N.J.S.A 17:48F-4 Review of application.

17:48F-4 Review of application.

4. Following receipt of an application, the commissioner shall review it and notify the applicant of any deficiencies contained therein.

a. The commissioner shall issue a certificate of authority to an applicant in a timely manner, if the following conditions are met:

(1) All of the material required by section 3 of this act has been filed;

(2) The persons responsible for conducting the applicant’s affairs are competent, trustworthy and possess good reputations, and have had appropriate experience, training and education;

(3) The applicant is financially sound and may reasonably be expected to meet its obligations to enrollees and the contract holder. In making this determination, the commissioner shall consider:

(a) The financial soundness of the applicant’s arrangements for prescription services and the minimum standard rates, deductibles, copayments and other enrollee charges used in connection therewith;

(b) The adequacy of working capital, other sources of funding and provisions for contingencies;

(c) Whether any deposit of cash or securities, or any other evidence of financial protection submitted meets the requirements set forth in this act or by the commissioner; and

(d) The applicant’s rates and rating methodology;

(4) The agreements with providers for the provision of prescription services comply with the provisions of this act;

(5) Any deficiencies identified by the commissioner have been corrected; and

(6) Any other factors determined by the commissioner to be relevant have been addressed to the satisfaction of the commissioner.

b. If the certificate of authority is denied, the commissioner shall notify the applicant and shall set forth the reasons for the denial in writing. The applicant may request a hearing by notice to the commissioner within 30 business days of receiving the notice of denial. Upon such denial, the applicant shall submit to the commissioner a plan for bringing the prepaid prescription service organization into compliance or providing for the closing down of its businesS.

L.1997,C. 380,S.4.


Look up case for New Jersey Statute 17:48F-4 Review of application.

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NJ Maintained Unanotated Statutes References to 17:48F-4 Review of application.

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