This bill amends existing legislation regarding the determination of health insurance rates in New Jersey, specifically focusing on individual health benefits plans and small employer health benefits plans. Key provisions include the requirement for carriers to submit an informational filing of their full schedule of rates to the commissioner before issuing new contracts or policy forms. Additionally, carriers are mandated to maintain a minimum loss ratio of 80% based on a three-year rolling average of premiums collected, with stipulations for issuing dividends or credits to policyholders if this requirement is not met. The bill also outlines the process for carriers to adjust premiums, ensuring that any increases or decreases are accompanied by actuarial assumptions and methods.

Several sections of the current law have been deleted, including provisions that previously governed certain aspects of premium rate determination and requirements for small employer health benefits plans. The bill emphasizes that premium rates for small employers must not exceed 200% of the lowest rate charged for the same health benefits plan, with allowable factors for rate differentials being age, gender, and geography. The act is set to take effect immediately and will apply to all relevant health plans delivered, issued, or renewed in the state after its enactment.

Statutes affected:
Introduced: 17B:27A-9, 17B:27A-25
Advance Law: 17B:27A-9, 17B:27A-25
Pamphlet Law: 17B:27A-9, 17B:27A-25