Recent New Jersey Department of Banking and Insurance Developments

Linked below are regulations proposed by the New Jersey Department of Banking and Insurance (Department) with respect to the dental plan organization (DPO) expense limitation. The proposed regulations would amend N.J.A.C. 11:10-1.9 and are intended to implement a 2015 Department Bulletin addressing the expense limitation in light of certain expenses imposed under the Affordable Care Act (ACA).  Consistent with the 2015 Bulletin, the Department proposes to amend N.J.A.C. 11:10-1.9 to specifically exclude new federal fees and taxes imposed by the ACA (and not contemplated when the DPO laws were originally promulgated) from the calculation of premiums for purpose of determining the expense limitation.  The proposed amendment will specify how these federal fees and taxes imposed by the ACA apply to the determination of the applicable expense limitation as specified at N.J.S.A. 17:48D-14 and the current implementing rules.  Further, the exclusion of the new federal fees and taxes is intended to maintain the status quo in determining the expense limitation.  Comments with respect to this proposal may be submitted to Denise Illes, Chief, Legislative and Regulatory Affairs, New Jersey Department of Banking and Insurance, on or before August 4, 2017.  http://www.state.nj.us/dobi/proposed/prn17_90.pdf

The Department has also issued a notice of increase in the medical component of the consumer price index (CPI), needed for the calculation of deposit requirements for organized delivery systems.  Specifically, the Department, in furtherance of N.J.A.C. 11:22-4.8(e), provides notice of an average 3.9% increase from December 2015 to December 2016, to the medical component of the CPI for all urban consumers in the New York-Northern New Jersey-Long Island region, and the Philadelphia-Wilmington-Atlantic City region as reported by the United States Department of Labor, Bureau of Labor Statistics.  Thus, the minimum deposit required by N.J.A.C. 11:22-4.8(e) relevant to organized delivery systems shall be revised to include an increase of 3.9% effective July 1, 2017 so that $36,684.45 specified at N.J.A.C.11:22-4.8(e) shall be $38,115.15.  http://www.state.nj.us/dobi/notices/pn170605.pdf