Department of Health and Senior Services
The Office of Managed Care in the New Jersey Department of Health and Senior Services monitors the compliance of managed health care plans with New Jersey rules through annual examinations and in-depth reviews of each plan conducted every three years. The office investigates consumer complaints and oversees the Independent Health Care Appeals Program (IHCAP). For information, call the Office of Managed Care toll-free at (888) 393-1062 or visit the web site, www.state.nj.us/health.

Department of Banking and Insurance
The New Jersey Department of Banking and Insurance (DOBI) publishes Buyer's Guides for individual and small employer coverage. You may obtain a copy of the Buyer's Guide for individuals at (800) 838-0935 and for small employers at (800) 263-5912. These are also available at DOBI's web site: www.njdobi.org.
DOBI also publishes a Managed Care Compendium each year. This contains information on enrollment by county, premiums, expenses, hospital utilization, net worth and profitability for all New Jersey HMOs as well as summary information on other managed care companies. Information about this Compendium and related matters are available at the DOBI Managed Care web site: www.njdobi.org/managed.htm.

Medicare
For information on managed care options for Medicare in New Jersey, call the New Jersey Department of Health and Senior Services, Division of Senior Affairs, State Health Insurance Assistance Program (SHIP) at (800) 792-8820, or call (800) MEDICARE. You can also visit www.medicare.gov. If you have a complaint about a Medicare managed care plan, refer to your member services handbook for detailed information about where to submit your complaint based on the type of complaint you have.

Medicaid
For information on Medicaid health plan options, quality information and complaints, call the New Jersey Department of Human Services at (800) 356-1561 or visit www.state.nj.us/humanservices.

Physicians
For information on New Jersey physicians, including disciplinary actions, call the New Jersey State Board of Medical Examiners at (609) 826-7100 or visit www.state.nj.us/lps/ca/bme/docdir.htm.

Self-Insured Plans
Large employers and unions often assume financial responsibility for employee health benefits instead of buying insurance. Employers may contract with outside organizations to administer their self-insured health benefits plans. These plans are not bound by our state's statutory or regulatory requirements, but rather by federal rules. Roughly half of all New Jerseyans getting health benefits through their employers are in self-insured plans. Questions or complaints about these self-insured plans can only be addressed by the federal Department of Labor's Pension and Welfare Benefits Administration. The main number is: (866) 275-7922. The web site is: www.dol.gov/dol/pwba.