New Jersey Statutes 17:48E-35.39. Health service corporation to provide coverage regardless of gender identity, expression
Terms Used In New Jersey Statutes 17:48E-35.39
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- person: includes corporations, companies, associations, societies, firms, partnerships and joint stock companies as well as individuals, unless restricted by the context to an individual as distinguished from a corporate entity or specifically restricted to one or some of the above enumerated synonyms and, when used to designate the owner of property which may be the subject of an offense, includes this State, the United States, any other State of the United States as defined infra and any foreign country or government lawfully owning or possessing property within this State. See New Jersey Statutes 1:1-2
- State: extends to and includes any State, territory or possession of the United States, the District of Columbia and the Canal Zone. See New Jersey Statutes 1:1-2
b. The discrimination prohibited by this section shall include:
(1) denying, cancelling, limiting or refusing to issue or renew a contract on the basis of a covered person’s or prospective covered person’s gender identity or expression, or for the reason that the covered person or prospective covered person is a transgender person;
(2) demanding or requiring a payment or premium that is based in whole or in part on a covered person’s or prospective covered person’s gender identity or expression, or for the reason that the covered person or prospective covered person is a transgender person;
(3) designating a covered person’s or prospective covered person’s gender identity or expression, or the fact that a covered person or prospective covered person is a transgender person, as a preexisting condition for which coverage will be denied or limited; or
(4) denying or limiting coverage, or denying a claim, for services including but not limited to the following, due to a covered person’s gender identity or expression or for the reason that the covered person is a transgender person:
(a) health care services related to gender transition if coverage is available for those services under the contract when the services are not related to gender transition, including but not limited to hormone therapy, hysterectomy, mastectomy, and vocal training; or
(b) health care services that are ordinarily or exclusively available to individuals of one sex when the denial or limitation is due only to the fact that the covered person is enrolled as belonging to the other sex or has undergone, or is in the process of undergoing, gender transition.
c. For the purposes of this section:
“Gender expression” means a person’s gender-related appearance and behavior, whether or not stereotypically associated with the person’s assigned sex at birth.
“Gender identity” means a person’s internal sense of their own gender, regardless of the sex the person was assigned at birth.
“Gender transition” means the process of changing a person’s outward appearance, including physical sex characteristics, to accord with the person’s actual gender identity.
“Transgender person” means a person who identifies as a gender different from the sex assigned to the person at birth.
d. The provisions of this section shall apply to all health service corporation contracts in which the health service corporation has reserved the right to change the premium.
e. Nothing in this section shall preclude the health service corporation from performing utilization review, including periodic review of the medical necessity of a particular service.
L.2017, c.176, s.3.