This bill proposes significant reforms to the governance and administration of the State Health Benefits Commission (SHBC) in New Jersey, expanding its membership from five to 13 members, which will include representatives from local government, higher education, and public employee organizations. It introduces a non-voting member with expertise in health care plan administration and establishes co-chairs for different member groups. The commission will have the authority to create, modify, or terminate health plans while acting in the best interests of plan participants. Additionally, the bill outlines the qualifications for members, their terms of service, and the voting requirements for commission actions, emphasizing the fiduciary responsibilities of commission members and mandating transparency in their dealings.

The bill also revises the dispute resolution process within the commission, requiring the engagement of a neutral third-party arbitrator if the commission cannot reach a decision within a specified timeframe. The arbitrator will have the authority to conduct investigatory proceedings and issue binding decisions if the commission remains at an impasse. Furthermore, the bill mandates that third-party administrators provide detailed reports on reimbursement rates and payments for health care services, which will contribute to an interactive price transparency dashboard. It eliminates the SHBP Plan Design Committee and the use of a super conciliator for resolving deadlocked matters, ensuring that decisions are made within 30 days, with a final binding decision from the arbitrator if necessary. Overall, these changes aim to enhance the effectiveness, efficiency, and transparency of the SHBC in managing health benefits for state employees.

Statutes affected:
Introduced: 52:14-17.27, 52:14-17.29