Bill Text: NJ A147 | 2010-2011 | Regular Session | Introduced
Bill Title: Revises definition of religious employer in statute concerning insurance coverage of prescription female contraceptives.
Spectrum: Partisan Bill (Republican 2-0)
Status: (Introduced - Dead) 2010-01-12 - Introduced, Referred to Assembly Financial Institutions and Insurance Committee [A147 Detail]
Download: New_Jersey-2010-A147-Introduced.html
STATE OF NEW JERSEY
214th LEGISLATURE
PRE-FILED FOR INTRODUCTION IN THE 2010 SESSION
Sponsored by:
Assemblywoman ALISON LITTELL MCHOSE
District 24 (Sussex, Hunterdon and Morris)
Co-Sponsored by:
Assemblyman Chiusano
SYNOPSIS
Revises definition of religious employer in statute concerning insurance coverage of prescription female contraceptives.
CURRENT VERSION OF TEXT
Introduced Pending Technical Review by Legislative Counsel
An Act concerning insurance coverage for prescribed contraceptives and amending P.L.2005, c.251.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2005, c.251 (C.17:48-6ee) is amended to read as follows:
1. A hospital service corporation that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a contract shall provide coverage under every such contract delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a hospital service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective subscribers and subscribers. The provisions of this section shall not be construed as authorizing a hospital service corporation to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of a subscriber. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the contract.
This section shall apply to those contracts in which the hospital service corporation has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.1)
2. Section 2 of P.L.2005, c.251 (C.17:48A-7bb) is amended to read as follows:
2. A medical service corporation that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a contract shall provide coverage under every such contract delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a medical service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective subscribers and subscribers. The provisions of this section shall not be construed as authorizing a medical service corporation to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of a subscriber. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the contract.
This section shall apply to
those contracts in which the medical
service corporation has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.2)
3. Section 3 of P.L.2005, c.251 (C.17:48E-35.29) is amended to read as follows:
3. A health service corporation that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a contract shall provide coverage under every such contract delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a health service corporation shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective subscribers and subscribers. The provisions of this section shall not be construed as authorizing a health service corporation to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of a subscriber. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the contract.
This section shall apply to those contracts in which the health service corporation has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.3)
4. Section 4 of P.L.2005, c.251 (C.17B:27-46.1ee) is amended to read as follows:
4. A group health insurer that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a policy shall provide coverage under every such policy delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and an insurer shall grant, an exclusion under the policy for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective insureds and insureds. The provisions of this section shall not be construed as authorizing an insurer to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of an insured. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.4)
5. Section 5 of P.L.2005, c.251 (C.17B:26-2.1y) is amended to read as follows:
5. An individual health insurer that provides hospital or medical expense benefits for expenses incurred in the purchase of outpatient prescription drugs under a policy shall provide coverage under every such policy delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and an insurer shall grant, an exclusion under the policy for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective insureds and insureds. The provisions of this section shall not be construed as authorizing an insurer to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of an insured. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the policy.
This section shall apply to those policies in which the insurer has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.5)
6. Section 6 of P.L.2005, c.251 (C.26:2J-4.30) is amended to read as follows:
6. A certificate of authority to establish and operate a health maintenance organization in this State shall not be issued or continued on or after the effective date of this act for a health maintenance organization that provides health care services for outpatient prescription drugs under a contract, unless the health maintenance organization also provides health care services for prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a health maintenance organization shall grant, an exclusion under the contract for the health care services required by this section if the required health care services conflict with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective enrollees and enrollees. The provisions of this section shall not be construed as authorizing a health maintenance organization to exclude health care services for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of an enrollee. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The health care services shall be provided to the same extent as for any other outpatient prescription drug under the contract.
The provisions of this section shall apply to those contracts for health care services by health maintenance organizations under which the right to change the schedule of charges for enrollee coverage is reserved.
(cf: P.L.2005, c.251, s.6)
7. Section 7 of P.L.2005, c.251 (C.17B:27A-7.12) is amended to read as follows:
7. An individual health benefits plan required pursuant to section 3 of P.L.1992, c.161 (C.17B:27A-4) that provides benefits for expenses incurred in the purchase of outpatient prescription drugs shall provide coverage for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a carrier shall grant, an exclusion under the health benefits plan for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective covered persons and covered persons. The provisions of this section shall not be construed as authorizing a carrier to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of a covered person. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the health benefits plan.
This section shall apply to all individual health benefits plans in which the carrier has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.7)
8. Section 8 of P.L.2005, c.251 (C.17B:27A-19.15) is amended to read as follows:
8. A small employer health benefits plan required pursuant to section 3 of P.L.1992, c.162 (C.17B:27A-19) that provides benefits for expenses incurred in the purchase of outpatient prescription drugs shall provide coverage for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a carrier shall grant, an exclusion under the health benefits plan for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective covered persons and covered persons. The provisions of this section shall not be construed as authorizing a carrier to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of a covered person. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the health benefits plan.
This section shall apply to all small employer health benefits plans in which the carrier has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.8)
9. Section 9 of P.L.2005, c.251 (C.17:48F-13.2) is amended to read as follows:
9. A prepaid prescription service organization that provides benefits for expenses incurred in the purchase of outpatient prescription drugs under a contract shall provide coverage under every such contract delivered, issued, executed or renewed in this State or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance, on or after the effective date of this act, for expenses incurred in the purchase of prescription female contraceptives. For the purposes of this section, "prescription female contraceptives" means any drug or device used for contraception by a female, which is approved by the federal Food and Drug Administration for that purpose, that can only be purchased in this State with a prescription written by a health care professional licensed or authorized to write prescriptions, and includes, but is not limited to, birth control pills and diaphragms.
A religious employer may request, and a prepaid prescription service organization shall grant, an exclusion under the contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains such an exclusion shall provide written notice thereof to prospective enrollees and enrollees. The provisions of this section shall not be construed as authorizing a prepaid prescription service organization to exclude coverage for prescription drugs that are prescribed for reasons other than contraceptive purposes or for prescription female contraceptives that are necessary to preserve the life or health of an enrollee. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or [an elementary or secondary school that is controlled, operated or principally supported by] any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or by a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
The benefits shall be provided to the same extent as for any other outpatient prescription drug under the contract.
This section shall apply to those prepaid prescription contracts in which the prepaid prescription service organization has reserved the right to change the premium.
(cf: P.L.2005, c.251, s.9)
10. This act shall take effect on the 90th day after enactment.
STATEMENT
This bill amends P.L.2005, c.251, which is the statute requiring insurers that provide coverage for the purchase of outpatient prescription drugs to cover the purchase of prescription female contraceptives, to revise the definition of "religious employer" contained therein. Under the bill, "religious employer" is defined to mean an employer that is a church, convention or association of churches or any group or entity, including, but not limited to, an elementary or secondary school, institution of higher education, health care facility or charitable organization, which is operated, supervised, or controlled by or in connection with a church or a convention or association of churches as defined in 26 U.S.C.s.3121(w)(3)(A), and that qualifies as a tax-exempt organization under 26 U.S.C.s.501(c)(3).
