26:2J-33. Avoidance of duplication of benefits, regulations
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/nj/title-26/chapter-2j/26-2j-33A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
3. a. No medicare supplement contract or evidence of coverage shall provide for health care services which duplicate any benefits provided by medicare.
b. The commissioner shall promulgate regulations to establish specific standards for the provisions to be contained in any medicare supplement contract or evidence of coverage, which shall be in addition to and in accordance with the applicable laws of this State. The regulations may provide, but shall not be limited to:
(1)Terms of renewability;
(2)Initial and subsequent conditions of eligibility;
(3)Non-duplication of coverage;
(4)Probationary periods;
(5)Benefit limitations, exceptions and reductions;
(6)Elimination periods;
(7)Requirements for replacement;
(8)Recurrent conditions; and
(9)Definition of terms.
c. The commissioner may promulgate regulations that specify prohibited medicare supplement contract or evidence of coverage provisions not otherwise specifically authorized by statute which, in the opinion of the commissioner, are unjust, unfair or unfairly discriminatory to any applicant for, or enrollee with, medicare supplement health care services coverage.
L.1992,c.164,s.3.