New Jersey Statutes 52:14-17.37b. Department of the Treasury, standard report, use of benefits, State Health Benefits Program, School Employees Health Benefits Program
Terms Used In New Jersey Statutes 52:14-17.37b
- month: means a calendar month, and the word "year" means a calendar year. 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
The report shall also provide for a listing of de-identified claims within each plan of both the State Health Benefits Program and the School Employees Health Benefits Program, without reference to a specific employer participating in the programs, in excess of $50,000 that were paid in any of the months covered by the report. The report shall cover both health and prescription benefits.
(2) The Department of the Treasury shall provide the reports to a requesting participating employer within 60 days of receipt of such request.
b. As soon as practicable, the Department of the Treasury shall collect and analyze claims data within the State Health Benefits Program and the School Employees Health Benefits Program to develop, and make publicly available, a claims trend report for each program in the following categories: (1) inpatient hospital; (2) outpatient hospital; (3) in network medical; (4) out of network medical; (5) prescription drugs; (6) medical drugs; (7) emergency room services; and (8) behavioral health. The claims trend report shall provide the information in segments including active, early retiree, and Medicare retiree for each plan in the State Health Benefits Program, and in the School Employees Health Benefits Program, and in the aggregate for each plan in both programs. The report shall be made publicly available on the Department of the Treasury’s website in a prominent and accessible location.
The claims trend report shall be submitted to the Legislature pursuant to section 2 of P.L.1991, c.164 (C. 52:14-19.1), each member of the State Health Benefits Plan Design Committee and of the School Employees’ Health Benefits Plan Design Committee, each member of the State Health Benefits Commission and of the School Employees’ Health Benefits Commission, and the Governor’s Office of Employee Relations.
c. No later than 12 months from the effective date of P.L.2023, c.195 (C. 52:14-17.28f et al.), the Department of the Treasury shall provide the State Health Benefits Plan Design Committee and the School Employees Health Benefits Plan Design Committee with a feasibility study of strategies to lower the cost of health care service for the participants of the programs. There shall be a review of short-term savings achievable within three to 12 months, medium-term savings achievable within 12 to 24 months, and long-term savings achievable after 24 months.
L.2023, c.195, s.6.
