17:48F-9 - Issuance of evidence of coverage - New Jersey Statutes

17:48F-9  Issuance of evidence of coverage.

9.Every contract holder and enrollee shall be issued an evidence of coverage, which shall contain a clear and complete statement of:

a.The coverage to which each enrollee is entitled;

b.Any limitation to which covered services are subject, including, but not limited to, exclusions, deductibles, copayments or other charges;

c.Where information is available as to where and how services may be obtained; and

d.The method for resolving complaints.

If any part of the benefits offered under the contract are subcontracted, the document issued to the contract holder by the organization may contain the information required herein on behalf of the subcontractor.

L.1997,c.380,s.9.