Sponsored by:
Assemblyman ANTHONY S. VERRELLI
District 15 (Hunterdon and Mercer)
SYNOPSIS
Establishes New Jersey Easy Enrollment Health Insurance Program.
CURRENT VERSION OF TEXT
As introduced.
An Act establishing the New Jersey Easy Enrollment Health Insurance Program and supplementing P.L.2019, c.141 (C.17B:27A-57 et seq.).
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. As used in this act:
Commissioner means the Commissioner of Banking and Insurance.
Cost-sharing reduction means a reduction described in Section 1402(c) of the Affordable Care Act.
Department means the Department of Banking and Insurance.
Insurance affordability assistance means:
(1) the State Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.);
(2) the NJ FamilyCare Program established pursuant to P.L.2005, c.156 (C.30:4J-8 et al.);
(3) premium tax credits; or
(4) cost-sharing reductions.
Modified adjusted gross income has the meaning stated in 42 U.S.C. s.1395r(i)(4)(A).
Poverty line has the meaning stated in 42 U.S.C. s.1397jj(c)(5).
Premium tax credits means the tax credits described in section 36B of the Internal Revenue Code.
Proactively contact means an attempt by the program to reach an individual by:
(1) making multiple attempts to contact the individual as requested on a State income tax return in accordance with section 8 of this act;
(2) if the attempts described in paragraph (1) of this definition do not successfully reach the individual or if no specific methods for contacting the individual were requested, making multiple attempts to contact the individual through telephonic and electronic means; and
(3) if the attempts described in paragraphs (1) and (2) of this definition do not successfully reach the individual to obtain the requested information, sending paper forms or notices to the individual by mail.
Program means the New Jersey Easy Enrollment Health Insurance Program established pursuant to this act.
Individual means an individual under the age of 65 years who is identified through a State income tax return under section 8 of this act as not having minimum essential coverage.
Workgroup means the New
Jersey Easy Enrollment Health Insurance Program Advisory Workgroup established
pursuant to section 3 of this act.
2. a. The Department of Banking and Insurance shall establish and have the authority to operate the New Jersey Easy Enrollment Health Insurance Program. The department shall integrate the program with the State-based exchange established pursuant to P.L.2019, c.141 (C.17B:27A-57 et seq.), and may enter into an agreement with a third-party for operation of the program. The purpose of the program shall be to:
(1) establish a State-based reporting system to provide information about the health insurance status of State residents through the use of State income tax returns to identify individuals without minimum essential coverage and determine whether the individual is interested in obtaining minimum essential coverage;
(2) determine whether an individual who is interested in obtaining minimum essential coverage qualifies for insurance affordability assistance;
(3) proactively contact an individual who is interested in obtaining minimum essential coverage to assist in enrolling the individual in insurance affordability assistance and minimum essential coverage; and
(4) maximize enrollment of eligible individuals in insurance affordability assistance and minimum essential coverage to improve access to care and reduce insurance costs for all residents of the State.
b. The Commissioner of Banking and Insurance, the Commissioner of Human Services, and the State Treasurer shall develop and implement systems, policies, and practices that encourage, facilitate, and streamline determination of eligibility for insurance affordability assistance and enrollment in minimum essential coverage to achieve the purposes of the program.
c. To facilitate the most efficient implementation of the program, the Commissioner of Banking and Insurance, the Commissioner of Human Services, and the State Treasurer may enter into agreements, adopt regulations and guidelines, establish accounts, conduct trainings, provide public information, educate tax preparers, and take any other steps as may be necessary to accomplish the purpose of the program.
d. Notwithstanding the provisions of subsection a. of R.S.54:50-8 to the contrary, the State Treasurer may share with the Commissioner of Banking and Insurance the taxpayer information that is necessary for the purposes of this act.
e. The Commissioner of Human Services may pursue any necessary waivers from the federal Department of Health and Human Services in order to implement the provisions of this act.
3. a. The Commissioner of Banking and Insurance shall establish a New Jersey Easy Enrollment Health Insurance Program Advisory Workgroup to provide ongoing advice regarding the implementation of the program.
b. The workgroup shall include representation from:
(1) the commissioner;
(2) consumer groups;
(3) employers;
(4) insurers;
(5) health care providers;
(6) navigators or other consumer assisters;
(7) insurance brokers or agents;
(8) labor organizations;
(9) income tax preparers;
(10) national policy experts; and
(11) any other organizations or groups selected by the commissioner.
c. The workgroup shall meet at least once every six months.
d. This section shall not be construed to prevent the commissioner from convening other formal or informal working or advisory groups to facilitate the implementation of the program.
4. a. The New Jersey Easy Enrollment Health Insurance Program shall determine eligibility for insurance affordability assistance as soon as possible after an individual files a State income tax return on which the individual indicates pursuant to paragraph (3) of subsection c. of sect