ASSEMBLY, No. 4538

STATE OF NEW JERSEY

219th LEGISLATURE

 

INTRODUCED AUGUST 13, 2020

 

 

Sponsored by:

Assemblywoman  PAMELA R. LAMPITT

District 6 (Burlington and Camden)

Assemblywoman  ANNETTE QUIJANO

District 20 (Union)

 

 

 

 

SYNOPSIS

     Requires dental insurers to provide credits for reduced usage during coronavirus disease 2019 pandemic.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act concerning certain credits and rate reductions for dental insurers related to the coronavirus disease 2019 pandemic.

 

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

 

     1.  a.  A carrier writing a dental benefits plan in this State shall issue to each subscriber with a plan that was in effect on March 21, 2020 a credit as provided in subsection b. of this section which reflects the actuarial value of the carrier’s reduced risk exposure resulting from reduced application of dental procedures to covered persons in New Jersey during the Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020.

     b.  The credit required by subsection a. of this section shall be calculated retroactively to plans in effect on March 27, 2020. The credit may be returned to the subscriber in the form of a direct refund, or credit toward future premiums, and shall apply to both fully paid and monthly billed plans. A subscriber shall not be required to take any action to receive the refund or credit. The refund or credit shall be applied for the period beginning on March 27, 2020 and ending 90 days after the stay-at-home provisions of Executive Order 109 of 2020 have been rescinded.

     c.  A carrier writing a dental benefits plan in this State shall provide to the Department of Banking and Insurance a report containing all actions taken, and contemplated future actions, to reduce premiums in compliance with P.L.    , c.    (C.        ) (pending before the Legislature as this bill). The report shall include New Jersey-specific information and an explanation and justification for the amount and duration of any premium reductions based on the carrier’s claim and premium data. The report shall also provide monthly and overall totals for the following: aggregate premium prior to, and subject to, application of refunds or adjustments; aggregate premium refunds and adjustments; the number of in-force plans, and number of subscribers receiving refunds or adjustments. These reports shall be due on August 1, September 1, October 1, and November 1; the information provided in each report shall reflect activity through the preceding month’s end.

 

     2.  This act shall take effect immediately and shall be retroactive to March 27, 2020.

 

 

STATEMENT

 

     This bill requires dental insurers to provide credits for reduced usage during the coronavirus disease 2019 pandemic. Under the bill, every carrier writing dental insurance plans in this State shall issue to each subscriber with a plan that was in effect on March 27, 2020 a credit reflecting the actuarial value of the carrier’s reduced risk exposure resulting from reduced application of dental procedures to covered persons in New Jersey during the Public Health Emergency and State of Emergency declared by the Governor in Executive Order 103 of 2020. The credit shall be applied for the period beginning on March 27, 2020 and ending 90 days after the stay-at-home provisions of Executive Order 109 of 2020 have been rescinded. Executive Order 109 was rescinded by Executive Order 145, effective on May 26th, 2020. Thus, this bill will cover the period lasting until August 24th, 2020. The credit may be returned to the subscriber in the form of a direct refund, or credit toward future premiums, and shall apply to both fully paid and monthly billed policies. Subscribers shall not be required to take any action to receive the refund or credit.

     Under the bill, every insurer shall provide to the Department of Banking and Insurance a report containing all actions taken, and contemplated future actions, to reduce premiums in compliance with the bill. These reports shall be due on August 1, September 1, October 1, and November 1; the information provided in each report shall reflect activity through the preceding month’s end.