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 ensure compliance with federal and state laws regarding risk pooling and adjustment, as well as considering various factors when determining rates for qualified health plans. These factors include the purchasing power of consumers eligible for premium subsidies and the appropriateness of rates in relation to other metal-level plans.

Additionally, the bill stipulates that carriers must offer both gold and silver level plans in any geographic area where they provide an individual or small employer health plan and provider network. It also outlines specific pricing strategies for silver level plans based on enrollment distributions and actuarial values. Furthermore, the bill 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 of such transfers. The legislation is set to take effect immediately and will apply to health benefits plans issued or renewed on or after January 1, 2024.