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NJ S3586
Bill
Status
2/19/2026
Primary Sponsor
James Beach
Click for details
AI Summary
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Expands claims experience data availability from the State Health Benefits Program (SHBP) and School Employees' Health Benefits Program (SEHBP) to participating public employers, changing the request period from once every 24 months to once per calendar year.
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Allows majority representatives of public employees to request and receive claims experience data within 15 days, provided the public employer has already requested the data.
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Mandates 26 specific categories of information in claims data reports, including medical loss ratios, group census reports, top 20 diagnoses by amount paid, network utilization reports, and detailed prescription claims data.
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Requires prescription-related data to include national drug codes, days' supply, ingredient costs, dispensing fees, rebate reports, and top 50 drugs by both total dispensed and total dollars paid.
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Takes effect 90 days after enactment and maintains HIPAA privacy compliance while prohibiting release of data that could identify individuals or adversely affect personal privacy rights.
Legislative Description
Requires certain information to be included in SHBP and SEHBP claims experience data provided to certain public employers.
State Government, Wagering, Tourism & Historic Preservation
Last Action
Introduced in the Senate, Referred to Senate State Government, Wagering, Tourism & Historic Preservation Committee
2/19/2026