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. A non-voting member with expertise in health care plan administration will also be appointed through a collaborative process. The bill emphasizes the fiduciary responsibilities of commission members to act in the best interests of plan participants and grants the commission the authority to create, modify, or terminate health plans. Additionally, it mandates the commission to conduct audits and claims reviews, and it requires the publication of an annual report detailing the fiscal transactions of the health benefits program.

The bill also introduces a new dispute resolution process, where a neutral third-party arbitrator will be engaged if the commission cannot reach a decision on a matter. The arbitrator will have the authority to conduct investigatory proceedings and issue binding decisions if the commission remains at an impasse for an extended period. Furthermore, the bill establishes a fiduciary responsibility for the commission to plan participants, eliminates the SHBP Plan Design Committee, and mandates that decisions be resolved within 30 days, with a binding decision from the arbitrator required if no resolution is reached within 60 days. The bill aims to enhance the efficiency, transparency, and accountability of the SHBC in managing health benefits for state employees and their dependents.

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