New Jersey § 26:2j-10

§ 26:2j-10.

a. A health maintenance organization contract or certificate in which dependent coverage

is available shall continue to make that coverage available for an adult child until the child turns

26 years of age. A contract or certificate shall not deny coverage for an enrollee's child for health care services on the grounds

that: (1) The child was born out of wedlock; (2) The child is not claimed as a dependent on the enrollee's federal tax return; (3) The child does not reside with the enrollee or in the health maintenance organization's

service area, provided that the child complies with the terms and conditions of the

coverage with respect to the use of specified providers ; (4) The child is married; (5) The child has or adopts a child; or (6) The child starts or leaves school . b. If a child has coverage through a health maintenance organization plan of a noncustodial

parent, the health maintenance organization shall: (1) Provide such information to the custodial parent as may be necessary for the child

to obtain health care services through the child's noncustodial parent's coverage; (2) Permit the custodial parent, or the health care provider with the authorization

of the custodial parent, to submit claims for health care services without the approval

of the noncustodial parent; and (3) Make payments on claims submitted in accordance with paragraph (2) of this subsection

directly to the custodial parent, the health care provider or the Division of Medical

Assistance and Health Services in the Department of Human Services which administers

the State Medicaid program, as appropriate. c. When a parent who is the enrollee is eligible for dependent coverage and is required

by a court or administrative order to provide health insurance coverage for his child,

the health maintenance organization shall: (1) Permit the parent to enroll his child as a dependent, without regard to any open enrollment restrictions; (2) Permit the child's other parent, or the Division of Medical Assistance and Health

Services as the State Medicaid agency or the Division of Family Development as the

State IV-D agency, in the Department of Human Services, to enroll the child if the

parent who is the enrollee fails to enroll the child; and (3) Not terminate coverage of the child unless the parent who is the enrollee provides

the health maintenance organization with satisfactory written evidence that: the

court or administrative order is no longer in effect; or the child is or will be

enrolled in a comparable health benefits plan whose coverage will be effective on

the date of the termination of coverage.