other person or independent contractor involved in the business of insurance in this State shall employ any prohibited person in any capacity without having first ensured that said prohibited person has obtained a waiver in accordance with 18 U.S.C. §
										1033(e)(2) and this subchapter.
(c) All prohibited persons seeking to obtain a waiver in accordance with (a) above shall complete and file "Application for Waiver Short Form" or "Application for Waiver Comprehensive Form," set forth at Exhibits A and B respectively in the Appendix to this chapter and incorporated herein by reference to:
New Jersey Department of Banking and Insurance
Consumer Protection Services--Licensing
PO Box 329
Trenton, NJ 08625- 0329
(d) This State shall be deemed to be the appropriate state from which an applicant shall obtain a waiver where:
1. The applicant will be employed in the business of insurance in this State;
2. The applicant would be required to obtain a producer's license to do business in this State; or
3. The applicant is or will be an officer, director or employee of a domestic insurer, reinsurer, producer, third-party administrator or independent contractor performing substantial insurance related activities for a domestic insurer or producer.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.4 - Applications, general provisions and maintenance of records

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Except as provided in (b) below, all prohibited persons who are, or seek to be, employed in the business of insurance in any capacity in this State shall complete and file an application for waiver using the Initial Application (Short Form), set forth as Exhibit A in the Appendix to this chapter and available on the Department website at http:
www.state.nj.us/dobi/inslic.htm
.
(b) The following prohibited persons when seeking a waiver shall complete and file the "Comprehensive Form," set forth as Exhibit B in the Appendix to this subchapter and available on the Department website at http:
www.state.nj.us/dobi/inslic.htm
.
1. Persons in possession of any license to engage in the business of insurance as a producer in this State;
2. Persons seeking to obtain or renew an insurance producer's license in this State; or
3. Persons who are engaged in the business of insurance, whose scope of employment includes any of the following duties or powers:
i. Corporate officer, director or manager;
ii. Direct involvement in the handling of customer funds; or
iii. Direct involvement in selling policies to the public.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.5 - Commissioner's action, order and scope of waiver

Current through Register Vol. 56, No. 14, July 15, 2024
(a) After consideration and review, the Commissioner or his or her designee may:
1. Grant the application for waiver;
2. Deny the application for waiver; and/or
3. Require such other conditions as are deemed appropriate.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.6 - Confidential records and information

Current through Register Vol. 56, No. 14, July 15, 2024
All information and materials in the possession of the Department concerning waivers and applications for waiver are confidential, and not subject to public inspection or copying under the "Right to Know" Law, 47:1A-1 et seq. However, the Department may share information and materials with other states and agencies, in accordance with procedures established by the NAIC's National Special Activities Database (SAD) for the sharing of information pertaining to applications for waiver.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 17E - PERSONS EMPLOYED IN THE BUSINESS OF INSURANCE › Subchapter 1 - CONVICTED PERSONS; WAIVERS › Section 11:17E-1.7 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this chapter shall result in the imposition of penalties as authorized by law.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 1 - ANNUAL AND QUARTERLY FINANCIAL STATEMENT SUBMISSION REQUIREMENTS › Section 11:19-1.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth requirements for the filing of annual and quarterly financial statement data with the NAIC and the Department.
