Healthcare (Insurance)

in committee · New Jersey · General Assembly Jun 18, 2026

A 1142: Expands requirements for health insurance carriers concerning prostate cancer screening. *

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.

Topics ✓ HealthcareSupports HealthcareExpands mandatory coverage for prostate cancer screenings without cost sharing, increasing patient access to preventive care as required by law.95% confidence

Sub-Topics Insurance

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died · New Jersey · Senate Jan 13, 2026

S 1402: Provides health care benefits to disabled members of TPAF and PERS.

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 The bill was withdrawn after being approved as part of P.L.2025, c.370, meaning the policy changes are now law.

Topics ✓ HealthcareSupports HealthcareReplaces disability retirement with insurance coverage, providing 60% salary benefits via new fund for disabled public employees, expanding health coverage access.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentProvides disability insurance benefits (60% salary min $50) for new public employees, replacing retirement benefits with funded coverage, strengthening worker benefits under employment standards.92% confidence

Sub-Topics Insurance

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in committee · New Jersey · Senate Jan 13, 2026

S 2573: Increases hourly limit of reimbursable personal care assistant services under NJ WorkAbility Program.

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.

Topics ✓ HealthcareSupports HealthcareIncreases PCA service hours from 40 to 112 weekly, expanding access to essential healthcare support for disabled workers under NJ's WorkAbility Program.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentIncreases PCA service hours for disabled workers, enabling sustained employment and expanding access to critical support services under WorkAbility Program.95% confidence

Sub-Topics Insurance Medicaid

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died · New Jersey · Senate Jan 13, 2026

S 3008: Requires health insurance and Medicaid coverage for screening, prevention, and treatment services of behavioral health issues affecting children.

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.

Topics ✓ HealthcareSupports HealthcareMandates insurance/Medicaid coverage for children's behavioral health without diagnosis requirement, requires parity with medical services, directly expanding mental health access and coverage.95% confidence

Sub-Topics Insurance Medicaid Mental Health

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in committee · New Jersey · Senate Jan 13, 2026

S 968: Requires insurers offering commercial general liability insurance policies to provide notification of exclusion for communicable disease.

S 968 requires New Jersey insurers selling commercial general liability insurance to clearly notify businesses - before purchase or renewal - whether their policy excludes coverage for communicable disease outbreaks like COVID-19. If exclusions exist, insurers must state either the cost to remove them or where businesses can obtain coverage from another insurer. If insurers fail to provide this notice, the exclusion becomes invalid, and coverage automatically includes communicable disease transmission. This directly affects commercial insurers and businesses relying on this insurance for liability protection.

Topics ✓ HealthcareSupports HealthcareBill mandates insurers to disclose communicable disease coverage exclusions in commercial liability policies. Failure to notify invalidates exclusions, ensuring coverage for outbreaks like COVID-19. This protects businesses from coverage gaps duri...95% confidence

Sub-Topics Insurance Public Health

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in committee · New Jersey · Senate Jan 13, 2026

S 2405: Requires health insurers to provide coverage for hearing aids.

This New Jersey bill (S 2405) requires most health insurance plans sold in the state to cover hearing aids. Insurers must provide one hearing aid per ear every 48 months for medically necessary devices prescribed by licensed audiologists or hearing aid dispensers, with patients paying no more than 15% of the cost. The mandate applies to hospital service corporations, medical service corporations, health maintenance organizations, and individual/group health insurance policies. It directly affects all health insurers operating in New Jersey and policyholders needing hearing aids.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for hearing aids, expanding health service access and patient coverage for medically necessary devices.95% confidence

Sub-Topics Hospitals Insurance

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in committee · New Jersey · Senate Jan 13, 2026

S 1607: Prohibits health insurance carriers from placing time limit on coverage of anesthesia services before, during, or after medical or surgical procedures.

