Bill Text: NJ A1255 | 2010-2011 | Regular Session | Introduced
Bill Title: Requires SHBP and School Employees' Health Benefits Program audit programs to review employee, retiree and dependent eligibility at least every five years.
Spectrum: Partisan Bill (Democrat 2-0)
Status: (Introduced - Dead) 2010-01-12 - Introduced, Referred to Assembly State Government Committee [A1255 Detail]
Download: New_Jersey-2010-A1255-Introduced.html
STATE OF NEW JERSEY
214th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2010 SESSION
Sponsored by:
Assemblywoman LINDA STENDER
District 22 (Middlesex, Somerset and Union)
Assemblywoman VALERIE VAINIERI HUTTLE
District 37 (Bergen)
SYNOPSIS
Requires SHBP and School Employees' Health Benefits Program audit programs to review employee, retiree and dependent eligibility at least every five years.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning the audit programs of the State Health Benefits Commission and the School Employees' Health Benefits Commission, amending P.L.2008, c.89, and supplementing P.L.1961, c.49 (C.52:14-17.25 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 17 of P.L.2008, c.89 (C.52:14-17.27a) is amended to read as follows:
17. The State Health Benefits Commission shall establish an audit program through which it shall conduct a continuous review of the various public employers participating in the State Health Benefits Program for the purpose of ensuring that only eligible employees and retirees, and their dependents, are receiving health care coverage under the program. The audit program shall review and confirm the eligibility of each employee or retiree, and their dependents, on a periodic basis, the length of which period shall not exceed five years. The commission shall retain records of the supporting documentation of eligibility submitted by an employee or retiree at the time of an enrollment or a prior audit.
Every public entity whose employees are covered by the program, as well as employees and retirees thereof, and their dependents, and any other public entity having relevant information, shall cooperate fully with the commission and shall provide all information, records and documents requested by the commission in connection with an audit.
(cf: P.L.2008, c.89, s.17)
2. (New section) The School Employees' Health Benefits Commission shall establish an audit program through which it shall conduct a continuous review of the various public employers participating in the School Employees' Health Benefits Program for the purpose of ensuring that only eligible employees and retirees, and their dependents, are receiving health care coverage under the program. The audit program shall review and confirm the eligibility of each employee or retiree, and their dependents, on a periodic basis, the length of which period shall not exceed five years. The commission shall retain records of the supporting documentation of eligibility submitted by an employee or retiree at the time of an enrollment or a prior audit.
Every public entity whose employees are covered by the program, as well as employees and retirees thereof, and their dependents, and any other public entity having relevant information, shall cooperate fully with the commission and shall provide all information, records and documents requested by the commission in connection with an audit.
3. This act shall take effect immediately.
STATEMENT
Current law requires that the State Health Benefits Commission establish an audit program to conduct a continuous review of the various public employers participating in the State Health Benefits Program for the purpose of ensuring that only eligible employees and retirees, and their dependents, are receiving health care coverage under the program. This bill requires the audit program to review and confirm the eligibility of each employee or retiree, and their dependents, on a periodic basis, the length of which will not exceed five years. In addition, the bill establishes an identical audit program for the School Employees' Health Benefits Commission, which administers the School Employees' Health Benefits Program. The bill requires that both commissions retain records of the supporting documentation of eligibility submitted by an employee or retiree at the time of an enrollment or a prior audit, in order to minimize the compliance burden for employees and retirees.
