New Jersey § 26:2j-19

§ 26:2j-19.

a. The commissioner may suspend or revoke any certificate of authority issued to a

health maintenance organization under this act if he finds that any of the following

conditions exist: (1) The health maintenance organization is operating in a manner significantly contrary

to that described in section 3, hereof, 1 unless amendments to such submissions have been filed with the commissioner; (2) The health maintenance organization issues evidence of coverage which does not

comply with the requirements of section 8 hereof; 2 (3) the health maintenance organization does not provide or arrange for basic health

care services; (4) the commissioner finds that: (a) the health maintenance organization does not meet the requirements of section

4 a. (2), hereof; 3 or (b) the health maintenance organization is unable to fulfill its obligations to furnish

health care services. (5) the health maintenance organization is no longer financially responsible and may

reasonably be expected to be unable to meet its obligations to enrollees or prospective

enrollees; (6) the health maintenance organization has failed to implement a mechanism affording

the enrollees an opportunity to participate in matters of policy and operation under

section 6, hereof; 4 (7) the health maintenance organization has failed to implement the complaint system

required by section 12, hereof, 5 in a manner to reasonably resolve valid complaints; (8) the continued operation of the health maintenance organization would be hazardous

to the health and safety of its enrollees; (9) the health maintenance organization has otherwise failed to substantially comply

with this act; or (10) the health maintenance organization, or any person on its behalf, has advertised

or merchandised its services in an untrue, misrepresentative, misleading, deceptive

or unfair manner. b. A certificate of authority shall be suspended or revoked only after compliance

with the requirements of section 21, hereof. 6 c. When the certificate of authority of a health maintenance organization is suspended,

the health maintenance organization shall not, during the period of such suspension,

enroll any additional enrollees except newborn children or other newly acquired dependents

of existing enrollees, and shall not engage in any advertising or solicitation whatsoever. d. When the certificate of authority of a health maintenance organization is revoked,

such organization shall proceed, immediately following the effective date of the order

of revocation, to dissolve its structure, and shall conduct no further business except

as may be essential to the orderly conclusion of the affairs of such organization. It shall engage in no further advertising or solicitation whatsoever. The commissioner or where applicable the Commissioner of Insurance may, by written

order, permit such further operation of the organization as he may find to be in the

best interest of enrollees, to the end that enrollees will be afforded the greatest

practical opportunity to obtain continuing health care coverage. 1

N.J.S.A. § 26:2J-3. 2

N.J.S.A. § 26:2J-8. 3

N.J.S.A. § 26:2J-4. 4

N.J.S.A. § 26:2J-6. 5

N.J.S.A. § 26:2J-12. 6

N.J.S.A. § 26:2J-21.