(b) This subchapter applies to licensed insurers in this State.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 1 - ANNUAL AND QUARTERLY FINANCIAL STATEMENT SUBMISSION REQUIREMENTS › Section 11:19-1.2 - 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 clearly indicates otherwise.
"Department" means the New Jersey Department of Banking and Insurance.
"Licensed insurer" means an insurer authorized, admitted or eligible to transact insurance in this State.
"NAIC" means the National Association of Insurance Commissioners.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 1 - ANNUAL AND QUARTERLY FINANCIAL STATEMENT SUBMISSION REQUIREMENTS › Section 11:19-1.3 - Annual and Quarterly Financial Statement Submission Requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All New Jersey licensed insurers shall file their annual and quarterly financial information with the NAIC in accordance with the NAIC Annual Statement Diskette Filing Specifications and the NAIC Diskette Submission Directive in addition to filing this information with the Department in hard copy as set forth in (b) below.
(b) In addition to filing with the NAIC pursuant to (a) above, all domestic insurers regardless of premium volume, as well as any foreign or alien admitted insurer with more than 90 percent of its direct written premiums in New Jersey, shall file required statements in hard copy with the Department. Eligible surplus lines insurers may comply with applicable filing requirements by filing such statements electronically with the NAIC, provided that hard copies of the Juart page, Schedule T and page 3 (Liabilities and Surplus) are filed with the Department.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 1 - ANNUAL AND QUARTERLY FINANCIAL STATEMENT SUBMISSION REQUIREMENTS › Section 11:19-1.4 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter may result in the imposition of penalties as authorized by law, including, but not limited to, penalties authorized by 17:23-2 and 17B:21-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Section 11:19-2.1 - Purpose and Scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth the filing requirements and procedures for the submission of financial data under various Financial Examinations Monitoring System (FEMS) subsystems, for all domestic insurers to the Department.
(b) These rules apply to all domestic insurers regulated under the laws of New Jersey unless specifically stated otherwise.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Section 11:19-2.3 - General data filing requirements for all domestic insurers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All domestic insurers shall file with the Department on an annual basis the information required by this subchapter for the prior calendar year ending December 31 by March 1, of the next year, in accordance with the Appendices to this subchapter incorporated herein by reference.
(b) Upon request by the Commissioner, any domestic insurer shall provide the information required by this subchapter to the Department in accordance with formats set forth in this subchapter.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Section 11:19-2.4 - IVS subsystem filing requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All domestic insurers shall provide the Department with a report on their securities by either CD-ROM or DVD-ROM in accordance with (c) below.
(b) Domestic insurers owning securities which are held by custodians shall utilize custodians which shall:
1. Submit to the Department a certification of securities held; and
2. Provide the Department with an independent report of the insurer's securities by either CD-ROM or DVD-ROM in accordance with (c) below.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Section 11:19-2.9 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter shall subject the insurer to penalties as provided in 17:23-2 and 17B:21-2.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Appendix A

