Bill Text: NJ S2811 | 2016-2017 | Regular Session | Introduced
Bill Title: Requires individual health benefits plans to be offered solely through the federally-facilitated Health Insurance Marketplace for New Jersey.
Spectrum: Partisan Bill (Democrat 3-0)
Status: (Introduced - Dead) 2016-12-05 - Introduced in the Senate, Referred to Senate Commerce Committee [S2811 Detail]
Download: New_Jersey-2016-S2811-Introduced.html
Sponsored by:
Senator JOSEPH F. VITALE
District 19 (Middlesex)
Senator RAYMOND J. LESNIAK
District 20 (Union)
SYNOPSIS
Requires individual health benefits plans to be offered solely through the federally-facilitated Health Insurance Marketplace for New Jersey.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning individual health benefits plans and supplementing P.L.1992, c.161 (17B:27A-2 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Pursuant to subsection a. of section 3 of P.L.1992, c.161 (C.17B:27A-4), a carrier shall, as a condition of issuing small employer health benefits plans in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), offer individual health benefits plans in the federally-facilitated Health Insurance Marketplace for New Jersey.
2. Beginning with open enrollment periods for plans effective after December 31, 2017, a carrier that offers individual health benefit plans in this State shall offer such plans solely through the federally-facilitated Health Insurance Marketplace for New Jersey operated by the Centers for Medicare and Medicaid Services, pursuant to the procedures established under section 3 of this act.
3. a. The Commissioner of Banking and Insurance shall design a plan and establish procedures to allow the transition, beginning with plans effective after December 31, 2017, from the offering of plans by carriers and the purchasing of plans by individuals through the New Jersey Individual Health Coverage Program to the offering of plans by carriers and the purchasing of plans by individuals through the federally-facilitated Health Insurance Marketplace for New Jersey. The commissioner shall establish procedures for carriers to inform individuals seeking to obtain coverage in the New Jersey Individual Health Coverage Program on how to obtain coverage in the marketplace instead.
b. The commissioner shall apply to the U.S. Department of Health and Human Services for any approvals or waivers necessary to effectuate the purposes of this act, including applications for waivers of requirements under the Affordable Care Act in order to allow persons who would otherwise be unable to obtain coverage through the marketplace by reason of their immigration status to obtain coverage through the federally-facilitated Health Insurance Marketplace for New Jersey.
c. In a manner consistent with State and federal law, the commissioner shall ensure that rate filings by a carrier for a plan offered to individuals in the federally-facilitated Health Insurance Marketplace for New Jersey, effective after December 31, 2017, shall, for the purposes of assessing and pooling risk, be based upon the combined enrollment of all individuals enrolled in that plan.
4. This act shall take effect on the 90th day next following the date of enactment, but the Commissioner of Banking and Insurance may take any anticipatory administrative action in advance as shall be necessary for the implementation of this act.
STATEMENT
This bill provides that, beginning with open enrollment periods for plans effective after December 31, 2017, a carrier that offers individual health benefit plans in this State shall offer such plans solely through the federally-facilitated Health Insurance Marketplace for New Jersey operated by the U.S. Centers for Medicare and Medicaid Services.
Current law, at section 3 of P.L.1992, c.161 (C.17B:27A-4), requires a carrier to also offer individual health benefits plans as a condition of issuing small employer health benefits plans in this State. To satisfy this requirement, the bill specifies that the carrier must offer individual plans in the federally-facilitated Marketplace.
The bill requires the Commissioner of Banking and Insurance to design a plan and establish procedures to allow the transition, beginning with plans effective after December 31, 2017, from the offering of plans by carriers and the purchasing of plans by individuals through the New Jersey Individual Health Coverage Program to the offering of plans by carriers and the purchasing of plans by individuals through the federally-facilitated Health Insurance Marketplace for New Jersey. The commissioner shall establish procedures for carriers to inform individuals seeking to obtain coverage in the New Jersey Individual Health Coverage Program on how to obtain coverage in the marketplace instead.
The bill provides that the commissioner shall seek any approvals or waivers necessary to effectuate the purposes of the bill from the U.S. Department of Health and Human Services. In addition, since undocumented immigrants can currently purchase health insurance through the New Jersey Individual Health Insurance Program, which is phased out under this bill, the bill also directs the commissioner to apply for waiver of requirements under the Affordable Care Act in order to allow persons who would otherwise be unable to obtain coverage through the Marketplace by reason of their immigration status to obtain coverage through the federally-facilitated Health Insurance Marketplace for New Jersey.
The bill also provides that, in a manner consistent with State and federal law, the commissioner shall ensure that rate filings by a carrier for a plan offered to individuals in the federally-facilitated Health Insurance Marketplace for New Jersey, effective after December 31, 2017, shall, for the purposes of assessing and pooling risk, be based upon the combined enrollment of all individuals enrolled in that plan.
Finally, the bill provides that it will take effect on the 90th day next following the date of enactment, but the Commissioner of Banking and Insurance may take any anticipatory administrative action in advance as shall be necessary for the implementation of the bill's provisions.
Currently, the individual health insurance market in New Jersey is bifurcated between the New Jersey Individual Health Coverage Program and the federally-facilitated marketplace. This bill is intended to create a single risk pool for the individual market in New Jersey by transferring all individual plans to the federally-facilitated marketplace.
