Bill

Bill > S4418


NJ S4418

Establishes 60-day special enrollment period to initiate when provider in carrier's network of providers is leaving carrier's network.


summary

Introduced
05/19/2025
In Committee
05/19/2025
Crossed Over
Passed
Dead

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill requires a special enrollment period to be initiated if a provider in a carrier's network of providers is to become out-of-network. Under the bill, the special enrollment period is to begin 60 days prior to the expiration of the contract between the carrier and the provider in the carrier's network of providers. Notice of the special enrollment period is to be issued to insured individuals of a carrier in a form and manner as determined by the Department of Banking and Insurance.

AI Summary

This bill establishes a new requirement for health insurance carriers in New Jersey to provide a special enrollment period for insured individuals when a healthcare provider in the carrier's network is leaving that network. Specifically, the bill mandates a 60-day special enrollment period that begins 60 days before the contract between the carrier and the provider expires, allowing insured individuals to change their health insurance coverage if their current provider will become out-of-network. The Department of Banking and Insurance will determine the format and method of notifying insured individuals about this special enrollment period. This provision gives patients more flexibility to switch insurance plans if their preferred healthcare provider is no longer going to be in-network, helping to minimize potential disruptions in medical care. The bill would take effect immediately upon enactment.

Committee Categories

Business and Industry

Sponsors (2)

Last Action

Introduced in the Senate, Referred to Senate Commerce Committee (on 05/19/2025)

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