This bill creates the "Health Care for Child Care Program" to provide state-funded health insurance coverage for employees at licensed New Jersey child care centers. It appropriates $10 million from the General Fund to cover the full premium costs for eligible workers - those employed at least 30 hours weekly for 90 days at a licensed center or registered family child care home - through New Jersey’s gold-level health plan. The program eliminates out-of-pocket costs for workers and their employers, with the Department of Banking and Insurance administering the fund. It directly affects child care workers, who often lack employer-provided health benefits, and aims to stabilize the sector by reducing financial strain on centers.
This bill requires all health insurance plans in New Jersey - including Medicaid - to cover planned home births at the same level as hospital-based care. It mandates coverage for services provided by certified midwives, doulas, and related medical supplies, such as equipment and medications. The law applies to hospital service contracts, medical service contracts, health service contracts, and individual health insurance policies issued in New Jersey. This policy change directly affects pregnant individuals seeking home births and their insurance providers by eliminating coverage barriers for this birth option.
This bill requires all health insurance policies in New Jersey to cover at-home rehabilitation services for people recovering from injury or illness. It applies to every type of health plan - including individual policies, group plans, HMOs, and health benefits plans - mandating that coverage must be provided "to the same extent as for any other medical condition." The law defines "at-home rehabilitation" as treatment using medical equipment within a person's home for functional physical or mental impairments. This change directly affects insurers (who must include this coverage) and patients needing such services, eliminating gaps in coverage for home-based care.
This bill (S 3549) requires all health insurance plans sold in New Jersey to cover specific obesity treatments, including preventive care, nutrition counseling, behavioral therapy, bariatric surgery, and FDA-approved anti-obesity medications. It applies to hospital service corporations, medical service corporations, health service corporations, and individual or group health insurance policies. Insurance plans must cover these treatments "to the same extent as for any other medical condition," without additional cost-sharing. The law affects all insurers operating in New Jersey that provide hospital or medical expense benefits, ensuring comprehensive coverage for obesity treatment as a standard medical service.
This bill prohibits health insurance carriers from denying coverage for nonopioid pain medications in favor of opioids or requiring patients to try opioids first. It requires insurers to treat FDA-approved nonopioid drugs equally to opioids in formularies, meaning coverage restrictions, prior authorization, and cost-sharing tiers must be no more restrictive for nonopioid drugs. The law applies to state health benefit plans, school employee health programs, and Medicaid for acute pain treatment. It takes effect January 1, 2026, directly affecting insurers and patients covered by these plans.
This New Jersey bill (A3979) requires all health insurance plans sold in the state - including hospital, medical, and health service corporation contracts - to cover specific lipedema treatments. It mandates coverage for compression garments, manual lymphatic drainage, medical nutrition therapy, mental health care, medically necessary lipectomies, and related appointments. Insurers must accept physician diagnoses and surgeon-provided photos for verification, cannot deny coverage based solely on photos, and must cover the full number of lipectomies deemed necessary by a surgeon. The coverage must align with existing cost-sharing structures (deductibles, coinsurance) and standard medical care for lipedema.
This bill expands New Jersey's existing requirement for health insurance plans to cover prostate cancer screenings without any out-of-pocket costs. It specifically requires coverage for annual screenings - including digital rectal exams and PSA tests - for men aged 50 and older (asymptomatic) and men aged 40 and older with a family history of prostate cancer or other risk factors. The law applies to most health insurance plans, including high-deductible plans where permitted by federal law, and mandates coverage "to the same extent as for any other medical condition." It does not alter existing coverage for other preventive services but ensures no cost-sharing (like deductibles or copays) applies to these specific screenings.
This bill (S 1402) provides disability insurance coverage instead of disability retirement benefits for new members of New Jersey's Teachers' Pension and Annuity Fund (TPAF) and Public Employees' Retirement System (PERS) who become disabled. It creates a special fund to pay for group disability insurance premiums, replacing the previous system. Covered members receive 60% of their base salary (minimum $50/month) if totally disabled for six+ months, with benefits ending at age 70 or when returning to work. The bill was withdrawn after being approved as part of P.L.2025, c.370, meaning the policy changes are now law.
This bill increases the maximum weekly limit for reimbursable personal care assistant (PCA) services under New Jersey's WorkAbility Program from 40 to 112 hours per calendar week. It directly affects employed, permanently-disabled individuals who qualify for the program - specifically those working while meeting income thresholds (under 250% of federal poverty level for earned income) and paying a $25 monthly premium. The key mechanism removes the current 40-hour cap on PCA services, requiring the Commissioner of Human Services to seek federal Medicaid waivers and update regulations to implement the change. This adjustment allows greater flexibility for participants to access necessary personal care support while working.
This bill requires health insurance companies and Medicaid programs in New Jersey to cover screening, prevention, and treatment services for children's behavioral health issues without needing a formal mental health diagnosis. It allows providers to use "at-risk diagnosis" billing codes (like Social Determinants of Health Z-codes) for services such as early screenings and therapy for children under 18. The coverage must be provided at the same level as other medical services, including for children showing potential issues before a diagnosis is made. This applies to all private health plans, state employee health benefits, school employee health plans, and NJ FamilyCare Medicaid programs.
