Common use of STOP-LOSS INSURANCE Clause in Contracts

STOP-LOSS INSURANCE. At the discretion of the Departments of Banking and Insurance, Human Services, and Health and Senior Services and notwithstanding the requirements of N.J.A.C. 8:38-11.5 (b), the contractor may be required to obtain, prior to this contract, and maintain "stop-loss" insurance from a reinsurance company authorized to do business in New Jersey that will cover medical costs that exceed a threshold per case for the duration of the contract period. Any coverage other than stipulated must be based on an actuarial review, taking into account geographic and demographic factors, the nature of the clients, and state solvency safeguard requirements. All "stop-loss" insurance arrangements, including modifications, shall be reviewed and prior approved by the Departments of Banking and Insurance, Human Services, and Health and Senior Services. The "stop-loss" insurance underwriter must meet the standards of financial stability as set forth by the DOBI. Contractors with sufficient reserves may choose self-insurance, subject to approval by the Department of Human Services and the DOBI where appropriate.

STOP-LOSS INSURANCE. At the discretion of the Departments of Banking and Insurance, Human Services, and Health and Senior Services and notwithstanding the requirements of N.J.A.C. 8:38-11.5 (b), the contractor may be required to obtain, prior to this contract, and maintain "stop-loss" insurance from a reinsurance company authorized to do business in New Jersey that will cover medical costs that exceed a threshold per case for the duration of the contract period. Any coverage other than stipulated must be based on an actuarial review, taking into account geographic and demographic factors, the nature of the clients, and state solvency safeguard requirements. All "stop-loss" insurance arrangements, including modifications, shall be reviewed and prior approved by the Departments of Banking and Insurance, Human Services, and Health and Senior Services. The "stop-loss" insurance underwriter must meet the standards of financial stability as set forth by the DOBI. Contractors with sufficient reserves may choose self-insurance, subject to approval by the Department of Human Services and the DOBI where appropriate.

STOP-LOSS INSURANCE. At the discretion of the Departments of Banking and Insurance, ; and Human Services, and Health and Senior Services ; and notwithstanding the requirements of N.J.A.C. 8:38-11.5 (b), the contractor may be required to obtain, prior to this contract, and maintain "“stop-loss" ” insurance from a reinsurance company authorized to do business in New Jersey that will cover medical costs that exceed a threshold per case for the duration of the contract period. Any coverage other than stipulated must be based on an actuarial review, taking into account geographic and demographic factors, the nature of the clients, and state solvency safeguard requirements. All "“stop-loss" ” insurance arrangements, including modifications, shall be reviewed and prior approved by the Departments of Banking and Insurance, and Human Services, and Health and Senior Services. The "“stop-loss" ” insurance underwriter must meet the standards of financial stability as set forth by the DOBI. Contractors with sufficient reserves may choose self-insurance, subject to approval by the Department of Human Services and the DOBI where appropriate.

STOP-LOSS INSURANCE. At the discretion of the Departments of Banking and Insurance, Insurance and Human Services, and Health and Senior Services and notwithstanding the requirements of N.J.A.C. 8:3811:24-11.5 (b), the contractor may be required to obtain, prior to this contract, and maintain "stop-loss" insurance from a reinsurance company authorized to do business in New Jersey that will cover medical costs that exceed a threshold per case for the duration of the contract period. Any coverage other than stipulated must be based on an actuarial review, taking into account geographic and demographic factors, the nature of the clients, and state solvency safeguard requirements. All "stop-loss" insurance arrangements, including modifications, shall be reviewed and prior approved by the Departments of Banking and Insurance, Insurance and Human Services, and Health and Senior Services. The "stop-loss" insurance underwriter must meet the standards of financial stability as set forth by the DOBI. Contractors with sufficient reserves may choose self-insurance, subject to approval by the Department of Human Services and the DOBI where appropriate.