S 1607 (New Jersey) prohibits health insurance carriers (including companies, HMOs, and health service corporations) from restricting coverage based on the duration of anesthesia services before, during, or after medical or surgical procedures. The bill defines "anesthesia services" using standard medical coding (AMA’s Current Procedural Terminology codes) and requires insurers to cover these services without time-based limits. It applies to policies delivered, issued, or renewed 90 days after enactment. This directly affects insurers operating in New Jersey and ensures continuous coverage for anesthesia during all phases of care.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from restricting anesthesia coverage duration, ensuring uninterrupted access to essential services and expanding patient coverage rights under healthcare policy.95% confidence

Sub-Topics Insurance

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in committee · New Jersey · Senate Jan 13, 2026

S 2581: Establishes "Recovery Tax Credit Program"; incentivizes hiring and continued employment of certain individuals in recovery from substance use disorder.

S 2581 establishes a tax credit program in New Jersey to incentivize employers to hire and retain individuals in recovery from substance use disorder. Employers must become "certified" by partnering with treatment providers, offering qualifying health insurance, and meeting other criteria to qualify for the program. Certified employers can claim a tax credit of $1 per hour worked by eligible employees, up to $2,000 per employee annually, for part-time or full-time employment. The program, administered by the Division of Mental Health and Addiction Services, allocates up to $2 million yearly and requires employers to verify employee eligibility and recovery status. This bill directly affects New Jersey employers seeking tax incentives and individuals with substance use disorder seeking stable employment.

Topics ✓ Budget & TaxesSupports Budget & TaxesCreates tax credit ($1/hr up to $2k/employee) for employers hiring recovery individuals, reducing tax liability to incentivize employment - fiscal support via tax relief for workforce development.95% confidence ✓ HealthcareSupports HealthcareBill requires qualifying health insurance for employer certification, directly incentivizing expanded health coverage for individuals in recovery from substance use disorder.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentIncentivizes hiring/retention of individuals in recovery through tax credits, directly advancing employment opportunities for vulnerable workers under Labor & Employment policies.95% confidence

Sub-Topics Tax Credits Insurance Mental Health Substance Abuse

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in committee · New Jersey · Senate Jan 13, 2026

S 1102: Requires health benefits coverage of continuous glucose monitoring system for treatment of glycogen storage disease.

This bill (S 1102) requires all health insurance plans in New Jersey - covering hospital services, medical expenses, individual policies, group plans, and health maintenance organizations - to cover the cost of continuous glucose monitoring systems when prescribed by a healthcare provider for treating glycogen storage disease. It applies to all new or renewed insurance contracts on or after the bill's effective date, mandating coverage "to the same extent as for any other medical condition." The law directly affects patients with glycogen storage disease who rely on these monitoring systems and insurers who must now include this coverage without additional cost-sharing. It does not change existing coverage standards for other conditions but ensures consistent access to this specific treatment tool.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for glucose monitoring systems treating glycogen storage disease, expanding patient access to necessary medical devices under all insurance plans.95% confidence

Sub-Topics Hospitals Insurance

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in committee · New Jersey · Senate Jan 13, 2026

S 2943: Requires DOBI to establish integrated enrollment platform for State-based health insurance exchange and NJ FamilyCare program.

S 2943 requires New Jersey's Department of Banking and Insurance (DOBI) to create an integrated enrollment platform connecting the state's health insurance exchange with the NJ FamilyCare program (which includes Medicaid and CHIP). This directly affects New Jersey residents applying for health coverage through the Individual Health Coverage Program, Small Employer Health Benefits Program, or NJ FamilyCare. The bill mandates DOBI, in coordination with the Department of Human Services, to integrate the exchange with Medicaid eligibility systems so applicants can determine eligibility for all programs through one platform. It also establishes a nine-member advisory committee with health insurance expertise to guide implementation, including consumer advocates and industry representatives.

Topics ✓ HealthcareSupports HealthcareIntegrates health insurance exchange and NJ FamilyCare enrollment, improving access to coverage for residents through streamlined application process.85% confidence

Sub-Topics Children's Health Insurance Medicaid

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