Requires availability of electronic fund transfers by health insurance carriers to reimburse covered persons.

A1824

ASSEMBLY, No. 1824

STATE OF NEW JERSEY

222nd LEGISLATURE

�

PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION

Sponsored by:

Assemblyman ANTHONY S. VERRELLI

District 15 (Hunterdon and Mercer)

SYNOPSIS

���� Requires availability of electronic fund transfers by
health insurance carriers to reimburse covered persons.

CURRENT VERSION OF TEXT

���� Introduced Pending Technical Review by Legislative
Counsel.

��

An Act
concerning reimbursements
for certain health
insurance costs and supplementing Title 17B of the New Jersey Statutes.

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

���� 1.��� a. A carrier, or the
carrier's contracted vendor, shall allow payment to a covered person for
reimbursement to include reimbursement through an electronic funds transfer.

���� b.��� A carrier shall include,
as part of its health benefits plan, notification to a covered person:

���� (1)�� if a reimbursement
payment through an electronic funds transfer has a fee associated with it; and

���� (2)�� of the instructions on
the carrier's, or the carrier's contracted vendor's, website to select an
electronic funds transfer as the means to receive a reimbursement payment.

���� c.���� Any violation of this
act may be subject to enforcement by the Department of Banking and Insurance.�
The department shall provide the carrier notice and an opportunity to be heard,
and upon a finding of a violation of the act, shall impose a civil penalty
pursuant to the "Penalty Enforcement Law of 1999," P.L.1999, c.274
(C.2A:58-10 et seq.), and shall order the carrier to reimburse a covered person
for any documented fees or charges reasonably incurred as a result of
violation.

���� d.��� As used in this section:

���� �Carrier� means an insurance
company; health service corporation; hospital service corporation; medical
service corporation or health maintenance organization authorized to issue
health benefit plans in this State, and a dental service corporation or dental
plan organization authorized to issue dental plans in this State.

���� �Covered person� means
a person on whose behalf a carrier offering the plan is
obligated to pay benefits or provide services pursuant to the health benefits
plan

���� �Health benefits plan�
means a benefits plan which pays or
provides hospital and medical expense benefits for covered services and is
delivered or issued for delivery in this State by or through a carrier.
For the purposes of this act,

�health benefits plan� shall not include the following plans, policies, or
contracts: accident only; credit; disability; long-term care; Medicare
Supplement; Medicare Advantage; Medicaid; Civilian Health and Medical Program
for the Uniformed Services; CHAMPUS supplement coverage; coverage arising out
of a workers' compensation or similar law; automobile medical payment
insurance; personal injury protection insurance issued pursuant to P.L.1972,
c.70 (C.39:6A-1 et seq.); or hospital confinement indemnity coverage.

���� 2.��� This act shall take
effect on the 90th day next following the date of enactment and shall apply to
claims for reimbursement submitted under a health benefits plan initiated or
renewed on or after the effective date.

STATEMENT

���� This bill requires a carrier,
or the carrier's contracted vendor, to allow payment to a covered person for
reimbursement to include reimbursement through an electronic funds transfer. A
carrier is to include, as part of its health benefits plan, notification to a
covered person: (1) if a reimbursement payment through an electronic funds
transfer has a fee associated with it; and (2) of the instructions on the
carrier's, or the carrier's contracted vendor's, website to select an
electronic funds transfer as the means to receive a reimbursement payment.� Any
violation of the bill�s provisions may be subject to enforcement by the
Department of Banking and Insurance.