Definitions relative to certain assessments.

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17B:27A-65 Definitions relative to certain assessments.

1. As used in this act:

"Commissioner" means the Commissioner of Banking and Insurance.

"Entity subject to this act" or "entity" means an insurance company, health service corporation, hospital service corporation, medical service corporation, health maintenance organization, or dental plan organization authorized to issue health benefits or dental benefits plans in this State. "Entity" shall include a multiple employer welfare arrangement that is initially registered pursuant to the "Self-Funded Multiple Employer Welfare Arrangement Regulation Act," P.L.2001, c.352 (C.17B:27C-1 et seq.) after the date of enactment of this act. "Entity" shall not include a dental service corporation or a multiple employer welfare arrangement that is registered pursuant to the "Self-Funded Multiple Employer Welfare Arrangement Regulation Act," P.L.2001, c.352 (C.17B:27C-1 et seq.) as of the date of enactment of this act.

"Health benefits plan" means a benefits plan which pays or provides hospital and medical expense benefits for covered services, and is delivered or issued for delivery in this State by or through an entity subject to this act, including a vision or dental plan as defined pursuant to section 1 of P.L.2014, c.70 (C.26:2S-26). For the purposes of this act, "health benefits plan" shall not include the following plans, policies or contracts: Medicaid, Medicare, Medicare Advantage, Medicare supplement, accident only, credit, disability, long-term care, TRICARE supplement coverage, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance, personal injury protection insurance issued pursuant to P.L.1972, c.70 (C.39:6A-1 et seq.), small employer health benefits plans issued pursuant to P.L.1992, c.162 (C.17B:27A-17),and hospital confinement indemnity coverage.

"Net written premiums" means the premiums earned in this State on health benefits plans, less return premiums thereon and dividends paid or credited to policy or contract holders on the health benefits plan business. Net earned premium shall include the aggregate premiums earned on the entity's insured group and individual business, excluding premiums from any Medicaid or NJ FamilyCare contracts.

L.2020, c.61, s.1.


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