A 3972 New Jersey General Assembly · 2024-2025 Regular Session

Makes certain changes to calculation of minimum loss ratio requirements for health benefits plans in individual and small employer markets.

This bill changes how health insurers in New Jersey calculate their minimum loss ratio requirement for individual and small employer health plans. It requires insurers to maintain at least 80% of premiums spent on claims and quality improvements, calculated using a three-year rolling average instead of annual figures. The law specifies that the numerator must include claims paid plus quality improvement spending, excludes new taxes from the calculation, and mandates that insurers issue rebates if the loss ratio falls below 80%. This applies to all health insurance carriers selling plans in New Jersey's individual and small-group markets.
Bill status in committee 1 of 4 stages cleared
Introduction
Mar 2024
Committee Review
Floor Vote
Governor
Introduced Mar 4, 2024 Last action Jun 28, 2024
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Full legislative history

Actions timeline

Total actions
5
Key actions
1
Committee
3
Jun 13, 2024
Lower · Passed
Reported out of Assembly Committee with Amendments, 2nd Reading
lower
Mar 14, 2024
Committee
Reported out of Assembly Committee with Amendments and Referred to Assembly Financial Institutions and Insurance Committee
lower
Mar 14, 2024
Committee
Transferred to Assembly Health Committee
lower
Mar 4, 2024
Introduced
Introduced in the Assembly, Referred to Assembly Financial Institutions and Insurance Committee
lower
3 primary · 3 co-sponsors

Sponsors