LEGISLATIVE FISCAL ESTIMATE

ASSEMBLY, No. 5337

STATE OF NEW JERSEY

222nd LEGISLATURE

 

DATED: JUNE 30, 2026

 

 

SUMMARY

 

Synopsis:

Makes various changes to SHBP governance and administration.

Type of Impact:

Potential State and local government expenditure decreases and increases.

Agencies Affected:

Division of Pension and Benefits in the Department of the Treasury; certain local government employers.

 

 

Office of Legislative Services Estimate

Fiscal Impact

 

One-time 

Annual 

 

Potential State Expenditure Increase

 

Indeterminate

Indeterminate

 

State Expenditure Decrease

 

Minimum $1.1 million

Minimum $870,000

 

Potential Local Expenditure Increase

 

Indeterminate

Indeterminate

 

Local Expenditure Decrease

 

Minimum $700,000

Minimum $550,000

 

 

·         The Office of Legislative Services (OLS) finds that requiring the State Health Benefits Commission to establish an interactive, Internet-based price transparency dashboard that allows the commission, participating employers, and members to view the health care prices paid by the third-party administrator for health care services will result in one-time and recurring indeterminate State and local government expenditure increases stemming from third-party administrator fees and maintenance costs.

·         The State and local governments will also experience one-time and recurring annual expenditure decreases due to the inclusion of out-of-State claims in the third-party medical claims review contract.  The current vendor, Health Management Systems, Inc., has suggested that the State will realize a minimum of $1.1 million in one-time savings and $870,000 in recurring savings and local governments will realize a minimum of $700,000 in one-time savings and $550,000 in recurring savings from the inclusion of out-of-State claims in third-party medical claims review.

 

 

 

BILL DESCRIPTION

 

      This bill makes various changes to the governance of the State Health Benefits program. The changes include:

·         expanding the membership of the State Health Benefits Commission from five to 13 members;

·         abolishing the State Health Benefits Plan Design Committee and transferring the powers and responsibilities of the committee to the State Health Benefits Commission;

·         removing the super-conciliator process and replacing it with a binding arbitration process;

·         requiring the commission to include claims reimbursed to providers located in another state as part of third-party medical claims review; and

·         requiring the commission to establish an interactive, Internet-based price transparency dashboard that allows the commission, participating employers, and members to view the health care prices paid by the third-party administrator for health care services.

 

 

FISCAL ANALYSIS

 

EXECUTIVE BRANCH

 

      None received.

 

OFFICE OF LEGISLATIVE SERVICES

 

      The OLS finds that requiring the State Health Benefits Commission to establish an interactive, Internet-based price transparency dashboard that allows the commission, participating employers, and members to view the health care prices paid by the third-party administrator for health care services will result in one-time and recurring indeterminate State and local government expenditure increases stemming from third-party administrator fees and maintenance costs.

      The State and local governments will also experience one-time and recurring annual expenditure decreases due to the inclusion of out-of-State claims in the third-party medical claims review contract.  The current vendor, Health Management Systems, Inc., has suggested that the State will realize a minimum of $1.1 million in one-time savings and $870,000 in recurring savings, and local governments will realize a minimum of $700,000 in one-time savings and $550,000 in recurring savings from the inclusion of out-of-State claims in third-party medical claims review.

 

 

Section:

State Government

Analyst:

Anna Harris

Associate Fiscal Analyst

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.).