Current through Register Vol. 56, No. 14, July 15, 2024
Exhibit 1 Header Record Layout
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Exhibit 2 Header Record Layout Description
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Exhibit 3 Detail Record Layout
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Exhibit 4 Detail Record Layout Description
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Exhibit 5 Trailer Record Layout
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Exhibit 6 Trailer Record Layout Description
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New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 2 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC INSURERS › Appendix B

Current through Register Vol. 56, No. 14, July 15, 2024
Exhibit 1 General Ledger Account Detail Record Layout
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New Rule, R.1994 d.104, effective February 22, 1994.
See: 25 N.J.R. 2820(b), 26 N.J.R. 1100(b).
Amended by R.1998 d.109, effective February 17, 1998.
See: 29 N.J.R. 5260(a), 30 N.J.R. 674(b).
Exhibit 2 General Ledger Account Detail Record Layout Description
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New Rule, R.1994 d.104, effective February 22, 1994.
See: 25 N.J.R. 2820(b), 26 N.J.R. 1100(b).
Amended by R.1998 d.109, effective February 17, 1998.
See: 29 N.J.R. 5260(a), 30 N.J.R. 674(b).
Exhibit 3 Adjusting Entry Detail Record Layout
Click here to view image.
New Rule, R.1994 d.104, effective February 22, 1994.
See: 25 N.J.R. 2820(b), 26 N.J.R. 1100(b).
Amended by R.1998 d.109, effective February 17, 1998.
See: 29 N.J.R. 5260(a), 30 N.J.R. 674(b).
Exhibit 4 Adjusting Entry Detail Record Layout Description
Click here to view image.
New Rule, R.1994 d.104, effective February 22, 1994.
See: 25 N.J.R. 2820(b), 26 N.J.R. 1100(b).
Amended by R.1998 d.109, effective February 17, 1998.
See: 29 N.J.R. 5260(a), 30 N.J.R. 674(b).
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth the filing and reporting requirements and procedures for the submission/maintaining of:
1. All eligible surplus lines insurers' annual net written premiums for the State of New Jersey; and
2. Tax and surcharge filings for all licensed surplus lines producers.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.2 - 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:
"Alien insurer" means an insurer formed under the laws of any country other than the United States of America, its states, districts, territories, commonwealths or possessions.
"Commissioner" means the Commissioner of the New Jersey Department of Banking and Insurance.
"Department" means the Department of Banking and Insurance.
"Due date" means a date prior to or on which a submission shall be received by the Department.
"Foreign insurer" means an insurer formed under the laws of a jurisdiction of the United States of America, other than the State of New Jersey.
"Home state" is as defined in
N.J.S.A. 17:22-6.4 1(g)
.
"Insurer" or "insurance company" means an entity authorized or eligible to transact the business of insurance in New Jersey.
"ISI Number" means the nine digit identifying number issued by the NAIC to uniquely identify an "alien insurer."
"NAIC" means the National Association of Insurance Commissioners.
"NAIC number" means the five digit number assigned by the NAIC to uniquely identify a foreign or admitted insurer.
"Net written premiums" means direct gross premiums on insurance policies written by a surplus lines insurer less return premiums thereon. If a policy issued by a surplus lines insurer covers risks or exposures only partially located in this State, the "net written premiums" do not include premiums on the risks or exposures outside of the State.
"SLAS" means Surplus Lines Automation Suite, which is a web-based software developed to assist the Department in monitoring the activities of licensees which sell surplus lines insurance to New Jersey residents and matches agent tax data to company policy data.
"SLPS" means the Surplus Lines Processing Subsystem, which assists the Department in monitoring the activities of licensees which sell surplus lines insurance to New Jersey residents and matches quarterly agent tax data to quarterly company policy data.
"Surplus lines insurer" means an unauthorized insurer eligible to transact surplus lines insurance business in this State, in which an insurance coverage is placed or may be placed pursuant to N.J.S.A. 17:22-6.4 0 et seq.
"Transaction number" means the 12-character number made up of the producer's surplus line agent number (assigned by the Department), the year of the placements, and a sequential number (maintained by the agent).
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.3 - General requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All eligible surplus lines insurers qualified to transact business in New Jersey shall maintain reports of the information required by this subchapter for the preceding calendar year for inspection by the Department upon request beginning May 15, 2001. Each annual report on an insurer's net written premiums for the State of New Jersey shall be available for inspection by April 1 of each year. If requested, upon its receipt the data shall be used by the Department for the purpose of determining compliance with all laws and rules applicable to eligible insurers and insurance producers who placed business with such insurers, including, but not limited to, confirming the accuracy of the premium data reported by producers for purposes of the payment of premium tax pursuant to N.J.S.A. 17:22-6.59 and to determine whether all of the insurer's business was placed through a New Jersey licensed surplus lines insurance producer pursuant to N.J.S.A. 17:22-6.42.
(b)
All licensed surplus lines producers shall, on or before the due dates set forth in this subsection following each calendar quarter, remit premium taxes and surcharges utilizing the forms set forth on the Department's website:
www.njslasuite.com
. The due dates for these filings are as follows: May 15, August 14, November 14 and February 14. The requirements in this subsection shall apply beginning with the filing covering the calendar quarter occurring immediately following May 18, 2015.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.4 - SLAS requirements for all surplus lines insurers

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All eligible surplus lines insurers shall prepare and maintain an annual report listing net written premiums for all insurance covering a subject of insurance where New Jersey is the home state. Surplus lines insurers which write no business where New Jersey is the home state during a calendar year shall prepare and maintain a signed affidavit attesting that no such business was written for the calendar year.
(b) An insurer's annual report shall list for each policy, the named insured, the transaction number, the producer's name and address, the policy number, the written premium amount, and the effective and expiration dates. Insurers shall note all premium activity that occurred on a policy during the calendar year. Transaction numbers are not required with respect to risks that are directly procured without the participation of a New Jersey surplus lines agent. Upon request by the Department, an insurer shall file this report for the requested calendar year with the Department through the SLAS website:
www.njslasuite.com
.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.5 - SLAS filing requirements for all licensed producers with surplus lines authority

