New Jersey-2018-S3807-Introduced

An Act concerning health insurance and supplementing P.L.1992, c.161 (C.17B:27A-2 et seq.).

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. a. There is established in the Department of the Treasury a nonlapsing revolving fund to be known as the "Individual Health Insurance Exchange Trust Fund." This fund shall be the repository for monies collected pursuant to subsection c. of this section and other monies received as grants or otherwise appropriated for the purposes of supporting health insurance outreach, enrollment, and reinsurance efforts. The monies in the fund shall be used only for the purpose of supporting the exchange authorized in subsection d. of this section through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, reinsurance, and other means of supporting the exchange.

b. The State Treasurer shall be the custodian of the fund and all disbursements from the fund shall be made by the State Treasurer upon vouchers signed by the Commissioner of Banking and Insurance. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury to the same extent that other trust funds that are in the custody of the State Treasurer are invested and reinvested, in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.

c. The commissioner may apply a monthly assessment to each health benefits plan offered by a carrier. The assessment shall be paid by the carrier and deposited into the fund and shall be used only for the purpose of supporting the exchange through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, reinsurance, and other means of supporting the exchange. The assessment may be applied at a rate of:

(1) .5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a federally-facilitated exchange;

(2) 1 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange using the federal platform; or

(3) 3.5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange. The commissioner shall have the discretion to adjust this rate to ensure that the State-based exchange is fully funded.

d. Notwithstanding any other law to the contrary, the Department of Banking and Insurance shall have the authority to:

(1) operate a State-based exchange in the department; and

(2) coordinate the exchange operations with the operations of the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program, including reorganization of the boards, as the commissioner deems appropriate.

2. The Department of Banking and Insurance shall adopt rules and regulations pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), to effectuate the purposes of this act.

3. This act shall take effect on January 1, 2020, except the commissioner may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.

STATEMENT

This bill authorizes the Department of Banking and Insurance to establish, operate, and fund a State-based exchange for certain health benefits plans.

Specifically, the bill establishes in the Department of the Treasury a nonlapsing revolving fund to be known as the "Individual Health Insurance Exchange Trust Fund." This fund is to be the repository for monies collected pursuant to the bill and other monies received as grants or otherwise appropriated for the purposes of supporting health insurance outreach, enrollment, and reinsurance efforts. The monies in the fund are to be used only for the purpose of supporting the exchange through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, reinsurance, and other means of supporting the exchange.

The bill allows the Commissioner of Banking and Insurance to apply a monthly assessment to each individual health benefits plan offered by a carrier. The assessment is to be deposited into the fund and is to be used only for the purpose of supporting the exchange through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, reinsurance, and other means of supporting the exchange. The assessment may be applied at a rate of:

(1) .5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a federally-facilitated exchange;

(2) 1 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange using the federal platform; or

(3) 3.5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange. The bill provides that the commissioner has discretion to adjust this rate to ensure that the State-based exchange is fully funded.

New Jersey's health insurance exchange is currently operated through the federally-facilitated exchange. This bill takes into account that the State may opt to establish either a State-based exchange using the federal platform, or a wholly Stated-based exchange.

The bill also specifically authorizes the department to operate a State-based exchange in the department and to coordinate the exchange operations with the operations of the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program, including reorganization of the boards, as the commissioner deems appropriate.