Bill
Bill > A5080
NJ A5080
NJ A5080Establishes special enrollment period for covered persons whose in-network health care provider leaves network of health benefits plan.
summary
Introduced
12/12/2024
12/12/2024
In Committee
12/12/2024
12/12/2024
Crossed Over
Passed
Dead
01/12/2026
01/12/2026
Introduced Session
2024-2025 Regular Session
Bill Summary
This bill establishes a special enrollment period for covered persons whose in-network health care provider leaves a carrier's network during the covered person's policy period. Under the bill, the Department of Banking and Insurance will establish a special enrollment period for a covered person whose health care provider, after participating in the covered person's health benefits plan network, decides to no longer participate in the health benefits plan network during the covered person's policy or contract period. The special enrollment period established will last for a certain period of time to be determined by the department, which will not be shorter than 30 days. Finally, the carrier will be required to provide information about the enrollment period to the public and affected individuals.
AI Summary
This bill establishes a special enrollment period for individuals with health insurance who unexpectedly lose access to their current in-network healthcare provider during their policy period. Specifically, if a healthcare provider decides to stop participating in a health benefits plan network, the New Jersey Department of Banking and Insurance will create a special enrollment period lasting at least 30 calendar days that allows affected individuals to change their health insurance plan. The carrier (insurance company) will be required to proactively communicate information about this enrollment period to impacted individuals. The bill mandates that the department develop specific rules and regulations to implement this process through the standard Administrative Procedure Act. The provisions will take effect 90 days after enactment and will apply to new, renewed, delivered, or executed insurance policies from that point forward, giving consumers more flexibility and protection when their healthcare provider networks change unexpectedly.
Committee Categories
Business and Industry
Sponsors (2)
Last Action
Introduced, Referred to Assembly Financial Institutions and Insurance Committee (on 12/12/2024)
Official Document
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://www.njleg.state.nj.us/bill-search/2024/A5080 |
| BillText | https://pub.njleg.gov/Bills/2024/A5500/5080_I1.HTM |
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