ASSEMBLY FINANCIAL INSTITUTIONS AND INSURANCE COMMITTEE

STATEMENT TO

ASSEMBLY, No. 5785

with committee amendments

STATE OF NEW JERSEY

DATED: DECEMBER 11, 2025

      The Assembly Financial Institutions and Insurance Committee reports favorably and with committee amendments Assembly Bill No. 5785.

      As amended, this bill requires health insurers (health, hospital and medical service corporations, commercial individual and group health insurers; health maintenance organizations, health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, 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.

      This bill is intended to prevent insurers from requiring covered persons to wait a full 12 months between visits to health care providers, which can result in persons not being able to properly schedule visits to receive preventive services.

COMMITTEE AMENDMENTS:

      The committee amended this bill to:

      (1)  allow waiting periods for preventive services if it is medically necessary to ensure the safety of the services; and

      (2)  provide that nothing within the bill requires coverage of duplicative preventive services unless a provider determines the duplicative services are clinically indicated.