Revised HINT Enrollment Forms - N.J.A.C. 11:22-3

State of New Jersey State of New Jersey DEPARTMENT OF BANKING AND INSURANCE OFFICE OF THE COMMISSIONER PO BOX 325 TRENTON, NJ 08625-0325 Tel (609) 292-5360 ___________________________________________________________________________________________ Visit us on the Web at www.njdobi.org New Jersey is an Equal Opportunity Employer • Printed on Recycled Paper and Recyclable JAMES E. MCGREEVEY Governor HOLLY C. BAKKE Commissioner BULLETIN NO. 03-26 TO: ALL HOSPITAL SERVICE CORPORATIONS; MEDICAL SERVICE CORPORATIONS; HEALTH SERVICE CORPORATIONS; INDIVIDUAL AND GROUP HEALTH INSURERS; HEALTH MAINTENANCE ORGANIZATIONS; DENTAL SERVICE CORPORATIONS; DENTAL PLAN ORGANIZATIONS; PREPAID PRESCRIPTION SERVICE ORGANIZATIONS; AND ALL OTHER INTERESTED PARTIES FROM: HOLLY C. BAKKE, COMMISSIONER RE: REVISED HINT ENROLLMENT FORMS – N.J.A.C. 11:22-3 The Department will soon propose amendments to N.J.A.C. 11:22-3, Appendix 1. The amendments will provide separate enrollment forms for group and individual markets to address with greater clarity the regulatory and operational procedures of each market. The purpose of this Bulletin is to provide affected entities with the revised enrollment forms so that they may be utilized to satisfy the requirements of N.J.A.C. 11:22-3, Appendix 1. Appendix 1A is for use by the group market; Appendix 1B is for use by the individual market. _9/19/03 /s/ Holly C. Bakke Date Holly C. Bakke Commissioner Kg03-01/inoord