Bill Text: NJ A5080 | 2024-2025 | Regular Session | Introduced
Bill Title: Establishes special enrollment period for covered persons whose in-network health care provider leaves network of health benefits plan.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced) 2024-12-12 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A5080 Detail]
Download: New_Jersey-2024-A5080-Introduced.html
Sponsored by:
Assemblyman LOUIS D. GREENWALD
District 6 (Burlington and Camden)
Co-Sponsored by:
Assemblywoman Hall
SYNOPSIS
Establishes special enrollment period for covered persons whose in-network health care provider leaves network of health benefits plan.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning special enrollment periods and supplementing P.L.1997, c.192 (C.26:2S-1 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The department shall establish a special enrollment period for a covered person if a health care provider decides to no longer participate in the health benefits plan network during the covered person's policy or contract period.
b. The enrollment period described pursuant to subsection a. of this section shall be determined by the department and shall not be shorter than 30 calendar days.
c. Information about the enrollment period described pursuant to this section shall be communicated to affected individuals by the carrier.
2. The department shall adopt, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), rules and regulations as necessary to effectuate the purposes of this act.
3. This act shall take effect on the 90th day next following enactment and shall apply to policies and contracts that are delivered, issued, executed, or renewed on or after that date.
STATEMENT
This bill establishes a special enrollment period for covered persons whose in-network health care provider leaves a carrier's network during the covered person's policy period.
Under the bill, the Department of Banking and Insurance will establish a special enrollment period for a covered person whose health care provider, after participating in the covered person's health benefits plan network, decides to no longer participate in the health benefits plan network during the covered person's policy or contract period. The special enrollment period established will last for a certain period of time to be determined by the department, which will not be shorter than 30 days. Finally, the carrier will be required to provide information about the enrollment period to the public and affected individuals.
