SENATE COMMITTEE SUBSTITUTE FOR
SENATE, No. 2824
STATE OF NEW JERSEY
220th LEGISLATURE
ADOPTED JANUARY 26, 2023
Sponsored by:
Senator JOSEPH F. VITALE
District 19 (Middlesex)
Senator NELLIE POU
District 35 (Bergen and Passaic)
SYNOPSIS
Requires DOBI to conduct study on impact of certain changes to individual and small group health insurance markets.
CURRENT VERSION OF TEXT
As reported by the Senate Budget and Appropriations Committee on March 16, 2023, with amendments.
An Act requiring study of small employer health insurance and supplementing P.L.2020, c.61 (C.17B:27A-65 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. a. The Department of Banking and Insurance shall conduct a study of:
(1) the 1potential1 impact on the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program of pursuing an amendment to the waiver of applicable provisions of the Affordable Care Act granted by the United States Secretary of Health and Human Services pursuant to 42 U.S.C. s.18052 in order to merge the individual and small group markets and 1[extend] the availability and impact of extending1 reinsurance to small businesses purchasing health insurance through the pooled market; 1[and]1
(2) the 1[creation of] costs and benefits of creating1 a small employer health insurance subsidy1, and other affordability measures as deemed appropriate by the commissioner,1 and sustainable funding sources for that subsidy 1and those measures1. The examination shall consider the size of an effective and meaningful subsidy, an analysis of available sustainable funding sources, including an examination of the establishment of an assessment on other lines of insurance, the size of any such assessment, and how best to administer both the subsidy and a potential assessment. The department shall examine similar subsidies and assessments in other states, including the New Mexico health care affordability fund and health insurance premium surtax1;
(3) the actuarial impact of increasing the age rating ratio in the New Jersey Small Employer Health Benefits Program from 2:1 to various ranges up to 3:1 . The department shall specifically examine the impact of any increase of the age rating ratio on consumers and overall premiums in the small group market, as well as any impact on market viability, competitiveness, enrollment, and any other factors that the department finds necessary. The study shall examine and illustrate the impact of the implementation schedule of any age rating ratio changes. Additionally, the study shall examine the effect of geographic region ratings on premiums and whether it would be in the best interests of the small group market’s viability and employers and employees to retain or eliminate this factor. The study shall include recommendations to the Legislature to support the health of the small group market and its eligible enrollees; and
(4) other policies that could contribute to stabilizing the small employer health insurance market1.
b. The department shall make 1a report of the study’s findings and recommendations and provide a copy of the report to the1 public 1[and] through the Internet website of the department. The department shall also provide the1 report 1[its findings and recommendations]1 to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), 1[of the study conducted pursuant to this section]1 no later than 1[120 days] one year1 following the effective date of this act 1.
c. The commissioner is authorized to request directly from any other department or agency of State government information or data that may be needed to carry out the requirements of this section; and such department or agency is authorized and shall furnish the requested information or data.
d. The commissioner may request from any carrier participating in the Small Employer Health Benefits Program and Individual Health Coverage Program data necessary to conduct the study pursuant to this section, and carriers shall provide the requested data.
e. The commissioner may engage the services of experts and consultants to assist with the preparation of the study required under this section1.
2. This act shall take effect immediately.