NJDOBI | IHC Rule Proposals and Adoptions

•

Translate

Translator Disclaimer

Home > Insurance Division > Individual Health Coverage Program > Rule Proposals and Adoptions

IHC Rule Proposals and Adoptions (2002 to Present)

Find Rule Proposals with Comment Period Open > Rule Proposals with Comment Period Closed > Rule Adoptions

Please Note: Most files are in Portable Document Format (PDF). Download the latest version of .

Proposals - Comment Period OPEN

Proposals - Comment Period CLOSED (see Adoptions for any further action)

Comment period ended November 17, 2025: Proposed Amendments: N.J.A.C. 11:20 Appendix Exhibits A and B
- Proposal Summary
- Appendix Exhibit A - Plans A/50 through D
- Appendix Exhibit B - HMO Contract
Comment period ended December 17, 2024: Proposed Amendments: N.J.A.C. 11:20 Appendix Exhibits A and B
- Proposal Summary
- Appendix Exhibit A - Plans A/50 through D
- Appendix Exhibit B - HMO Contract
Comment period ended December 6, 2023: Proposed Amendments: N.J.A.C. 11:20 Appendix Exhibits A and B
- Proposal Summary
- Plans A/50 through D (Exhibit A)
- HMO Contract (Exhibit B)
Comment period ended December 23, 2022: Proposed Amendments to the Standard Health Benefit Plans
- Proposal Summary
- Plans A/50 through D (Exhibit A)
- HMO Contract (Exhibit B)
Comment period ended April 7, 2021: Proposed Amendments to the Standard Health Benefit Plans
- Proposal Summary
- Plans A/50 through D (Exhibit A)
- HMO Contract (Exhibit B)
Comment period ended June 4, 2018: Proposed Readoption with Amendments and Repeals
- Proposal Summary
- Plans A/50 through D
- HMO Plan
- Exhibit K
Comment period ended September 6, 2017: Amendments to Comply with Federal Law and Recently Enacted State Law
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period ended April 18, 2017: Amendments to Comply with the Substance Use Disorder Requirements of P.L. 2017, c. 28
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period ended August 22, 2016: Proposal to amend various IHC Program regulations and the standard plans to comply with Federal law and to include Board-initiated amendments
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period ended October 1, 2015: Rule proposal to amend the Standard Plans as required by Federal law and to include Board-initiated amendments:
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period ended May 11, 2015: Amendments to comply with the requirements of Federal law
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period through November 7, 2014: Amendments to Standard Plans and Regulations to comply with State Law and PPACA
- Proposal Summary
- Plans A/50 through D
- HMO Plan
Comment period through September 30, 2013: Amendments to Regulations and Standard Individual Health Benefits Plans as required by PPACA
- Proposal Summary which includes Amendments to N.J.A.C. 11:20-1, 3, 12, 22 and 24
- Standard Plans A/50 through D (Appendix A): PDF or MS Word
- Standard HMO Plan (Appendix B): PDF or MS Word
- Explanation of Brackets (Appendix C): PDF or MS Word
Comment period through Sept. 4, 2012: Amendments to Policy Forms to Comply with State and Federal Law and to Add an Optional Product Type
- Standard Plans A/50 through D proposed amendments (Appendix A): PDF or MS Word
- Standard HMO Plan proposed amendments (Appendix B): PDF or MS Word
- Basic & Essential Plan proposed amendments (Appendix F): PDF or MS Word
Comment period through July 25, 2011: Amendment to the Opportunities for a Person Who Already had Coverage to Purchase a Different Policy
Comment period through March 19, 2011: Individual Health Coverage Program
Proposed Readoption with Amendments: N.J.A.C. 11:20-1, 2, 3, 8, 12, 17, 19, 20, 22, 23 and 24, and 11:20
Appendix Exhibits A through D, F, G, H, K and L
Proposed Repeals: N.J.A.C. 11:20-2.13, 8.4, 8.5, 8.8 and 8.9
Comment period through September 28, 2010: Changes to the Benefit Levels and Policy Forms to Comply with State and Federal Law
Proposed Amendments: Exhibits A and B of the Appendix to N.J.A.C. 11:20
- Standard Plans A/50-D - PDF or MS Word
- Standard HMO Plan - PDF or MS Word
Comment period through September 28, 2010: Changes to the Benefit Levels and Policy Forms to Comply with State and Federal Law
Proposed Amendments: Exhibit F of the Appendix to N.J.A.C. 11:20
- Basic and Essential Services Plan - PDF or MS Word
Comment period through December 15, 2008: Notice of Rule Proposal to Comply with P.L. 2007, c. 345 and P.L. 2008, c. 38
- Standard Plans A/50-D
- Standard HMO Plan
- Specimen Basic and Essential Plan
- Explanation of Brackets
- Plan Update Rider
- Exhibit K
- Exhibit L part 2
Comment period through April 2, 2008: Proposed Amendments to the Standard Plans and Regulations to Address Coverage Required by P.L. 2006, c. 103 Relating to Civil Union Partners
- Proposed Text for Plans A/50 - D
- Proposed Text for the HMO Plan
- Proposed Text for the Specimen Basic & Essential Plan
Comment period through April 22, 2006: Proposed New Rule N.J.A.C. 11:20-2.17 Concerning the Loss Assessment Methodology beginning 1997/1998 - Spreadsheets illustrating the methodology included in the proposed new rule are set forth below. These spreadsheets were created using the best available data and are subject to change if new data becomes available.
- 1997/1998 Loss Assessment
- 1999/2000 Loss Assessment
- 2001/2002 Loss Assessment
Comment period through October 14, 2005: Proposed Readoption of Parts of N.J.A.C. 11:20
Comment period through April 11, 2005: Proposed New Rule - HSA2 - Public Hearing April 6, 2005
- Standard Policy Plan C
- Standard Policy Plan D
- Explanation of Brackets
Comment period through January 18, 2005: Proposed New Rule - Public Hearing January 18, 2005
- Standard Policy Plan C
- Standard Policy Plan D
Comment period through January 8, 2003: Basic and Essential Rule Proposal
- Exhibit V - Policy Form
- Exhibit L - Part 1
- Exhibit L - Part 2
Comment period through July 22, 2002: Individual Health Coverage Program; Amendments to Exhibit G
- Exhibit G

