NJ S301

Bill

Provides that purchase of insulin is not subject to deductible and requires health insurers to limit copayments and coinsurance for insulin.

Introduced
01/11/2022

In Committee
01/11/2022

Crossed Over

Passed

Dead
01/08/2024

Introduced Session

2022-2023 Regular Session

Bill Summary

This bill makes certain findings and declarations concerning the rising cost of insulin and requires health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees' Health Benefits Program, to provide coverage for insulin for the treatment of diabetes. The bill further requires health insurers (health, hospital and medical service corporations, commercial individual and group health insurers, and health maintenance organizations) and health benefits plans issued pursuant to the New Jersey Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees' Health Benefits Program to provide coverage for the purchase of insulin that is not subject to any deductible and to limit the copayment or coinsurance that may be required for an insulin prescription to $50 per 30 day supply of insulin. The bill specifies that nothing in the bill is to prevent the State Health Benefits Commission or the School Employees' Health Benefits Commission from reducing an enrollee's cost-sharing requirement by an amount greater than the amount specified in the bill or from utilizing formulary management, including a mandatory generic policy, to promote the use of lower-cost alternative generic drugs that are the therapeutic equivalent of the brand-name drug.

AI Summary

This bill makes several key provisions: 1. It requires health insurance plans in New Jersey, including those under the Individual Health Coverage and Small Employer Health Benefits Programs, the State Health Benefits Program, and the School Employees' Health Benefits Program, to cover the purchase of insulin without requiring a deductible and to limit the copayment or coinsurance for a 30-day supply of insulin to $50 or less. 2. It mandates that these health insurance plans provide coverage for equipment and supplies related to the treatment of diabetes, such as blood glucose monitors, test strips, and insulin pumps, to the same extent as for any other sickness under the plan. 3. It requires the State Health Benefits Commission and the School Employees' Health Benefits Commission to ensure their contracted health plans provide the required insulin coverage, while allowing the commissions to further reduce enrollee cost-sharing or utilize formulary management to promote the use of lower-cost generic alternatives. 4. The bill's effective dates are staggered, with the majority of provisions taking effect 180-270 days after enactment and applying to plans issued or renewed in the following calendar year, while the provisions for the state and school employee health plans take effect 90 days after enactment.

Committee Categories

Business and Industry

Sponsors (8)

Nellie Pou (D)*, Joe Vitale (D)*, Vin Gopal (D), Joe Lagana (D), Fred Madden (D), Teresa Ruiz (D), Shirley Turner (D), Andrew Zwicker (D),

Last Action

Introduced in the Senate, Referred to Senate Commerce Committee (on 01/11/2022)

Official Document

https://www.njleg.state.nj.us/bill-search/2022/S301

(7 Companion Bills)

Version:

Document Type	Source Location
State Bill Page	https://www.njleg.state.nj.us/bill-search/2022/S301
BillText	https://pub.njleg.gov/Bills/2024/S0500/301_I1.HTM
BillText	https://www.njleg.state.nj.us/Bills/2022/S0500/301_I1.HTM
Bill	https://www.njleg.state.nj.us/Bills/2022/S0500/301_I1.PDF

Bill	Bill Name	Last Action	Type
A1669	Requires health insurers to limit copayments for insulin.	Combined with A954/653 (ACS)	Carry Over
A5268	Makes FY 2021 supplemental appropriation of $180 million to DCF and DHS for increased rates for social service providers in financial distress due to coronavirus disease 2019 public health crisis.	Introduced, Referred to Assembly Human Services Committee	Carry Over
A553	Provides that purchase of insulin is not subject to deductible; requires health insurers to limit copayments and coinsurance for insulin; requires insulin manufacturers to submit report to Commissioner of Banking and Insurance.	Introduced, Referred to Assembly Financial Institutions and Insurance Committee	Same As
A653	Places cap of $100 on amount paid by covered persons for purchase of insulin.	Combined with A954/1669 (ACS)	Carry Over
A954	Provides that purchase of insulin is not subject to deductible; requires health insurers to limit copayments and coinsurance for insulin; requires insulin manufacturers to submit report to Commissioner of Banking and Insurance.	Assembly Appropriations Hearing (19:00 6/16/2021 A4663 (1R), A5896, A5897 and A5898 have been added.)	Carry Over
S3588	Requires health benefits carriers to allow parents or guardians of dependent child to determine order of benefits under certain circumstances.	Introduced in the Senate, Referred to Senate Commerce Committee	Carry Over
S526	Provides that purchase of insulin is not subject to deductible and requires health insurers to limit copayments and coinsurance for insulin.	Recommitted to Assembly Appropriations Committee	Carry Over

Bill > S301

summary

Introduced Session

Bill Summary

AI Summary

Committee Categories

Sponsors (8)

Last Action

Official Document

bill text

bill summary

bill summary

bill summary