Financial Standards and Reporting

Joint Adopted Amendments: N.J.A.C. 8:38-11.1 and 11.6

Proposed: January 16, 2001 at 33 N.J.R. 159(a)

Adopted: March 19, 2001 by Karen L. Suter, Commissioner, Department of Banking and Insurance and Christine Grant, Commissioner, Department of Health and Senior Services

Filed: March 20, 2001 as R. 2001 d. 126, with a technical change not requiring additional public notice and comment (see N.J.A.C. 1:30-4.3).

Authority: N.J.S.A. 26:2J-1 et seq.

Effective Date: April 16, 2001

Expiration Date: January 17, 2002.

Summary of Public Comment and Agency Response:

No comments were received.

Federal Standards Statement

Certain aspects of an HMO’s business are regulated by the Federal government, to the extent that the HMO elects to become Federally-qualified. However, these adopted amendments do not attempt to regulate any area of HMO operation currently regulated by the Federal Government, and so are not inconsistent with or more stringent than any Federal statutes or rules. Thus, no Federal standards analysis is necessary.

Full text of the adoption follows: (addition to proposal indicated in boldface with asterisks *thus*; deletion from proposal indicated in brackets with asterisks *[thus]*):


8:38-11.6 Financial reporting requirements

(a) (No change from proposal.)

(b) Every HMO shall submit, no later than June 1, audited annual financial reports for the immediately preceding calendar year for the HMO and any company that is a financial guarantor for the HMO, completed on a SAP basis; except that any financial guarantor that is not an insurer or HMO shall submit audited annual financial reports as set forth herein on a GAAP basis.

1. – 3. (No change from proposal.)

4. Each HMO required by this subchapter to file an annual audited financial report shall, within 60 days after becoming subject to such requirements, register with the Commissioner of Banking and Insurance in writing the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit. HMOs not retaining an independent certified public accountant on *[(the effective date of this amendment)]* *April 16, 2001* shall register the name and address of their retained certified public accountant not less than six months before the date when the audited financial report is to be filed.

5. – 6. (No change from proposal.)

(c) – (k) (No change from proposal.)