Adoptions (note the dates for the most current amendments and new rules)

December 2, 2025: Adopted Amendments: N.J.A.C. 11:20 Appendix Exhibits A and B
December 20, 2024: Adopted Amendments: N.J.A.C. 11:20 Appendix Exhibits A and B
December 20, 2023: Adopted Amendments to the Standard Health Benefit Plans
December 29, 2022: Adopted Amendments to the Standard Health Benefit Plans
August 27, 2021: Adopted Amendments to the Standard Health Benefit Plans
October 23, 2018: Readoption with Amendments and Repeals
November 6, 2017: Amendments to Comply with Federal Law and Recently Enacted State Law
April 20, 2017: Amendments to Comply with the Substance Use Disorder Requirements of P.L. 2017, c. 28
September 19, 2016: Amendment to the Standard Plans as required by Federal law and to include Board-initiated amendments
- Notice of Adoption
- Plans A/50 through D - MS Word or PDF
- HMO Plan - MS Word or PDF
October 21, 2015: Amendment to the Standard Plans as required by Federal law and to include Board-initiated amendments
- Notice of Adoption
- Plans A/50 through D - MS Word or PDF
- HMO Plan - MS Word or PDF
May 12, 2015: Amendment to comply with Federal Law
- Notice of Adoption
- Plans A/50 through D - MS Word or PDF
- HMO Plan - MS Word or PDF
November 17, 2014: Amendments to Standard Plans and Regulations to comply with State Law and PPACA
- Notice of Adoption
- Plans A/50 through D - MS Word or PDF
- HMO Plan - MS Word or PDF
September 13, 2012: Amendments to Policy Forms to Comply with State and Federal Law and to Add an Optional Product Type
Adopted Amendments: Exhibits A and B of the Appendix to N.J.A.C. 11:20
- Standard Plans A/50-D proposed amendments: Appendix A
- Standard HMO Plan proposed amendments: Appendix B
- Basic and Essential Plan proposed amendments: Appendix F

