NJ
New Jersey Assembly Bill A2765

New Jersey 2024-2025 Regular Session

New Jersey Assembly Bill A2765

Introduced
1/9/24  

Caption

Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

Impact

The bill significantly impacts how insurance companies calculate premiums for small group health benefits, requiring them to remove gender as a factor in premium rates. Additionally, it mandates that rate differentials based on age must now use one-year increments instead of five-year increments, as previously allowed. By establishing clear requirements for health benefits, including the inclusion of pediatric and maternity benefits as mandated by ACA, A2765 aims to provide a more comprehensive safety net for residents, particularly focusing on vulnerable groups. This alignment with federal standards may streamline regulatory compliance for insurers operating in New Jersey.

Summary

Assembly Bill A2765 proposes revisions to the requirements governing health benefits plans for individuals and small employers in New Jersey. This bill aims to align state regulations with the federal Affordable Care Act (ACA) by modifying rate-setting practices for health insurance carriers. It specifically addresses the calculation of premiums for health benefits, ensuring they comply with the ACA’s stipulations regarding community rating and age classifications. The bill aims to tighten the permissible range of premium rates, reducing the maximum differential from 350% to 300% for the highest-rated individual compared to the lowest-rated individual within the same plan, thereby promoting fairness in pricing.

Contention

Despite the benefits this bill is expected to provide in terms of consumer protection and alignment with federal law, there are areas of contention among stakeholders. Opponents may argue that the restrictions on premium rates will impact the diversity of the insurance market and potentially drive up costs for certain groups. Moreover, the adjustments might disadvantage large employers participating in multiple employer welfare arrangements (MEWAs) by imposing new requirements on their health plans. Ensuring balance between comprehensive coverage and affordable premiums will be a crucial point of discussion as the bill advances.

Companion Bills

NJ A1304

Carry Over Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

NJ S1188

Carry Over Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

Previously Filed As

NJ A1304

Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

NJ S1188

Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

NJ A5137

"The Small Business Health Insurance Affordability Act"; revises certain requirements for individual and small employer health benefits plans.

NJ S3480

"The Small Business Health Insurance Affordability Act"; revises certain requirements for individual and small employer health benefits plans.

NJ H5418

Amends the definition of "small employer" for purposes of the small employer health insurance availability act to mean a business employing less than one hundred (100) employees rather than fifty (50) employees.

NJ H7607

Amends the definition of "small employer" for purposes of the small employer health insurance availability act to mean a business employing less than one hundred (100) employees rather than fifty (50) employees.

NJ A432

Allows certain sole proprietors to join small employer health benefits purchasing alliance.

NJ S331

Permits inclusion of volunteer firefighters and other emergency responders within municipal eligible employee group for purposes of the small employer health benefits plan statutes.

NJ S1388

Permits inclusion of volunteer firefighters and other emergency responders within municipal eligible employee group for purposes of the small employer health benefits plan statutes.

NJ A4357

Permits inclusion of volunteer firefighters and other emergency responders within municipal eligible employee group for purposes of the small employer health benefits plan statutes.

Similar Bills

NJ S1188

Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

NJ A1304

Revises certain requirements for individual and small employer health benefits plans and for small employer members of multiple employer welfare arrangements.

NJ S1840

Makes technical corrections to individual health coverage and small employer health benefits programs and to NJ FamilyCare.

NJ S2875

Makes certain changes to calculation of minimum loss ratio requirements for health benefits plans in individual and small employer markets.

NJ A3972

Makes certain changes to calculation of minimum loss ratio requirements for health benefits plans in individual and small employer markets.

NJ S3480

"The Small Business Health Insurance Affordability Act"; revises certain requirements for individual and small employer health benefits plans.

NJ A5137

"The Small Business Health Insurance Affordability Act"; revises certain requirements for individual and small employer health benefits plans.

NJ A4294

Requires DOBI to conduct study on impact of certain changes to individual and small group health insurance markets.