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All licensed producers with surplus lines authority shall assign a transaction number to each new or renewal policy he or she places. All subsequent endorsements shall be identified by the same transaction number. All surplus lines producers shall provide surplus lines insurers with the appropriate transaction number for each new, renewal, additional or return premium policy or endorsement, including adjustments for policies prior to July 1, 1993.
(b) All licensed surplus lines producers shall file with the Department or other authority, as required, a quarterly tax return in the form set forth on the Department's website:
www.njslasuite.com
.
(c) The instructions and forms for completing the New Jersey surplus lines producer quarterly tax return may be found on the Department's website:
www.njslasuite.com
.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 3 - DATA SUBMISSION REQUIREMENTS FOR ALL LICENSED PRODUCERS WITH SURPLUS LINES AUTHORITY AND ELIGIBLE SURPLUS LINES INSURERS › Section 11:19-3.7 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Failure to comply with the provisions of this subchapter shall subject an eligible surplus lines insurer to penalties as provided in N.J.S.A. 17:22-6.6 1.
(b) Failure to comply with the provisions of this subchapter shall subject a licensed producer with surplus lines authority to penalties as provided in N.J.S.A. 17:22-6.6 1 and 17:22A-17.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 4 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC LIFE/HEALTH INSURERS › Section 11:19-4.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The purpose of this subchapter is to set forth the filing and reporting requirements and procedures for the submission of data related to an insurer's valuation of its reserves as part of the Financial Examination Monitoring System (FEMS) for all domestic life/health insurers. Insurers shall submit all the information required by this subchapter.
(b) These rules apply to all domestic life/health insurers regulated under the laws of New Jersey unless specifically stated otherwise.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 4 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC LIFE/HEALTH INSURERS › Section 11:19-4.3 - ADAS filing requirements

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All domestic life/health insurance companies shall provide the Department with a report on the insurer's year end summary valuation on a CD-ROM in accordance with (b) through (d) below.
(b) All CD-ROM disc submissions shall be Windows compatible.
1. The CD-ROM disc file shall be a non-delimited ASCII text file with a carriage return or line feed as the last character of each record. The data shall not be in compressed format.
2. The filename for CD-ROM discs is to be named using the letter D followed by a letter representative of the company type, that is, L for L/H, F for Fraternal, etc., followed by the year (two digits). All filenames shall end with the ASCII extension (.ASC). The filename shall not exceed eight characters.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 19 - FINANCIAL EXAMINATIONS MONITORING SYSTEM › Subchapter 4 - DATA SUBMISSION REQUIREMENTS FOR ALL DOMESTIC LIFE/HEALTH INSURERS › Section 11:19-4.4 - Penalties

Current through Register Vol. 56, No. 14, July 15, 2024
Failure to comply with the provisions of this subchapter shall subject the insurer to penalties pursuant to 17B:21-1 and 17B:21-2 and any other penalties permitted by law.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 1 - GENERAL PROVISIONS › Section 11:20-1.1 - Purpose and scope

Current through Register Vol. 56, No. 14, July 15, 2024
(a) This chapter implements provisions of P.L. 1992, c.161 (17B:27A-2 et seq.), the Individual Health Insurance Reform Act, as amended. This chapter establishes procedures and standards for carriers to meet their obligations under 17B:27A-2 et seq., and establishes procedures and standards applicable for the fair, reasonable and equitable administration of the Individual Health Coverage Program pursuant to 17B:27A-2 et seq.
(b) Provisions of the New Jersey Individual Health Insurance Reform Act and of this chapter shall be applicable to all carriers that are members of the Individual Health Coverage Program, as the term member is defined in this subchapter, and to such other carriers as the specific provisions of the statute and this chapter may state.
(c) Provisions of the New Jersey Individual Health Insurance Reform Act and this chapter shall be applicable to all health benefits plans delivered or issued for delivery in New Jersey, renewed or continued on or after August 1, 1993, except as the specific provisions of this chapter, the New Jersey Individual Health Insurance Reform Act, or applicable Federal laws state otherwise.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 1 - GENERAL PROVISIONS › Section 11:20-1.3 - Closing of noncomplying individual health benefits plan

Current through Register Vol. 56, No. 14, July 15, 2024
(a) All coverage under individual health benefits plans delivered or issued for delivery with an effective date of August 1, 1993 or thereafter shall comply with this chapter.
(b) Health benefits plans not subject to the Act shall remain subject to the full review and approval of the Commissioner in accordance with 17B:26-1 et seq., 17:49-1 et seq., 17:48A-1 et seq., 17:48E-1 et seq., 26:2J-1 et seq. and rules promulgated pursuant thereto.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 1 - GENERAL PROVISIONS › Section 11:20-1.4 - Other laws of this State

Current through Register Vol. 56, No. 14, July 15, 2024
All health benefits plans delivered or issued for delivery in New Jersey, as defined by this subchapter, shall be subject to the New Jersey Individual Health Insurance Reform Act, as well as all relevant statutes and rules of New Jersey not inconsistent with, amended or repealed by this Act.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 1 - GENERAL PROVISIONS › Section 11:20-1.6 - Mission statement