June 6, 2011: Individual Health Coverage Program
Readoption with Amendments: N.J.A.C. 11:20-1, 2, 3, 8, 12, 17, 19, 20, 22, 23 and 24, and 11:20
Appendix Exhibits A through D, F, G, H, K and L
Adopted Repeals: N.J.A.C. 11:20-2.13, 8.4, 8.5, 8.8 and 8.9
June 6, 2011: Individual Health Coverage Program
Carriers Informational Rate Filing Requirements; Loss Ratio and Refund Reporting Requirements; Relief from Obligations Imposed by the Individual Health Insurance Reform Act and Withdrawals of Carriers from the Individual Market and Withdrawal of Plan, Plan Option or Deductible/Copayment Option
Notice of Readoption: N.J.A.C. 11:20-3A, 6, 7, 11 and 18 and 11:20 Appendix Exhibits E and J
October 4, 2010: Changes to the Benefit Levels and Policy Forms to Comply with State and Federal Law
Adopted Amendments: Exhibits A and B of the Appendix to N.J.A.C. 11:20
- Standard Plans A/50-D
- Standard HMO Plan
October 4, 2010: Changes to the Benefit Levels and Policy Forms to Comply with State and Federal Law
Adopted Amendments: Exhibit F of the Appendix to N.J.A.C. 11:20
- Basic and Essential Services Plan
December 30, 2008: Adopted Amendments New Rules and Repeals to Comply with P.L. 2007, c. 345 and P.L. 2008 c. 38
- Plans A/50 - D: PDF or MS Word
- HMO Plan: PDF or MS Word
- Specimen Basic and Essential Plan: PDF or MS Word
- Explanation of Brackets: PDF or MS Word
- Exhibit K: PDF or MS Word
- Exhibit L Part 2: PDF or MS Excel
- Identification of Plans: PDF or MS Word
- Plan Update Rider: PDF or MS Word
April 17, 2008: Adopted amendment to the Standard Plans and Regulations to Address Coverage Required by P.L. 2006, c.103 Relating to Civil Union Partners
- Plans A/50 - D

October 17, 2006: Adopted New Rule: N.J.S.A. 11:20-2.17 - Assessments for Total Reimbursable Net Paid Losses for Two-Year Calculation Periods Beginning with 1997 and 1998
February 24, 2006: IHC Adoption of Amendments, New Rule, Plan Update Rider
- Adopted Appendix Exhibits - Operative Date January 3, 2006
  - Exhibit J - Loss Ratio Report (MS Word)
  - Exhibit K - Market Share and Net Paid Loss Report (MS Word)
- Adopted Appendix Exhibits - Operative Date July 1, 2006
  - Exhibit A - Standard Plans A/50 - D (MS Word)
  - Exhibit B - Standard HMO Plan (MS Word)
  - Exhibit C - Explanation of Brackets (MS Word)
  - Exhibit D - Compliance and Variability Rider (MS Word)
  - Exhibit E - Certification of Compliance (MS Word) UPDATED
    - Worksheet (Excel)
  - Exhibit F - B&E Specimen Form (MS Word)
  - Exhibit G - Plan Update Rider (MS Word)
  - Exhibit L - Enrollment Reports
    - Part 1 (Excel)
    - Part 2 (Excel)
December 5, 2005: IHC Readoption Adoption
April 12, 2005: Adopted - HSA High Deductible Health Plans
January 16 , 2003: Adoption of Basic and Essential Plan
- Exhibit G - Application
- Exhibit K - Assessment Report
- Exhibit L Part 1 - Enrollment Reporting
- Exhibit L Part 2
- Exhibit V - Specimen Form Basic and Essential Plan
September 13 , 2002: IHC Program rule adoption effective October 7, 2002



	OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.			You will need to download the latest version of Adobe Acrobat Reader in order to correctly view and print PDF (Portable Document Format) files from this web site.

	\| \| \| \|
\| \|
Copyright © 星空无限传媒app, 1996 - 星空无限传媒app New Jersey Department of Banking and Insurance

星空无限传媒app