Your State Government's Oversight of Health Insurance in New Jersey
The State Government in New Jersey is responsible for preparing and overseeing insurance regulations applicable to state activities. In meeting this requirement, the State Government will generally work to assure the rights of consumers within a business environment that supports a healthy economic growth rate. In the arena of health insurance, the State Government serves three separate groups: consumers, insurance providers, and licensed insurance brokers.
The State Government's most prevalent element of control for assuring a productive health insurance environment involves the licensing and oversight of insurance providers and independent health insurance brokers. For controlling insurance providers, the State Government develops applicable standards for health benefits and insurance products and performs periodic financial statement reviews, making sure that tax requirements are met. For health insurance brokers, the Government establishes professional licensing qualifications, performs license testing for brokers and issues approved licenses, oversees continuing education requirements, and collects license fees for broker applicants. The State Government is charged with investigating health insurance fraud, especially as it affects consumers or when it damages the local business environment.
For state health insurance consumers, the State Government provides public insurance information and consumer guidelines to help residents find the most favorable health insurance plans. The State Government can help consumers file appeals with their health care insurance provider when a dispute arises based on their issues with their insurance policy. Finally, the Government of the state is charged with administering the State's Medicare program where subsidized health care benefits are offered to low income families, children who do not have health insurance, qualifying seniors, or the self-employed.