New Jersey S2875 amends minimum loss ratio requirements for health benefits plans in individual and small employer markets.
New Jersey S2875 modifies the calculation of minimum loss ratios for health benefits plans in the individual and small employer markets. The bill requires health insurers to spend at least 80% of each premium dollar on claims and quality improvement activities, with the remaining portion allowed for administrative expenses. It mandates that the loss ratio for the previous year be calculated based on a three-year rolling average. If the loss ratio falls short of the 80% requirement, insurers must issue dividends or credits to policyholders.
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