N.J. Stat. § 17B:27A-57

Current through L. 2024, c. 80.
Section 17B:27A-57 - "Health Insurance Exchange Trust Fund."
a. There is established in the Department of the Treasury a nonlapsing revolving fund to be known as the "Health Insurance Exchange Trust Fund." This fund shall be the repository for monies collected pursuant to subsection c. of this section, any federal financial participation available, and other monies received as grants or otherwise appropriated for the purposes of supporting health insurance outreach and enrollment efforts through an exchange. The monies in the fund shall be used only for the purpose of supporting the exchange through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, and other means of supporting the exchange, including any efforts that can increase market stabilization and that may result in a net benefit to policyholders.
b. The State Treasurer shall be the custodian of the fund and all disbursements from the fund shall be made by the State Treasurer upon vouchers signed by the Commissioner of Banking and Insurance. The monies in the fund shall be invested and reinvested by the Director of the Division of Investment in the Department of the Treasury to the same extent that other trust funds that are in the custody of the State Treasurer are invested and reinvested, in the manner provided by law. Interest received on the monies in the fund shall be credited to the fund.
c. The commissioner may apply a monthly assessment to each individual health benefits plan sold in the individual market. The assessment shall be paid by the carrier and deposited into the fund and shall be used only for the purpose of supporting the exchange through initial start-up costs associated with establishment of the exchange, exchange operations, outreach, enrollment, and other means of supporting the exchange, including any efforts that can increase market stabilization and that may result in a net benefit to policyholders. The assessment may be applied at a rate of:
(1) .5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a federally-facilitated exchange;
(2) 1 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange using the federal platform; or
(3) 3.5 percent of the total monthly premium charged by a carrier for each health benefits plan during any period that the State is on a State-based exchange. The commissioner shall have the discretion to adjust this rate to ensure that the State-based exchange is fully funded, but in no case shall the assessment be applied at a rate that exceeds 4 percent of the total monthly premium charged by a carrier. If the commissioner determines it is necessary to adjust the rate above 3.5 percent pursuant to this paragraph, the commissioner shall, in advance of the adjustment, post on the department's website a report describing the reasons and justifications for the adjustment, which shall be consistent with the purposes of supporting the exchange as provided in this section.

After the 2020 plan year, the commissioner shall notify a carrier of its assessment rate for the subsequent year at least 20 days prior to the date the carrier is required to file its rate filing with the department. In the case of an assessment for the 2020 plan year, the commissioner shall notify carriers as soon as is practicable of the assessment amount.

d. Any unexpended balance in the fund at the end of a year shall be available for expenditure by the commissioner in the subsequent year. The commissioner shall consider any unexpended balance from a previous year when calculating the assessment pursuant to subsection c. of this section.

N.J.S. § 17B:27A-57

Added by L. 2019, c. 141,s. 1, eff. 1/1/2020.