The bill proposes extensive reforms to the governance and structure of the State Health Benefits Commission (SHBC) in New Jersey, expanding its membership from five to eleven, which includes key state officials and appointees from public employee organizations. It establishes specific qualifications and terms for members, emphasizing experience in health insurance administration. The bill also allows the commission to hire independent legal counsel in conflict situations and mandates the publication of an annual report on the health benefits program's fiscal transactions. Additionally, it eliminates the State Health Benefits Plan Design Committee, transferring its responsibilities to the SHBC, which will now oversee health plans, conduct audits, and resolve disputes through a neutral arbitrator if necessary.

Moreover, the bill introduces new requirements for the State Health Benefits Program (SHBP), including a mandate for annual reviews of claims and the selection of only five specific health plans for employees and retirees, while terminating other options for non-Medicare-eligible individuals. It outlines a structured contribution rate system based on salary, ensuring that long-serving employees and certain retirees are not subject to increased rates. The bill also establishes a framework for managing health plan premiums, requiring the commission to assess premium costs against a defined baseline and implement escalators or de-escalators for employee contributions based on these assessments. Public employers not participating in the SHBP are encouraged to negotiate comparable health plans and must decide on SHBP participation within a year of the bill's enactment.

Statutes affected:
Introduced: 52:14-17.27