Current through Register Vol. 56, No. 14, July 15, 2024
The mission of the New Jersey Individual Health Coverage Program Board is to administer the New Jersey Individual Health Coverage Program in a manner aimed at increasing access to coverage, protecting consumers, educating key stakeholders and other interested persons, and promoting carrier participation in the market. This includes establishment and modification of standard plans for marketing to individuals and establishing and administering the assessment mechanism. It also includes the regulation of individual health coverage carriers in conjunction with the New Jersey Department of Banking and Insurance.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.1 - Purpose and structure

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The "IHC Program" created pursuant to the N.J.S.A. 17B:27A-2 to 16, as amended, has as its members all insurance companies, health service corporations, hospital service corporations, medical service corporations, and health maintenance organizations that issue or have in force health benefits plans in this State. The IHC Program's purpose is:
1. To assure the availability of standardized individual health benefits plans in New Jersey on an open enrollment, modified community-rated basis; and
2. To reimburse certain losses of member companies as follows:
i. For the calendar year ending December 31, 1992, pursuant to N.J.S.A. 17B:27A-13;
ii. For each calendar year ending December 31, 1993 through December 31, 1996, and for each two-year calculation period through the 2007-2008 calculation period pursuant to N.J.S.A. 17B:27A-12, as amended; and
iii. For all periods following the 2007-2008 two-year calculation period no loss assessments shall be calculated or collected and no losses shall be reimbursed.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.2 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
(a) Words and terms defined at N.J.S.A. 17B:27A-2 as amended, and N.J.A.C. 11:20-1, when used in this subchapter, shall have the meanings as defined therein, unless more specifically defined in (b) below or unless the context clearly indicates otherwise.
(b) The following words and terms, when used in this subchapter, shall have the following meanings unless the context clearly indicates otherwise:
"Action" means an action by the Board adopted, in the Board's discretion, in accordance with the procedures set forth either in the Administrative Procedure Act, N.J.S.A. 52:14B-1 et seq., or in sections 7 and 8 of P.L. 1993, c. 164. "Action" includes, but is not limited to: the establishment and modification of health benefits plans; procedures and standards for assessment of members and the apportionment thereof; and the promulgation or modification of policy forms. "Action" shall not include the hearing and resolution of contested cases, or personnel matters.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.4 - Plan of Operation

Current through Register Vol. 56, No. 14, July 15, 2024
The Plan of Operation and amendments thereto shall become effective upon approval by the Commissioner and submission of final action to the Office of Administrative Law for publication. The Commissioner may amend the Plan of Operation by providing written notice to the Board of amendments and their effective dates and upon adoption of amendments in accordance with applicable law.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.5 - Board of Directors

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Board shall consist of nine Directors, including the Commissioner or his or her designee, who shall sit ex officio.
1. Four Directors shall be appointed by the Governor, with the advice and consent of the Senate.
i. One of the Governor's appointees shall be a representative of an employer, appointed upon the recommendation of a business trade association, who has experience in the management or administration of an employee health benefits plan. One of the Governor's appointees shall be a representative of organized labor, appointed upon the recommendation of the AFL-CIO, who has experience in the management or administration of an employee health plan. Two of the Governor's appointees shall be consumers of a health benefits plan who are reflective of the population in the State.
ii. The term of the initial appointment shall be for the period as set forth in the appointment.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.6 - Committees

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Board shall make appointments to standing and other committees from among Directors. Each of the standing committees shall include no more than four Directors, but the Chair may appoint additional Directors as needed subject to ratification by the Board at the next subsequent meeting.
(b) The Board may, by resolution:
1. Determine the size of a standing committee, appoint Directors, and fill a vacancy;
2. Appoint a Director to serve as an alternate member of any standing committee to act in the absence of a committee member with all the powers of such absent member;
3. Abolish any standing committee; and
4. Appoint or authorize the use of IHC Program staff, consultants, or other advisors to work with any standing committee.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.7 - Financial administration

