STATE OF NEW JERSEY
216th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2014 SESSION
Sponsored by:
Assemblyman CRAIG J. COUGHLIN
District 19 (Middlesex)
Assemblyman JASON O'DONNELL
District 31 (Hudson)
SYNOPSIS
Requires SHBP and joint insurance funds to provide certain information to participating public employers.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning the State Health Benefits Program and joint insurance funds and supplementing P.L.1961, c.49 (C.52:14-17.25 et seq.) and P.L.1983, c.337 (C.40A:10-36 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. The State Health Benefits Program shall provide at no cost to the requestor, and not more than once in a 24-month period, complete claims experience data to a public employer other than the State that participates in the State Health Benefits Program and makes a written request for its claims experience information, including loss reports and large claims data. The State Health Benefits Program shall provide the information in an electronic and manual format to the participating public employer who has made a written request for its information, within 60 days of the receipt of the written request made by the public employer. Notwithstanding the above, the State Health Benefits Program shall issue claims experience data only in a manner that complies with the privacy requirements of the federal Health Insurance Portability and Accountability Act of 1996, Pub. L.104-191, and related regulations.
2. A joint insurance fund established pursuant to P.L.1983, c.372 (C.40A:10-36 et seq.) and subsection e. of section 1 of P.L.1979, c.230 (C.40A:10-6) for the purposes of providing health benefits or health insurance coverage shall provide at no cost to the requestor, and not more than once in a 24-month period, complete claims experience data to a public employer that participates in the joint insurance fund and makes a written request for its claims experience information, including loss reports and large claims data. The joint insurance fund shall provide the information in an electronic and manual format to the participating public employer who has made a written request for its information, within 60 days of the receipt of the written request made by the public employer. Notwithstanding the above, the joint insurance fund shall issue claims experience data only in a manner that complies with the privacy requirements of the federal Health Insurance Portability and Accountability Act of 1996, Pub. L.104-191, and related regulations.
3. This act shall take effect immediately.
STATEMENT
This bill requires the State Health Benefits Program (SHBP) and certain joint insurance funds to provide at no cost, and not more than once in a 24-month period, complete claims experience data to a public employer other than the State that participates in the SHBP or joint insurance fund and makes a written request for its claims experience information including loss reports and large claims data. The bill requires the SHBP or joint insurance fund to provide the complete claims information in an electronic and manual format to the participating public employer within 60 days of receipt of a written request. The SHBP or joint insurance fund would be required to issue claims experience data in a manner that complies with the privacy requirements of the federal Health Insurance Portability and Accountability Act of 1996 and related regulations.
Under current law, provisions concerning the SHBP apply also to the School Employees Health Benefits Program (SEHBP). Therefore, provisions of this bill will apply to requests made by school districts participating in the SEHBP.