Bill Text: NJ S1239 | 2016-2017 | Regular Session | Introduced
Bill Title: Clarifies that insurance broker transparency requirement only applies to sale of health benefits plans.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2016-02-08 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S1239 Detail]
Download: New_Jersey-2016-S1239-Introduced.html
Sponsored by:
Senator JOSEPH F. VITALE
District 19 (Middlesex)
SYNOPSIS
Clarifies that insurance broker transparency requirement only applies to sale of health benefits plans.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning insurance producers and amending P.L.2008, c.38.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 25 of P.L.2008, c.38 (C.17:22A-41.1) is amended to read as follows:
25. a. An insurance producer licensed pursuant to P.L.2001, c.210 (C.17:22A-26 et al.) who sells, solicits, or negotiates health [insurance policies or contracts] benefits plans to residents of this State shall notify the purchaser of the insurance, in writing, of the amount of any commission, service fee, brokerage, or other valuable consideration that the producer will receive as a result of the sale, solicitation or negotiation of the health [insurance policy or contract] benefits plan. If the commission, fee, brokerage, or other valuable consideration is based on a percentage of premium, the insurance producer shall include that information in the notification to the purchaser.
b. The commissioner may specify, by regulation, the information that shall be provided by an insurance producer in the notification to a purchaser of health insurance and the procedure for providing the notification.
c. As used in this section, "health benefits plan" means: a hospital and medical expense insurance policy or certificate; a health, hospital, or medical service corporation contract or certificate; or a health maintenance organization subscriber contract or certificate delivered or issued for delivery in this State by any carrier. For purposes of this section, "health benefits plan" does not include one or more, or any combination of, the following: coverage only for accident or disability income insurance, or any combination thereof; coverage issued as a supplement to liability insurance; liability insurance, including general liability insurance and automobile liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; credit-only insurance; coverage for on-site medical clinics; or other similar insurance coverage, as specified in federal regulations, under which benefits for medical care are secondary or incidental to other insurance benefits. "Health benefits plan" does not include the following benefits if they are provided under a separate policy, certificate, or contract of insurance, or if they are otherwise not an integral part of the plan: limited scope dental or vision benefits; benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; or such other similar, limited benefits as are specified in federal regulations. "Health benefits plan" does not include hospital confinement indemnity coverage if the benefits are provided under a separate policy, certificate or contract of insurance, there is no coordination between the provision of the benefits and any exclusion of benefits under any group health benefits plan maintained by the same plan sponsor, and those benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor. "Health benefits plan" does not include the following if it is offered as a separate policy, certificate, or contract of insurance: Medicare supplemental health insurance as defined under section 1882(g)(1) of the federal Social Security Act (42 U.S.C.s.1395ss(g)(1)); coverage supplemental to the coverage provided under chapter 55 of Title 10, United States Code (10 U.S.C.s.1071 et seq.); or similar supplemental coverage provided to coverage under a group health plan.
(cf: P.L.2008, c.38, s.25)
2. This act shall take effect on the 60th day following enactment.
STATEMENT
This bill amends section 25 of P.L.2008, c.38 (C.17:22A-41.1) to clarify language regarding transparency in health insurance broker commissions.
The bill specifies that the provisions of that section only apply to the sale, solicitation, or negotiation of health benefits plans, rather than health insurance policies and contracts, as the section originally provided.
"Health benefits plan" includes a hospital and medical expense insurance policy or certificate; a health, hospital, or medical service corporation contract or certificate; or a health maintenance organization subscriber contract or certificate delivered or issued for delivery in this State by any carrier.
