17B:27A-20. Coinsurance, deductibles applicable
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/nj/title-17b/chapter-27a/17b-27a-20·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
4. Plans required to be offered under P.L.1992, c.162 (C.17B:27A-17 et seq.) may be subject to coinsurance and deductibles, which may vary by selected portions of the coverage. The department and the boards of directors of the New Jersey Individual Health Coverage Program and New Jersey Small Employer Health Benefits Program may promulgate regulations to create standard plans or plan design requirements. The standard plans or plan design requirements may include minimum cost-sharing standards, provided that the standards enable carriers to design and offer plans for the bronze, silver, gold, and platinum metal levels as defined under the actuarial value calculations pursuant to the federal "Patient Protection and Affordable Care Act," Pub.L.111-148, as amended by the "Health Care and Education Reconciliation Act of 2010," Pub.L.111-152.
In promulgating these regulations, the commissioner and boards of directors shall consider the best interests of consumers, the health of the markets, and plan design that promotes utilization of high value primary and preventative care to improve the health of the State's population. Any minimum standard regulations and standard plans promulgated by the commissioner or boards of directors pursuant to this section shall be reviewed and adjusted annually to achieve the goals of this section.
L.1992,c.162,s.4; amended 1993, c.162, s.3; 2023, c.194, s.4.