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Statutes and Regulations

The following is not an exhaustive list of statutes and regulations applicable to any particular carrier or any particular type of product, but is a list of statutes and regulations that are of interest to some or all that offer one or more types of health coverage with a managed care product. Applicable federal statutes and regulations are not included.

New Jersey statutes, as well as pending legislation and chapter laws, can be obtained through the New Jersey Legislature's internet pages.

You may also access these rules (with historical information), other rules as well as proposals and other information in the New Jersey Register by going to  You will be required to provide certain information and agree to the terms and conditions of the site in order to access the database. Otherwise, the New Jersey Administrative Code is available through many libraries or by ordering from LexisNexis
® (Matthew Bender).


N.J.S.A. 17:23A-1 et seq.

Information Practices Act

N.J.S.A. 17:27A-1 et seq.

Holding Company Act

N.J.S.A. 17:48E-1 et seq.

Health Service Corporations

N.J.S.A. 17:48H-1 et seq.

Organized Delivery Systems

N.J.S.A. 17B:17-1 et seq.

Policy Simplification Act

N.J.S.A. 17B:20-1 et seq.


N.J.S.A. 17B:27-26 et seq.

Group Health Insurance and Blanket Insurance

N.J.S.A. 17B:27A-2 et seq.

Individual Health Coverage Reform Act

N.J.S.A. 17B:27A-17 et seq.

Small Employer Health Benefits Act

N.J.S.A. 17B:30-1 et seq.

Trade Practices Act

N.J.S.A. 17B:32B-1 et seq.

Rehabilitation and Liquidation Act

N.J.S.A. 26:2J-1 et seq.

Health Maintenance Organizations

N.J.S.A. 26:2S-1 et seq.

Health Care Quality Act

N.J.S.A. 30:4D-1 et seq.

Medical Assistance and Health Services Act

N.J.S.A. 30:4J-1 et seq.

FamilyCare Health Coverage Act

N.J.S.A. 30:7E-1 et seq.

Insurance and Other Reimbursements Act

N.J.S.A. 44:10-40

Eligibility for Hospital Care Assistance for Low Income Persons without Dependent Children


N.J.A.C. 8:57-8

Childhood Immunization Insurance Coverage

N.J.A.C. 10:49

Medicaid Managed Care - New Jersey Care 2000 Services

N.J.A.C. 10:69

AFDC-Related Medicaid

N.J.A.C. 10:74

Managed Health Care Services for Medicaid Beneficiaries and NJ KidCare Beneficiaries

N.J.A.C. 10:78

NJ FamilyCare

N.J.A.C. 11:1-32

Fees and Special Purpose Apportionment

N.J.A.C. 11:1-35

Insurance Holding Company Systems

N.J.A.C. 11:2-13

Group Coverage Discontinuance and Replacement

N.J.A.C. 11:2-17

Unfair Claims Settlement Practices

N.J.A.C. 11:4-1

New Jersey Insolvent HMO Assistance Association

N.J.A.C. 11:4-28

Group Coordination of Benefits

N.J.A.C. 11:4-37

Selective Contracting Arrangements

N.J.A.C. 11:4-40

Life, Health and Annuity Forms

N.J.A.C. 11:4-49

Mandated Diabetes Benefit

N.J.A.C. 11:6

Workers' Compensation Managed Care Organizations

N.J.A.C. 11:20

Individual Health Coverage Program

N.J.A.C. 11:21

Small Employer Health Benefits Program

N.J.A.C. 11:22-1

Prompt Payment of Claims

N.J.A.C. 11:22-2

Health Wellness Promotion

N.J.A.C. 11:22-4

Organized Delivery Systems - Licensing and Financial Requirements

N.J.A.C. 11:24

Health Maintenance Organizations

N.J.A.C. 11:24A

Health Care Quality Act Application to Insurance Companies, Health Service Corporations, Hospital Service Corporations, and Medical Service Corporations

N.J.A.C. 11:24B

Organized Delivery Systems – Certification and Systems

N.J.A.C. 11:24C-1

Physician Credentialing Application

N.J.A.C. 11:24C-2

Designation of Hemophilia Health Care Providers

N.J.A.C. 11:24C-3

Benefits of Coverage of Service for Hemophilia Treatment

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New Jersey Department of Banking and Insurance