NJ A5903

Restructures the State Health Benefits Commission from 5 to 11 members, including gubernatorial appointees, public employee union representatives from AFL-CIO and non-AFL-CIO organizations, and an independent chairperson with health insurance expertise; eliminates the separate State Health Benefits Plan Design Committee

Limits the State Health Benefits Program to five health plans for non-State employers: SHBP Unity 2019 PPO, SHBP Tiered Network, SHBP PPO 2030, SHBP PPO 2035, and a new "NJ Gold" plan designed to require no employee salary contributions while providing 80% actuarial value benefits

Establishes detailed employee contribution rates based on salary brackets for the SHBP Unity 2019 PPO plan, ranging from 2.584% for employees earning $20,000-$30,000 up to fixed dollar amounts of $6,750-$17,500 annually for higher earners depending on coverage type (single, family, spouse/partner, parent/child)

Creates binding arbitration process for resolving commission impasses, requiring a neutral third-party arbitrator to issue a final decision if the commission fails to reach resolution within 30 days; also mandates annual claims reviews using data analytics for in-network, out-of-network, and New York/Pennsylvania provider claims

Implements annual premium escalator/de-escalator mechanism: if renewal premiums exceed baseline by 6% or more, employee contribution rates increase by Consumer Price Index rate; if premiums fall 6% or more below baseline, contribution rates decrease accordingly