State RegulationsNJ specificDifficulty 2/5
A New Jersey carrier writes insured health benefits for a small business. Which statement best describes the role of the Small Employer Health Benefits (SEH) Program under N.J.S.A. 17B:27A-17?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
The Small Employer Health Benefits Program, created in the reform chapter at N.J.S.A. 17B:27A-17, is the framework of market rules that governs how carriers issue insured health coverage in the small-employer market. The New Jersey Department of Banking and Insurance administers the program, which shapes rating, availability, and benefit requirements for small-group business rather than substituting state-paid benefits for private coverage.
Why the other options are wrong
- A) The SEH Program regulates the insured small-employer market; it does not replace employer coverage with state-paid benefits.
- B) Third-party administrator licensing is not the function of the SEH Program; the program sets market rules for carriers writing small-group business.
- D) Identical premiums for every employee is not what the program mandates; the program's role is establishing the governing market framework.
Memory hook
SEH = Small Employer Health: the rulebook carriers follow in the small-group market.