State RegulationsNJ specificDifficulty 1/5
Which New Jersey authority administers and enforces the Individual Health Coverage and Small Employer Health Benefits Programs?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
The Individual Health Coverage Program and the Small Employer Health Benefits Program, created in the reform chapter beginning at N.J.S.A. 17B:27A-1, are administered and enforced by the New Jersey Department of Banking and Insurance. The department's Commissioner oversees the market rules, carrier obligations, and program operations in both the individual and small-employer health markets. Carriers participate in the programs but do not administer them.
Why the other options are wrong
- A) Federal Medicare authorities administer federal health programs; these are New Jersey reform programs under state supervision.
- B) The Department of Health handles public health functions; insurance market programs belong to the Department of Banking and Insurance.
- D) Carriers are regulated participants in the programs; administration and enforcement rest with the state department, not with the industry it regulates.
Memory hook
Banking and Insurance runs the reform programs — the carriers just play on its field.