Early this month New Jersey elected to resume the operation of its own health insurance exchange by taking back this role previously handled by the federal government. The state named contractors who will handle programming and customer service for the new state exchange.
Immediately following that announcement the legislature passed a group of related bills signed into law on January 16
, 2020. The intent is to stabilize health insurance in New Jersey in the event that federal health insurance law is repealed or scaled back.This article summarizes the new laws.
No maximum benefits – prohibits insurance companies from imposing annual or lifetime spending limits on these. S562
Must include 10 essential health benefits: outpatient care (like visiting a doctor), emergency room services, hospitalization, maternity and newborn care, mental health and substance-addiction disorders, prescription drugs, rehabilitation services and devices, lab work, preventive care and chronic disease management, and pediatric services of all kinds. S562
Applicants with preexisting conditions must be offered covered at no extra charge. S626
Prohibits limited benefit or so-called mini-med insurance as “basic and essential” health benefits plans under individual health benefits plans and other statutes concerning basic health plans in all state markets.
Requires coverage for certain preventive services, like cancer screenings A5507 and expands access to birth control. A5508
The Department of Banking and Insurance may review rate increases of more than 10% for individual and small-business health-benefits plan under S3809
Requires an 85% loss-ratio requirement to large-group health insurance plans S3812 A5504
A child may remain on a parent’s health insurance until age 26. A5501
An adequate open enrollment period will be ensured under the Individual Health Coverage Program 5503