17:48H-15 - Services provided by licensed organized delivery system - New Jersey Statutes

17:48H-15.  Services provided by licensed organized delivery system
15.  A licensed organized delivery system may:

a.Contract with an insurer licensed in this State for the provision of indemnity coverage against the cost of services provided by the system or other obligations of the system, either on an individual or aggregate attachment basis; and

b.In addition to comprehensive or limited services, as applicable, provided by the system for enrollees or contract holders, provide:

(1) Additional services as approved by the Commissioner of Banking and Insurance, in consultation with the Commissioner of Health and Senior Services;

(2) Indemnity benefits covering urgent care or emergency services;

(3) Coverage for services from providers, other than participating providers, in accordance with the terms of the contract; and

(4) Any other function provided by law, in the system's organizational documents or in the license.

L.1999,c.409,s.15.