This bill establishes a fee for certain employers who have employees or dependents receiving health benefits through the State Medicaid program. Employers with 50 or more employees who qualify for Medicaid will be required to pay an annual fee based on the number of employees and dependents covered. Specifically, the fee structure is tiered: $325 for employers with 50-249 employees, $525 for those with 250-499 employees, and $725 for employers with 500 or more employees. However, employers will not be liable for fees related to employees or dependents with developmental, intellectual, or permanent physical disabilities. Additionally, starting July 1, 2027, certain employees, such as those employed for less than 90 days, part-time, temporary, or seasonal workers, will be excluded from the fee requirements.

The bill also outlines an appeal process for employers disputing the fee assessment and imposes penalties for non-compliance. It mandates that the Departments of Human Services, Labor and Workforce Development, and the Treasury collaborate to share necessary data for implementation. The legislation aims to generate approximately $145 million annually to help offset the state's healthcare costs associated with Medicaid beneficiaries, as the Department of the Treasury estimates the average cost of coverage at $1,700 per person per year. The bill is set to take effect immediately but will remain inoperative until July 1, 2026.