New Jersey § 17:48G-4 Inapplicability of act relative to certain decisions of insurers, third party administrators.

New Jersey Statutes

§ 17:48G-4 — Inapplicability of act relative to certain decisions of insurers, third party administrators.

New Jersey § 17:48G-4

Title 17CORPORATIONS AND INSTITUTIONS FOR FINANCE AND INSURANCE

This text of New Jersey § 17:48G-4 (Inapplicability of act relative to certain decisions of insurers, third party administrators.) is published on Counsel Stack Legal Research, covering New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

N.J. Stat. Ann. § 17:48G-4 (2026).

Text

7. This act shall not be construed: a. To regulate insurers' or third party administrators' making any decision, including, but not limited to, a decision concerning benefit or insurance coverage, that does not involve the making of a dental decision; b. To regulate insurers' or third party administrators' use of a protocol for denying or limiting benefit payments for dental services where the protocol:

(1)has been approved for use by a dentist who is duly licensed in this State or who has been issued a limited registration certificate pursuant to section 4 of this act; and (2) does not involve evaluation of an individual patient's dental care or condition; or c. To regulate the application of contract limitations and exclusions, the credentialing of dentists or the conduct of retrospecti

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7. This act shall not be construed: a. To regulate insurers' or third party administrators' making any decision, including, but not limited to, a decision concerning benefit or insurance coverage, that does not involve the making of a dental decision; b. To regulate insurers' or third party administrators' use of a protocol for denying or limiting benefit payments for dental services where the protocol: (1) has been approved for use by a dentist who is duly licensed in this State or who has been issued a limited registration certificate pursuant to section 4 of this act; and (2) does not involve evaluation of an individual patient's dental care or condition; or c. To regulate the application of contract limitations and exclusions, the credentialing of dentists or the conduct of retrospective fraud reviews. L.2007, c.259, s.7.