N.J. Admin. Code § 11:21-11.6

Current through Register Vol. 56, No. 24, December 18, 2024

Section 11:21-11.6 - Obligation to market

(a) Except with respect to nonstandard health benefits plans for which the carrier has filed a statement in accordance with N.J.A.C. 11:21-11.5, the carrier shall market the nonstandard health benefits plan to all small employers, their eligible employees and their eligible employees' dependents, as appropriate, within an association, out-of-State trust or other multiple employer arrangement, with all options and riders until such time as the carrier withdraws the nonstandard health benefits plan pursuant to N.J.A.C. 11:21-13, the carrier withdraws from the small employer market pursuant to N.J.A.C. 11:21-16, or, in the case of an association, the association terminates its sponsorship or endorsement of the nonstandard health benefits plan.

1. The obligation to market a nonstandard health benefits plan exists only with respect to an association's, trust's or other multiple employer arrangement's small employers, the small employers' eligible employees and the eligible employees' dependents, as appropriate; a carrier shall not newly issue a nonstandard health benefits plan to any other association, out-of-State trust or multiple employer arrangement (that will be offered to small employer members or participants of the association, multiple employer arrangement or out-of-State trust) except as N.J.A.C. 11:21-11.8 may apply.

2. The carrier shall similarly market every nonstandard health benefits plan that the carrier agrees to add to its portfolio in accordance with N.J.A.C. 11:21-11.8 at the request of a small employer or association, out-of-State trust or multiple employer arrangement.

(b) With respect to nonstandard health benefits plans offered by or through an association, multiple employer arrangement or out-of-State trust, the small employers of the association, multiple employer arrangement or out-of-State trust shall be offered one or more standard health benefits plans through the association, multiple employer arrangement or out-of-State trust, among which shall be Plan C.

(c) No carrier shall be relieved of its obligation to market all of the standard health benefits plans by virtue of marketing at least one standard health benefits plan through an association, multiple employer arrangement or out-of-State trust.

N.J. Admin. Code § 11:21-11.6