Rutgers Law

New Jersey Statutes, Title: 52, STATE GOVERNMENT, DEPARTMENTS AND OFFICERS

    Chapter 14: "Department" and "head of department" defined

      Section: 52:14-17.37b: Department of the Treasury, standard report, use of benefits, State Health Benefits Program, School Employees Health Benefits Program.

          6. a. (1) As soon as is practicable, but not later than 180 days from the effective date of P.L.2023, c.195 (C.52:14-17.28f et al.), the Department of the Treasury shall provide, upon request, but not more frequently than once in a 24-month period, to a participating employer in the State Health Benefits Program or the School Employees Health Benefits Program, a standard report which contains the requesting employer's de-identified aggregate data relating to the use of benefits by their employees and early retirees, and their dependents, covered under each plan in the program. The report shall include premiums paid by month for each month covered in the report. If the participating employer has more than 300 employees in the plan, then the report shall include paid claims by month for the following categories of services: (a) inpatient hospital; (b) outpatient hospital; (c) in network medical; (d) out of network medical; (e) prescription drugs; (f) emergency room services; and (g) behavioral health, each reported separately. The report shall cover both health and prescription benefits.

The report shall also provide for a listing of de-identified claims within each plan of both the State Health Benefits Program and the School Employees Health Benefits Program, without reference to a specific employer participating in the programs, in excess of $50,000 that were paid in any of the months covered by the report. The report shall cover both health and prescription benefits.

(2) The Department of the Treasury shall provide the reports to a requesting participating employer within 60 days of receipt of such request.

b. As soon as practicable, the Department of the Treasury shall collect and analyze claims data within the State Health Benefits Program and the School Employees Health Benefits Program to develop, and make publicly available, a claims trend report for each program in the following categories: (1) inpatient hospital; (2) outpatient hospital; (3) in network medical; (4) out of network medical; (5) prescription drugs; (6) medical drugs; (7) emergency room services; and (8) behavioral health. The claims trend report shall provide the information in segments including active, early retiree, and Medicare retiree for each plan in the State Health Benefits Program, and in the School Employees Health Benefits Program, and in the aggregate for each plan in both programs. The report shall be made publicly available on the Department of the Treasury's website in a prominent and accessible location.

The claims trend report shall be submitted to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), each member of the State Health Benefits Plan Design Committee and of the School Employees' Health Benefits Plan Design Committee, each member of the State Health Benefits Commission and of the School Employees' Health Benefits Commission, and the Governor's Office of Employee Relations.

c. No later than 12 months from the effective date of P.L.2023, c.195 (C.52:14-17.28f et al.), the Department of the Treasury shall provide the State Health Benefits Plan Design Committee and the School Employees Health Benefits Plan Design Committee with a feasibility study of strategies to lower the cost of health care service for the participants of the programs. There shall be a review of short-term savings achievable within three to 12 months, medium-term savings achievable within 12 to 24 months, and long-term savings achievable after 24 months.

L.2023, c.195, s.6.

This section added to the Rutgers Database: 2024-03-21 17:46:56.

Older versions of 52:14-17.37b (if available):

Court decisions that cite this statute: CLICK HERE.