S 4251 New Jersey Senate · 2024-2025 Regular Session

Establishes procedure for removal of health care facility from provider network and certain circumstances to allow for special enrollment period.

New Jersey's S 4251 establishes procedures for when health insurance carriers remove healthcare facilities from their provider networks or facilities leave a carrier's network. It requires 15 days of continued coverage for claims after notice is given to both parties and the Department of Banking and Insurance, along with public notices to patients about potential disruptions. If negotiations fail, the bill creates a 30-day special enrollment period for affected patients in small employer or individual health plans to switch coverage. During this period, carriers must cover claims from the former network as if in-network, and continue covering out-of-network claims until the next open enrollment or a new agreement is reached. The law directly affects patients in impacted counties, healthcare facilities, and insurers operating under New Jersey's health insurance regulations.
Bill status in committee 1 of 4 stages cleared
Introduction
Mar 2025
Committee Review
Floor Vote
Governor
Introduced Mar 3, 2025 Last action Mar 3, 2025
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Mar 3, 2025
Introduced
Introduced in the Senate, Referred to Senate Commerce Committee
upper
1 primary · 1 co-sponsor

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