LEGISLATIVE FISCAL ESTIMATE
[First Reprint]
ASSEMBLY, No. 5785
STATE OF NEW JERSEY
221st LEGISLATURE
DATED: DECEMBER 22, 2025
SUMMARY
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Synopsis: |
Requires certain preventive services to be provided on calendar year basis. |
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Type of Impact: |
Potential annual expenditure increase to the State and participating local government employers. |
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Agencies Affected: |
Division of Pensions and Benefits in the Department of the Treasury; certain local government employers. |
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Office of Legislative Services Estimate |
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Fiscal Impact |
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Annual |
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Potential State Expenditure Increase |
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Indeterminate |
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Potential Local Expenditure Increase |
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Indeterminate |
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· The Office of Legislative Services (OLS) determines that requiring every contract purchased by the State Health Benefits Commission and the School Employees’ Health Benefits Commission to provide coverage for preventive services recommended on an annual basis at least once per calendar year without requiring any waiting period, except as necessary to ensure the safety of those services, may result in annual indeterminate expenditure increases to the State and participating local government employers if such requirements increase the frequency or utilization of such services beyond current levels.
BILL DESCRIPTION
This bill requires health insurers, including the State Health Benefits Program, and the School Employees’ Health Benefits Program, to provide coverage for preventive services that are recommended on an annual basis at least once per calendar year, without requiring any waiting period.
Nothing within the bill requires coverage of duplicative services unless a provider determines those services are clinically indicated. An insurer under the bill may also require a waiting period if it is medically necessary to ensure the safety of the services.
FISCAL ANALYSIS
EXECUTIVE BRANCH
None received.
OFFICE OF LEGISLATIVE SERVICES
The OLS determines that requiring every contract purchased by the State Health Benefits Commission and the School Employees’ Health Benefits Commission to provide coverage for preventive services recommended on an annual basis at least once per calendar year without requiring any waiting period, except as necessary to ensure the safety of those services, may result in annual indeterminate expenditure increases to the State and participating local government employers if such requirements increase the frequency or utilization of such services beyond current levels.
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Section: |
State Government |
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Analyst: |
Associate Fiscal Analyst |
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Approved: |
Thomas Koenig Legislative Budget and Finance Officer |
This legislative fiscal estimate has been produced by the Office of Legislative Services due to the failure of the Executive Branch to respond to our request for a fiscal note.
This fiscal estimate has been prepared pursuant to P.L.1980, c.67 (C.52:13B-6 et seq.).