ASSEMBLY STATE GOVERNMENT COMMITTEE

STATEMENT TO

ASSEMBLY, No. 2618

STATE OF NEW JERSEY

DATED: JANUARY 23, 1997

      The Assembly State Government Committee reports favorably Assembly, No. 2618.

      This bill requires the State Health Benefits Commission to ensure that any enrollee or member under the State Health Benefits Program (SHBP) who is enrolled in a health maintenance organization or the NJ PLUS plan (the SHBP's preferred provider plan) and whose primary care physician is to be terminated from the provider network shall be provided with 90 days' advance notice of the termination. If such notice cannot be provided because the termination will occur before the end of the 90-day period, the health maintenance organization or NJ PLUS is to notify the enrollee or member as soon as it has knowledge of the termination. Upon receiving such notification, the covered person shall be permitted to change coverage to another health benefits plan, even if the physician's termination occurs outside of the annual open enrollment period.

      The notice requirement is to be applicable to each contract that the State Health Benefits Commission purchases on or after the date on which the bill takes effect as law.