8. If a third party administrator adjudicates claims under a health benefits plan, the commissions, fees or charges that the benefits payer pays the administrator, shall not be based solely on the number or amount of claims denied by the administrator. This provision shall not prohibit an administrator from receiving performance-based compensation if that compensation is not predicated on denial of claims or coverage.
N.J. Stat. Ann. § 17B:27B-8
Payment to third party administrators not based solely on claims denials
Known as the New Jersey Life and Health Insurance Guaranty Association Act
The act spans §§ 17B:17-1 to 17B:37-9 (1,003 sections).
L.2001,c.267,s.8.
Current official text: New Jersey Legislature. Digitized from the New Jersey Legislature bulk statutes download. Reproduced from public-domain New Jersey statutes; confirm against the official source for the current text. Not legal advice.