This bill establishes a fee for employers who have 50 or more employees receiving health benefits through the State Medicaid program. The fee structure is tiered based on the number of employees: employers with 50-249 employees will pay $325 per employee and dependent, those with 250-499 employees will pay $525, and employers with 500 or more employees will pay $725. Additionally, the bill exempts employers from this fee for employees or dependents with developmental, intellectual, or permanent physical disabilities. Starting July 1, 2027, the bill will also exclude certain categories of employees from the fee, including those employed for less than 90 days, part-time, temporary, or seasonal workers.

To ensure compliance, the bill includes penalties for employers who fail to pay the fee and establishes an appeal process for disputing fee assessments. The legislation aims to generate approximately $145 million annually to help offset the state's healthcare costs associated with Medicaid coverage, which is estimated to average $1,700 per person per year. The bill also mandates collaboration among various state departments to share data necessary for implementation and allows for immediate regulatory adoption to facilitate its provisions.