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Bill > A5525


NJ A5525

NJ A5525
Requires health benefits carriers to allow parents or guardians of dependent child to determine order of benefits under certain circumstances.


summary

Introduced
03/22/2021
In Committee
03/22/2021
Crossed Over
Passed
Dead
01/11/2022

Introduced Session

2020-2021 Regular Session

Bill Summary

This bill requires health benefits carriers to allow the parents or guardians of a dependent child to determine the order of benefits under certain circumstances. Specifically, the bill provides that a health benefits plan offered by a carrier in this State is required to allow the parents or guardians of a dependent child to determine the order of benefits for the child among the plans, if the child has coverage as a dependent under two or more health benefits plans of different subscribers. The bill provides that, if a court order provides that one of the parents or guardians is responsible for the dependent child's health care expenses or health care coverage, that plan is primary. If the parent or guardian with responsibility has no health care coverage for the dependent child's health care expenses, but the spouse of the parent or guardian has health care coverage, that spouse's plan is required to be the primary plan.

AI Summary

This bill requires health benefits carriers in New Jersey to allow the parents or guardians of a dependent child to determine the order of benefits among the child's health plans, with some exceptions. Specifically, if a court order designates one parent or guardian as responsible for the child's healthcare expenses or coverage, that plan is primary. If the responsible parent or guardian has no coverage, the spouse's plan becomes the primary plan. The bill also directs the Commissioner of Banking and Insurance to promulgate rules to implement these provisions, including rules for determining the order of benefits when a self-funded health plan is involved.

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 03/22/2021)

bill text


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