The Property Tax Relief Act implements substantial reforms to the State Health Benefits Program (SHBP) and the School Employees' Health Benefits Program (SEHBP). It sets new reimbursement limits for various medical procedures, including knee and hip replacements, MRIs, CT scans, and others, capping reimbursements at the lesser of the contract price, billed price, or a reference price set at 165% of Medicare rates for in-network providers and 150% for out-of-network providers. The bill also mandates that the Department of the Treasury evaluate the financial impact of these changes within two years. Additionally, it eliminates the SHBP and SEHBP Plan Design Committees, transferring their powers to the respective commissions, and repeals the statute governing the use of a super conciliator for resolving deadlocked matters.

Moreover, the bill requires that any health plan offered by the SHBP or SEHBP must have an actuarial value of at least 85%. Employers are required to decide on their participation in these programs within one year of the bill's effective date, with conditions on enrollment duration and re-enrollment restrictions. The legislation also includes provisions for automatic enrollment in the New Jersey Educators Health Plan for certain employees and retirees, and introduces the Garden State Health Plan starting January 1, 2022. These changes aim to streamline health benefits for school employees while ensuring cost-effectiveness and compliance with federal standards.

Statutes affected:
Introduced: 52:14-17.27, 52:14-17.29, 52:14-17.46.3, 52:14-17.46.4, 52:14-17.46.13