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The fiscal year of the IHC Program shall run from July 1 of each year to June 30 of the following year.
(b) All funds of the IHC Program shall be deposited into and disbursements made from the General Treasury in accordance with procedures established and approved by the Department of Treasury, Office of Management and Budget.
1. Monies pertaining to the IHC Program shall be deposited into a dedicated account within the State's General Fund.
2. Monies may be credited from the General Fund to IHC bank accounts upon request by the Board through the Department, which request shall include justification for the request with supporting documentation, and shall be pursuant to the approval of the Director of the Division of Budget and Accounting.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.8 - Audits

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Board shall have an annual audit of its operations conducted by a qualified independent certified public accountant.
1. The auditor shall be selected and approved by the Board through a competitive bidding process of certified public accountants qualified in New Jersey to perform audits of entities like the Board.
2. The annual audit shall include the following items:
i. A review of the handling and accounting of assets and monies of the IHC Program;
ii. A determination that administrative expenses have been properly allocated and are reasonable;
iii. A review of the internal financial controls of the IHC Program; and
iv. A review of the annual financial report of the IHC Program.
3. A copy of the annual audit and related management letters shall be delivered to each Director and to the Commissioner. The annual audit report shall be reviewed by the Technical Advisory Committee or Operations and Audit Committee, or both Committees, which shall present its recommendations to the Board for implementation of findings and recommendations made by the auditor. The actions adopted shall be reported to the Commissioner.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.9 - Records

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Board shall provide for the maintenance and retention of its official records, and may delegate this function to the Executive Director.
(b) The Board's records shall consist of the following:
1. Minutes of all Board meetings;
2. Written reports and recommendations of committees to the Board;
3. Informational and other filings made by carriers with the Board pursuant to the Act or the Board's rules;
4. The rulemaking file on rules proposed or adopted by the Board, including all comments received;
5. The Plan of Operation and any amendments thereto;
6. Records concerning the election of Directors and appointment of committees and committee members;
7. Other actions by the Board required by the Act; and
8. Such other specific records as the Board may from time to time direct or as may be required by law.
New Jersey Administrative Code › Title 11 - INSURANCE › Chapter 20 - INDIVIDUAL HEALTH COVERAGE PROGRAM › Subchapter 2 - INDIVIDUAL HEALTH COVERAGE PROGRAM PLAN OF OPERATION › Section 11:20-2.10 - Standard health benefits plans

Current through Register Vol. 56, No. 14, July 15, 2024
(a) The Board shall establish the policy and contract forms and benefit levels (standard health benefits plans) to be made available by members.
1. In designing and amending the standard health benefits plans, the Board shall give consideration to the types of coverage currently in force and/or available in the market, individuals' preferences, and the evolution of the market towards managed care.
2. The Board shall discuss amendments to the standard policy forms at a meeting open to the public prior to any vote by the Board to adopt, or modify any aspect of, a standard health benefits plan design.
3. The Board shall hold a public hearing on the standard health benefits plans or any amendments thereto prior to adopting or changing a standard health benefits plan.
i. The Board shall provide to all members and interested parties reasonable advance notice of a public hearing in accordance with the procedures set forth in the Act as amended.
ii. The Board may establish procedures for a public hearing and publish them with the notice of the public hearing.
iii. The Board shall maintain a written record of any public hearing and make it available for inspection at the office of the Executive Director.
4. The Board shall adopt or amend a standard health benefits plan in accordance with the procedures set forth in the Act, as amended, or in accordance with the procedures set forth in the Administrative Procedures Act.
i. In accordance with the procedures for taking action set forth in the Act, as amended, the Board may adopt a standard health benefits plan or modifications thereto and thereafter shall address in writing such comments as were received within a reasonable period following the adoption of the proposed action. The Board shall give due consideration to all comments received. Pursuant to the Act as amended, the Board shall, within a reasonable period of time following submission of the comments, prepare for public distribution a report listing all parties who provided written submissions concerning the intended action, summarizing the content of the submissions and providing the Board's response to the data views and arguments contained in the submissions. A copy of the report shall be filed with the Office of Administrative Law for publication in the New Jersey Register.
(1) The Board shall identify whether it made a change in the action proposed at its own initiative or in response to one or more comments.
ii. Except as may be required by law, members shall implement amendments to the standard health benefits plans in the time prescribed by the Board.
5. The Board shall take action as necessary to keep the standard health benefits plans in compliance with State and Federal law.
6. No member shall issue or renew a standard health benefits plan until a rate filing has been filed with the Department in accordance with N.J.A.C. 11:20-6.