New Jersey Assembly Bill A1762

New Jersey 2022-2023 Regular Session

• Introduced: 1/11/22
• Refer: 1/11/22

Caption

Requires health insurance carriers to offer clear cost share plans for individual health benefits plans.

Impact

By establishing a framework for clear cost share plans, A1762 is expected to impact state regulations around health insurance significantly. The Commissioner of the Department of Banking and Insurance will oversee the development of these plans, with considerations for actuarial value, consumer choice, and limitation of financial barriers to high-value care. Additionally, this bill amends existing laws to integrate strong consumer protections and facilitate a better understanding of health care costs among residents.

Summary

Assembly Bill A1762 requires health insurance carriers in New Jersey to provide clear cost share plans for individual health benefits plans. This initiative is aimed at enhancing transparency in the health insurance market, allowing consumers to better understand their costs associated with health care services. The bill mandates that standardized plans include set annual copayments, coinsurance, and deductibles, ensuring clarity in benefits across the various tiers of insurance as defined under federal guidelines.

Contention

One of the critical contentions surrounding A1762 involves concerns about the balance of providing standardized plans while allowing insurance carriers some flexibility to modify their offerings. This bill permits carriers to introduce modified plans with approved actuarial certifications, potentially leading to debates about the adequacy of consumer benefits versus the risk of adverse selection. Furthermore, stakeholder discussions may emphasize the importance of consumer input during the annual evaluation of these plans, ensuring they stay relevant to the changing healthcare landscape.