New Jersey § 26:2j-11

§ 26:2j-11.

a. After a health maintenance organization has been in operation 24 months, it shall

have an annual open enrollment period of at least one month during which it accepts

enrollees up to the limits of its capacity, as determined by the health maintenance

organization, in the order in which they apply for enrollment. A health maintenance organization may apply to the commissioner for authorization

to impose such underwriting restrictions upon enrollment as are necessary to preserve

its financial stability, to prevent excessive adverse selection by prospective enrollees,

or to avoid unreasonably high or unmarketable charges for enrollee coverage for health

care services. The commissioner shall approve or deny such application within 30 days of the receipt

thereof from the health maintenance organization. The Commissioner of Insurance shall certify to the commissioner the appropriateness

of any requested underwriting restrictions. b. Health maintenance organizations providing or arranging for services exclusively

on a group contract basis may limit the open enrollment provided for in subsection

a. to all members of the group or groups covered by such contracts. c. A health maintenance organization shall notify its enrollees in writing at the

time of enrollment, and include a notice in the promotional material which it distributes

to prospective enrollees, that a person's choice of health benefits plan will determine

his coverage until the next annual open enrollment period, regardless of the continued

availability of a particular health care provider who contracts with that health maintenance

organization, unless the enrollee moves his place of residence outside of the organization's

designated service area.