Bill Text: NJ S3606 | 2018-2019 | Regular Session | Amended


Bill Title: Requires carriers that offer health benefits plans to provide new or existing subscribers with notification of certain hospital and health system contract expirations.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2019-06-20 - Substituted by A5363 (1R) [S3606 Detail]

Download: New_Jersey-2018-S3606-Amended.html

[First Reprint]

SENATE, No. 3606

STATE OF NEW JERSEY

218th LEGISLATURE

 

INTRODUCED MARCH 18, 2019

 


 

Sponsored by:

Senator  VIN GOPAL

District 11 (Monmouth)

 

 

 

 

SYNOPSIS

     Requires carriers that offer health benefits plans to provide new or existing subscribers with notification of certain hospital and health system contract expirations.

 

CURRENT VERSION OF TEXT

     As reported by the Senate Commerce Committee on June 17, 2019, with amendments.

 


An Act concerning health benefits plans and hospital and health system contract expirations and supplementing P.L.1997, c.192 (C.26:2S-1 et al.).

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

      1.   a.  Notwithstanding the provisions of any law to the contrary, any carrier that offers a health benefits plan shall provide 1[any new or existing subscriber with] written1 notification 1to each subscriber at least 90 business days prior to the termination, withdrawal, or severance1 of any hospital or health system 1[contract scheduled to expire within six months of the effective or renewal date of the plan. The hospital or health system contract expiration date shall be communicated to all subscribers during the open enrollment period of the plan] from the carrier's network.

      The termination date shall be the written end date of a contract between a carrier and a hospital or health system, and the notice shall be provided pursuant to this section in cases in which the parties are required to continue operating under a previous agreement pursuant to section 2 of P.L.1989, c.321 (C.26:2J-11.1) or any other law or regulation.

      The written notice shall be provided to subscribers who reside within the county or in an adjacent county of any hospital, whether that hospital is a stand-alone facility or it is part of a health system that is scheduled to be terminated, withdrawn, or severed from the carrier's network.  The Department of Banking and Insurance shall create a standardized form to be used by carriers to comply with the provisions of this section. 

      Prior to enrolling, a prospective subscriber shall be informed by the carrier of:

      (1) any hospital or health system contract in effect at the date of enrollment; and

      (2) any hospital or health system contract which shall terminate or sever 90 days or less after the subscriber's effective enrollment date in that health plan1.

      b.   A carrier shall not automatically renew a contract with a hospital or health system unless the hospital or health system agrees to an automatic renewal clause at the time the contract is entered into.

 

     2.    This act shall take effect on the 90th day next following the date of enactment, and shall apply to any health benefits plan 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 that date.

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