This bill restructures the governance of New Jersey's State Health Benefits Program (SHBP), which provides health coverage to state employees. It creates a new 11-member State Health Benefits Commission (replacing the previous structure) and a separate 12-member Plan Design Committee. The Commission includes the Treasurer, agency heads, and members appointed by labor unions representing state employees, while the Plan Design Committee focuses specifically on designing health plan benefits like medical, dental, and prescription coverage. These changes affect all state employees enrolled in the SHBP by altering who oversees their health plan offerings and administration. The bill does not change the actual benefits provided, only the decision-making bodies managing the program.
This New Jersey bill (A 3127) requires Medicare supplement insurance policies sold in the state to include two key provisions: (1) limiting premium increases to once per calendar year, and (2) allowing policyholders to pay their annual premium in advance. It directly affects Medicare supplement insurers and policyholders in New Jersey by setting these specific terms for premium adjustments and payment options. The bill also mandates that insurers file annual rates demonstrating compliance with state loss ratio standards, but the core policy changes focus on consumer protections regarding premium timing. These requirements apply to policies issued or renewed after the bill's effective date.
This bill requires health insurance plans and Medicaid in New Jersey to cover all reproductive health care services, including family planning and abortion. It also prohibits medical malpractice insurers from raising premiums or canceling coverage for providers who offer these legally protected services. The law applies to all health insurance companies, Medicaid, and malpractice insurers operating in the state. By mandating coverage and preventing insurance penalties, the bill aims to remove financial barriers to reproductive health care access for all residents.
This bill establishes a new calculation method for retirement costs at New Jersey's public colleges and universities (like Rutgers and NJIT), requiring the state to set a separate "fringe benefit rate" reflecting actual retirement expenses. It also requires public institutions to pay for health insurance coverage for part-time faculty (including adjuncts and lecturers) who taught at least 24 credits in the prior fiscal year and 12 credits in the current year, making them eligible for benefits as if they were full-time. Employers must cover the full cost of health plans, shifting this responsibility from part-time faculty who meet the teaching credit thresholds. The bill aims to standardize retirement cost accounting and expand health coverage access for qualifying part-time educators.
This bill prohibits New Jersey's State Health Benefits Program (SHBP), School Employees' Health Benefits Program (SEHBP), and Medicaid from denying coverage for maintenance medications treating chronic conditions when a person's health plan or pharmacy benefits manager changes. It specifically prevents coverage loss if the person was already taking the medication before the change and the new plan covers that medication class. The law applies to all covered individuals under these programs who experience such plan transitions. It ensures continuity of essential medications without requiring new prior authorizations due to administrative changes.
This New Jersey bill (A 2432) requires the Commissioner of Human Services to ensure Medicaid beneficiaries receive respite care coverage when their primary health insurer (public or private) denies it, provided the beneficiary is otherwise Medicaid-eligible for such services. It mandates the Commissioner to create procedures guaranteeing this coverage without changing existing Medicaid eligibility rules for respite care. The law applies directly to Medicaid recipients who face coverage denials for respite care from their primary payer. It takes effect immediately upon enactment, with the Commissioner required to adopt implementing rules under the Administrative Procedure Act.
Michelle's Law requires all health insurance plans in New Jersey to cover mammograms when a healthcare provider recommends them. It mandates baseline mammograms for women at age 40, annual mammograms for women 40 and older, and coverage for women under 40 with breast cancer risk factors (like family history) based on provider recommendation. The law also requires coverage for additional tests like ultrasounds or MRIs if needed due to dense breast tissue, abnormal results, or other risk factors. This applies to all health insurance contracts, including those allowing premium changes, without limiting coverage for other medical conditions.
This bill requires New Jersey health insurers to cover specific breast cancer detection services for all women with health insurance in the state. It mandates coverage for a baseline mammogram starting at age 18 (previously 40), annual mammograms for women 18 and older, and additional imaging like ultrasounds or MRIs when medically necessary due to dense breast tissue, abnormal results, family history, genetic factors, or other risk indicators. The coverage applies to all group and individual health insurance contracts and must be provided at the same level as other medical benefits. The bill updates existing law to expand access to early detection screenings based on current medical guidelines.
This bill requires New Jersey health insurance companies (and their vendors) to offer electronic fund transfers (EFT) as a standard option for reimbursing policyholders for covered medical costs. It mandates that insurers notify policyholders about any fees for EFT and provide clear website instructions to select this payment method. Insurers violating these rules face enforcement by the Department of Banking and Insurance, including fines and orders to reimburse policyholders for any fees they incurred. The law applies to all health benefits plans (excluding Medicare Supplement, workers' comp, and similar coverage) for claims submitted after its effective date.
This Senate Resolution (SR 60) urges health insurance and prescription drug providers to include a simple "press zero" option on their automated phone systems, allowing callers to directly reach a human operator or leave a message during business hours. It specifically targets the frustration many experience - especially seniors and people with hearing impairments - when automated systems make it difficult to speak with a person. The resolution does not create new law but recommends this uniform method for contacting a human, and it directs copies to state agencies like the Banking Commissioner and Pharmacy Board. It directly affects consumers calling these providers and the providers themselves, who would need to adjust their phone systems.
