N.J. Admin. Code § 11:2-11.1

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

Section 11:2-11.1 - Purpose, general provisions and definitions

(a) The purpose of this subchapter is to formalize standards to be followed in order to avoid misleading and deceptive advertising in the health insurance business.

(b) The proper promotion, sale and expansion of health insurance are in the public interest, and these rules shall be construed in such a manner as not to unduly restrict, inhibit or retard such promotion, sale and expansion.

(c) The Department, in interpreting the meaning of the rules when applied to a specific advertisement, shall take into consideration the detail, character, purpose, use and entire content of the advertisement. In all instances the basic test will be a rule of reason as to whether the advertisement has the capacity and tendency to mislead and deceive.

(d) Specific interpretations of the rules will be issued from time to time as circumstances warrant.

(e) An advertisement for the purpose of this subchapter shall include:

1. Printed and published material, including material disseminated through electronic means (including, but not limited to, the internet, fax machines, and other similar devices), audiovisual material, and descriptive literature of an insurer used in direct mail, newspapers, magazines, radio, and television scripts, billboards and similar displays;

2. Descriptive literature and sales aids of all kinds issued by an insurer for presentation to members of the public, including but not limited to circulars, leaflets, booklets, depictions, illustration, and form letters; and

3. Prepared sales talks, presentations and material for use by agents, brokers, and solicitors and representations made by agents, brokers, and solicitors in accordance therewith.

(f) Policy for the purpose of these rules shall include any policy of health insurance as defined in N.J.S.A. 17B:17-4, plan, certificate, contract, agreement, statement of coverage, rider or endorsement which provides accident or sickness benefits, or medical, surgical or hospital expense benefits, whether on a cash indemnity, reimbursement, or service basis, except when issued in connection with another kind of insurance other than life, and except disability and double indemnity benefits included in life insurance and annuity contracts.

(g) Insurer for the purpose of these rules shall include any individual corporation, association, partnership, reciprocal exchange, interinsurer, Lloyds, fraternal benefit society, and any other legal entity engaged in the advertisement of a policy as herein defined.

(h) "Endorsement" means any appraisal, analysis, testimonial or other public statement describing or expressing approval of any insurance product or of the terms, benefits or any other aspect of any insurance product.

(i) "Person" means any individual, insurer, company, association, organization, society, partnership, syndicate, trust, business trust, corporation and every legal entity.

(j) These rules shall also apply to agents and brokers to the extent that they are responsible for the advertisements of any policy.

N.J. Admin. Code § 11:2-11.1

Amended by R.1989 d.391, effective 7/17/1989.
See: 21 New Jersey Register 970(a), 21 New Jersey Register 2039(a), 21 New Jersey Register 2289(c).
New (d) and (e) added definitions of "endorsement" and "person"; old (d) recodified to (f).
Amended by R.1996 d.3, effective 1/2/1996.
See: 27 New Jersey Register 3278(b), 28 New Jersey Register 152(b).
Amended by R.2005 d.350, effective 10/17/2005.
See: 37 New Jersey Register 2285(a), 37 New Jersey Register 4026(a).
In (e), substituted "this subchapter" for "these rules" in introductory paragraph; rewrote (e)1.