New Jersey Senate Bill S1130

New Jersey 2022-2023 Regular Session

• Introduced: 1/31/22
• Refer: 1/31/22

Caption

Establishes certain standards for health benefits plans with tiered network.

Impact

The bill mandates that insurance carriers must clearly and conspicuously disclose the cost-sharing differences for individuals covered under varying tiers of their health benefits plans. They must do this on their websites and within the documentation provided to subscribers. Furthermore, the bill requires that the variations in cost sharing are reasonable relative to the premiums charged, promoting a fairer pricing structure for consumers navigating tiered networks.

Summary

Senate Bill 1130 establishes certain standards for health benefits plans with a tiered network in New Jersey. The bill sets forth requirements for insurance carriers who offer managed care plans that include multiple levels of provider benefits, which are structured based on differing levels of cost sharing by the healthcare providers. This initiative aims to improve transparency for consumers and ensure they have clear information regarding their health plans and the associated costs within various tiers of providers.

Contention

One notable point of contention surrounding SB 1130 is the potential implications it may have for the flexibility of insurance carriers in designing their health plans. While proponents argue that the law will aid consumers in understanding their options and making informed choices, critics may argue that stringent requirements could restrict the carriers' ability to innovate or provide tailored products. The balance between ensuring consumer transparency and maintaining the flexibility for insurers is a critical aspect of the ongoing discussions regarding the bill.