This bill establishes new rate filing requirements for individual and small employer health benefits plans available on New Jersey's State-based exchange, Get Covered NJ. It mandates that health insurance carriers adhere to the Affordable Care Act's single-risk-pool rule, which requires pricing based on projected utilization by the entire market risk pool. The Commissioner of Banking and Insurance is tasked with creating regulations that impose additional requirements for health benefits plans, focusing on compliance with risk pooling, plan design, and other factors as outlined by federal regulations. The bill also specifies that carriers must offer both gold and silver level plans in any geographic area where they provide health plans.

Furthermore, the bill outlines how carriers should price silver level plans based on the distribution of silver-tier enrollment among cost-sharing reduction variants, with specific assumptions for rates charged in 2024 and beyond. It allows for the transfer of members from silver to gold plans under certain conditions, ensuring that members are informed and have the option to opt out. The legislation aims to enhance the affordability and accessibility of health insurance plans while ensuring compliance with both state and federal regulations.