ASSEMBLY, No. 820

STATE OF NEW JERSEY

217th LEGISLATURE

 

PRE-FILED FOR INTRODUCTION IN THE 2016 SESSION

 


 

Sponsored by:

Assemblywoman  ANGELICA M. JIMENEZ

District 32 (Bergen and Hudson)

Assemblyman  BENJIE E. WIMBERLY

District 35 (Bergen and Passaic)

 

 

 

 

SYNOPSIS

     Requires employers and birthing facilities to notify insured pregnant women if their health insurance coverage is not subject to 48-hour maternity law.

 

CURRENT VERSION OF TEXT

     Introduced Pending Technical Review by Legislative Counsel.

  


An Act concerning certain maternity health insurance benefits and supplementing Titles 34 and 26 of the Revised Statutes.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    An employer in this State who provides coverage for maternity benefits to his employees or their dependents shall annually and  upon request of an employee at other times during the year, notify his employees whether the employees' coverage for maternity benefits is subject to the requirements of P.L.1995, c.138 concerning the minimum time a woman shall be permitted to remain at a health care facility following childbirth.

 

     2.    The administrator of a licensed general hospital or other birthing facility providing maternity care to a pregnant woman who has health care insurance coverage which includes maternity benefits, or a person designated by the administrator, shall, prior to the woman's delivery date, determine if the coverage is subject to the requirements of P.L.1995, c.138 concerning the minimum time a woman shall be permitted to remain at the facility following childbirth. If the administrator or other designated person determines that the woman's coverage is not subject to the requirements of P.L.1995, c.138, that person shall promptly notify the woman of that fact and, if known, the duration of inpatient care to which the woman is entitled under her insurance coverage.

 

     3.    This act shall take effect on the 30th day after enactment.

 

 

STATEMENT

 

     P.L.1995, c.138 requires that health, hospital and medical service corporation contracts, individual, small employer and group health insurance policies and health maintenance organization contracts delivered, issued, executed or renewed in this State, which include maternity benefits, provide coverage for a minimum of 48 hours of in-patient care following a vaginal delivery and a minimum of 96 hours of in-patient care following a cesarean section for a mother and her newborn child in a licensed health care facility.

     The bill provides specifically as follows:

·         An employer in this State who provides coverage for maternity benefits to his employees or their dependents is required to annually, and upon request of an employee at other times during the year, notify each employee whether that employee's coverage for maternity benefits is subject to the requirements of P.L.1995, c.138.

·         The administrator of a licensed general hospital or other birthing facility providing maternity care to a pregnant woman who has health care insurance coverage which includes maternity benefits, or a person designated by the administrator, is required, prior to the delivery date, to:

     --  determine if the coverage is subject to the requirements of      P.L.1995, c.138; and

      -- if the person determines that the woman's coverage is not subject to the requirements of that law, promptly notify the woman of that fact and, if known, the duration of the inpatient care to which the woman is entitled under her insurance coverage.