Senator Joe Vitale (D-19) on Friday evening submitted his promised Horizon bill intended as a way to get the different players to the bargaining table for next week’s deadlocked  budget session. Vitale’s bill would single out Horizon by rearranging its governing structure and imposing new limits on the amount of money the insurer could keep in its reserve fund.

The bill is posted here.

It makes various revisions to the regulation of health service corporations.  The bill clarifies the charitable role of health service corporations, revises the membership of the board of directors of health service corporations, and establishes a process to determine an efficient level of surplus.  Specifically, the bill provides for three members of a health service corporation board of directors to be elected by its subscribers.

The bill also requires a public process, including input from experts, members of the public, and the health service corporation, to be established to determine an efficient and appropriate range of surplus for a health service corporation.  If a surplus falls above that range and the health service corporation cannot justify the excess, the health service corporation must provide a plan to reduce the surplus level in a manner that results in the surplus being within the efficient surplus range established under the bill.

The plan shall include:

(1)   proposals to benefit to policyholders; and

(2)   proposals to improve the overall health status of all New Jersey residents by: expanding access to affordable, quality health care for underserved individuals; responding to emerging health care issues in New Jersey; and promoting fundamental improvements in the health status of all New Jersey residents, including but not limited to substance use disorder treatment and prevention, behavioral healthcare, maternal, child and chronic health services, cancer screening, research and treatment, and improving veterans’ access to health care.

The bill takes effect on February 1, 2018, except effective immediately upon enactment, the bill requires the Department of Banking and Insurance to publish on its website the annual financial statement of each carrier required to file with the department within 30 days of the receipt of that statement.