Bill Text: NJ A2327 | 2016-2017 | Regular Session | Introduced
Bill Title: Places moratorium on implementation of certain tiered network health benefits plans until January 1, 2017.
Spectrum: Partisan Bill (Democrat 7-0)
Status: (N/A - Dead) 2016-02-04 - INT 1RA REF ARO [A2327 Detail]
Download: New_Jersey-2016-A2327-Introduced.html
Sponsored by:
Assemblywoman VALERIE VAINIERI HUTTLE
District 37 (Bergen)
SYNOPSIS
Places moratorium on implementation of certain tiered network health benefits plans until January 1, 2017.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning certain health benefits plans and supplementing P.L.1997, c.192 (C.26:2S-1 et al.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. Notwithstanding the provisions of any other law, rule or regulation to the contrary, no health benefits plan offered by a carrier for the first time in calendar year 2015 as a managed care plan with more than one level or tier of in-network benefits, based on different levels of reimbursement and cost sharing accepted by the health care providers in that network, shall take effect or otherwise apply to covered services under that plan on or before December 31, 2016.
b. A carrier which offered a health benefits plan described in subsection a. of this section which, but for the operation of subsection a. of this section, would take effect on or before December 31, 2016, shall provide to any individual who would be a covered person under that plan, a special, additional open enrollment period of not less than 30 days in which to choose from among existing health benefits plans offered by the carrier and in which the individual is eligible to enroll. The Commissioner of Banking and Insurance shall determine an appropriate date on which such open enrollment period may begin, taking into consideration timely notification of affected individuals.
c. For the purposes of this section, "carrier" shall include, in addition to an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State, the State Health Benefits Commission and the School Employees' Health Benefits Commission.
2. This act shall take effect immediately.
STATEMENT
This bill places a moratorium on the implementation of any managed care health benefits plan with more than one level or tier of in-network benefits that has been offered for the first time in calendar year 2015 and which would otherwise take effect before January 1, 2017. The bill further provides that, with respect to any individuals who may have selected such a plan, which, but for this bill, would be implemented before that date, the carrier must provide a special, additional open enrollment period of not less than 30 days in which those individuals may choose from among existing health benefits plans offered by the carrier and in which those individuals are eligible to enroll. The Commissioner of Banking and Insurance shall determine an appropriate date on which such open enrollment period may begin, taking into consideration timely notification of affected individuals.
