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A4238
ASSEMBLY, No. 4238
STATE OF NEW JERSEY
222nd LEGISLATURE
�
INTRODUCED FEBRUARY 19, 2026
Sponsored by:
Assemblywoman� HEATHER SIMMONS
District 3 (Cumberland, Gloucester and Salem)
SYNOPSIS
���� Requires Treasury to regularly review contract and
performance of pharmacy benefits manager for SHBP and SEHBP.
CURRENT VERSION OF TEXT
���� As introduced.
��
An Act
requiring the Department of the Treasury to regularly
review the contract and the performance of the pharmacy benefits manager for
the State Health Benefits Program and the School Employees� Health Benefits
Program.
����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:
���� 1.� a.� Beginning in the
calendar year of the effective date of P.L. , c.���
(C.������� ) (pending before the Legislature as this bill), and every five
calendar years thereafter, the Division of Pensions and Benefits in the
Department of the Treasury shall conduct a formal review of the contract and
the performance of the pharmacy benefits manager for the State Health Benefits
Program.
���� b.� The division shall
consider the following during the formal review process:
���� (1) �whether the contract for
the pharmacy benefits manager is cost-effective and beneficial to the State and
participating units of local government;
���� (2)� whether the pharmacy
benefits manager is meeting operational objectives;
���� (3)� whether the pharmacy
benefits manager is meeting financial objectives;
���� (4)� the amount of annual net
savings realized as a result of the contract and the performance of the
pharmacy benefits manager; and
���� (5) �any other factors that
may be deemed necessary by the division to implement the provisions of this
section.
���� c.� Following the formal
review process, the division shall publish a report summarizing the results of
the formal review.� The report shall include, but need not be limited to, the
parameters of the review, the factors considered during the review, the cost
impact of the contract and the performance of the pharmacy benefits manager to
the State and participating units of local government during the review period,
and any findings or conclusions realized as a result of the review.
���� The report shall be published
online on the Internet website of the Division of Pensions and Benefits and
made available to the public 30 days following the conclusion of the formal
review process.
���� 2.� a.� Beginning in the
calendar year of the effective date of P.L. , c.���
(C.������� ) (pending before the Legislature as this bill), and every five
calendar years thereafter, the Division of Pensions and Benefits in the
Department of the Treasury shall conduct a formal review of the contract and
the performance of the pharmacy benefits manager for the School Employees�
Health Benefits Program.
���� b.� The division shall
consider the following during the formal review process:
���� (1) �whether the contract for
the pharmacy benefits manager is cost-effective and beneficial to the State and
participating education units of local government;
���� (2)� whether the pharmacy
benefits manager is meeting operational objectives;
���� (3)� whether the pharmacy
benefits manager is meeting financial objectives;
���� (4)� the amount of annual net
savings realized as a result of the contract and the performance of the
pharmacy benefits manager; and
���� (5) �any other factors that
may be deemed necessary by the division to implement the provisions of this
section.
���� c.� Following the formal
review process, the division shall publish a report summarizing the results of
the formal review.� The report shall include, but need not be limited to, the
parameters of the review, the factors considered during the review, the cost
impact of the contract and the performance of the pharmacy benefits manager to
the State and participating education units of local government during the
review period, and any findings or conclusions realized as a result of the
review.
���� The report shall be published
online on the Internet website of the Division of Pensions and Benefits and
made available to the public 30 days following the conclusion of the formal
review process.
���� 3. �This act shall take effect
immediately.
STATEMENT
���� This bill requires the
Department of the Treasury to regularly review the contract and performance of
the pharmacy benefits manager for the State Health Benefits Program (SHBP) and
the School Employees� Health Benefits Program (SEHBP).
���� Under the bill, beginning in
the calendar year of the bill�s effective date and every five calendar years
thereafter, the Division of Pensions and Benefits is required to conduct a
formal review of the contract and the performance of the pharmacy benefits
manager for the SHBP and the SEHBP.�
���� During the review, the
division is required to consider: whether the contract for the pharmacy
benefits manager is cost-effective and beneficial to the State and
participating units and education units of local government; whether the
pharmacy benefits manager is meeting operational objectives; whether the
pharmacy benefits manager is meeting financial objectives; and the amount of
annual net savings realized as a result of the contract and the performance of
the pharmacy benefits manager.
���� Following the review, the
division is required to publish a report summarizing the results of the formal
review on the Internet website of the division and made available to the public
30 days following the conclusion of the formal review process.