Vote Smart's Synopsis:

Vote to require health insurance carriers to offer clear cost share plans for individual health plans.

Highlights:

• Requires the advisory committee to develop a cost-share plan for individual health benefits plans that provide for standardized benefits and cost-sharing for covered health services (Sec. 1).

• Requires the clear-cost share plan to consider the following (Sec. 1):

• The ability of a health plan to conform to actuarial value ranges;

• Focusing consumer choice to make the process of selecting a health plan more transparent and quality-based;

• Limiting out-of-pocket costs that serve as a financial barrier to accessing high-value care; and

• Fostering quality improvement through the promotion of benefits with a high value and a focus on the consumer.

• Requires the commissioner to submit an annual report to the Governor concerning the number of consumers enrolling in a clear-cost share plan compared to other health plans (Sec. 1).

• Authorizes the Department of Banking and Insurance to have the authority to operate a State-based exchange and coordinate the operation of the exchange with the operations of the New Jersey Small Employer Health Benefits Program (Sec. 2A).

• Requires the Commissioner of Human Services to submit a proposal for available federal financial participation funds to the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services (Sec. 2B).

• Authorizes the Commissioner of Banking and Insurance to require that plans offered on the exchange conform with standardized plan designs that provide for standardized cost-sharing for covered health services (Sec. 2C).

Full Bill Text